Comparative study between minimally invasive right anterior minithoracotomy versus mini-upper sternotomy in isolated aortic valve replacement (early outcome)

BackgroundMinimally invasive surgical methods have lately become popular in heart surgery. Ministernotomy and minithoracotomy are the most commonly used incisions in minimally invasive aortic valve replacement. It is still debated if one incision is better than the other.Patients and methodsA prospective comparative analysis was used to examine the outcomes of 30 patients who underwent isolated aortic valve replacement. A minimally invasive right anterior minithoracotomy approach was used in group A (n = 15), whereas a mini-upper sternotomy method was used in group B (n = 15).ResultsThe results in both groups reveal no statistical difference. However, the hospital stay, ventilation time, and blood loss had better results in the right minithoracotomy group, whereas in the upper-ministernotomy group, postoperative pain had better results. In group A, blood loss was 335.3174.5, while in group B, it was 433.3 ± 169.5. In group B, postoperative pain was 1.7 ± 0.7, which is better than group A 2.5 ± 0.6. Group B had a longer total hospital stay (7.2 ± 1.3 days) than group A (5.6 ± 0.6 days). In both groups, inotropes were determined to be negligible.ConclusionThe results of a right anterior minithoracotomy and an upper-ministernotomy approach in patients undergoing isolated Aortic valve replacement (AVR) are similar, with no notable differences. However, a right anterior minithoracotomy reduces the need for blood transfusions, assisted ventilation time, and hospital stay, while an upper-ministernotomy reduces postoperative pain. Furthermore, the cross-clamping and total operative time is highly significantly increased in right anterior minithoracotomy approach.