Key result
Right anterior thoracotomy for mitral valve replacement significantly improved skin incision length, 5th-day postoperative pain, and wound satisfaction compared to median sternotomy.
Why the study?
Minimally invasive right anterior thoracotomy is promoted to reduce surgical trauma compared to traditional complete sternotomy, prompting a direct comparison for mitral valve replacement.
Does right anterior thoracotomy improve postoperative pain and wound satisfaction compared to median sternotomy in patients requiring mitral valve replacement?
RCT (n=41)
randomized
No
Does right anterior thoracotomy improve postoperative pain and wound satisfaction compared to median sternotomy in patients requiring mitral valve replacement?
Right anterior thoracotomy for mitral valve replacement offers a faster return to normal lifestyle with better wound satisfaction and less pain compared to standard sternotomy.
Minimally invasive right anterior thoracotomy appears comparable for mitral valve replacement; leaves open need for larger trials to guide practice.
Background: With low rates of reoperation, perioperative morbidity, and short-term mortality, minimally restricted right anterior thoracotomy mitral valve surgery has proven to be a viable alternative to the traditional complete sternotomy procedure. Minimally invasive procedures are still being promoted as a way to reduce surgical trauma. Objective:Comparing between right anterior thoracotomy versus median sternotomy for mitral valve replacement. Patients and Methods: Prospective randomized clinical trial performed at Cardiothoracic Surgery Department, Zagazig University Hospitals for one year from May 2022 to May 2023. The study included 41 patients requiring mitral valve replacement divided into group (A) 20 patients underwent mitral valve replacement by right anterior thoracotomy and the other group (B) 21 patients underwent mitral valve replacement by standard sternotomy. Results: There was clinical and statistically significant difference between the two groups, regarding length of skin incision, 5th day postoperative pain and modified Likert scale for wound satisfaction from 1 to 5. Conclusion: Our study found that thoracotomy group demonstrated a quicker return to their normal lifestyle with accepted surgical scar compared to sternotomy group. The findings suggest that minimally invasive approaches like thoracotomy offer significant advantages for patients seeking a faster, more comfortable recovery process
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A 2025 study conducted an RCT in Mitral valve replacement (n=41). Right anterior thoracotomy vs. Median sternotomy was evaluated on Length of skin incision, 5th day postoperative pain and modified Likert scale for wound satisfaction. Right anterior thoracotomy for mitral valve replacement significantly improved skin incision length, 5th-day postoperative pain, and wound satisfaction compared to median sternotomy.
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