Background - Less invasive procedures for cardiac surgery are presently under evaluation. Valve repair or replacement are clearly feasible through small thoracotomies, even with video techniques. The purpose of this paper is to study results of less invasive valve surgery compared with standard techniques. Patients and Method - From November 1996 to February 1998, 2 groups of patients (8 cases in each), comparable regarding age, Sex, height, weight, functional class, valve lesion and valve procedure were assigned either to standard medium sternotomy or parasternal minithoracotomy (longitudinal or oblique, maximum 8 cm, plus femoral arteriovenous cannulation). During the immediate post-operative period, the following parameters were analyzed: duration of procedure, perfusion, myocardial ischemia, ICU, mechanical ventilation, hospitalization and period with opioid analgesia, plus volume of chest drainage. Results - There was no hospital mortality. Two major complications with good recovery were perioperative myocardial infraction with permanent heart block leading to pacemaker implant, and cerebrovascular accident. Both patients were from the medium sternotomy group and submitted to aortic decalcification. There was no significant difference in the remaining parameters between the two groups. In addition there were no related difficulties in valve approach, no differences in chest drainage, no femoral vascular complications, no wound problems, no case of conversion to sternotomy. The accompanying table summarizes the results. Conclusion _ Although feasible, heart valve surgery through less invasive thoracotomy presented no significant advantage over conventional sternotomy other than aesthetic aspect in this initial small series.
Surgical procedures; Thoracotomy; Aortic valve
