Miniesternotomía para cirugía valvular aórtica: Experiencia inicial en un centro cardiovascular en Chile

Abstract

Background: Aortic valve surgery can be performed through a reduced mid sternotomy with excellent long term results. Aim: To report the initial results obtained with this technique. Patients and methods: Descriptive study of 20 patients aged 48±11 years, subjected to valve replacement surgery for aortic valve disease between 2004 and 2007. Arterial and venous cannulation were performed with the usual method and extracorporeal circulation was performed with a mean perfusion of 4.5 L/min. Hypothermia and cardioplegia were performed infusing the hematic cardioplegic solution at 4°C in the aortic root or coronary ostia. Results: Sixteen patients were in functional class (FC) III. Fourteen patients had aortic insufficiency and six had predominant stenosis. There was no operative mortality. One patient had a left hemothora x and was reoperated. All patients were discharged between 4 and 6 days after surgery. Man follow up was 21±4 months. All patients are in FCI and free from cardiac events. Echo car dio graphic assessment was done in 16 patients, showing a good motility of valve disks. Actuarial survival probability was 100% and probability of freedom from cardiac events was 100% at 42 months of follow up. Conclusions: Mnisternotomy is an excellent approach for aortic valve surgery providing good visualization of the ascending aorta, simplifying the surgical technique.