A comparison of lower ministernotomy (manubrium-sparing sternotomy) and standard median sternotomy in coronary artery bypass surgery

Abstract

A comparison of lower ministernotomy (manubrium-sparing sternotomy) and standard median sternotomy in coronary artery bypass surgery Bul gu lar: Gruplar arasında kros-klemp süresi, kardiyopulmoner baypas süresi ve toplam işlem süresi açısından istatistiksel olarak anlamlı bir fark yoktu. Göğüs tüpü drenaj miktarı, ministernotomi grubunda daha düşük olan ameliyat sonrası kan transfüzyonu ihtiyacı ve ministernotomi grubunda daha yüksek olan ameliyat sonrası hematokrit düzeyleri, ameliyat sonrası hemoglobin düzeyleri ve ameliyat sonrası SaO 2 düzeyleri arasında istatistiksel olarak anlamlı bir fark vardı. Ventilasyon süresi ve yoğun bakım ünitesinde ve hastanede kalma süresi ministernotomi grubunun lehine istatistiksel olarak anlamlı idi. Bu çalışmada mortalite oranları açısından iki grup arasında istatistiksel olarak anlamlı bir fark yoktu.So nuç: Çalışma sonuçlarımız manibrium koruyucu sternotominin özellikle obez, diyabetik ve solunum fonksiyonu kötü olan hastalarda, klasik medyan sternotomi cerrahisine iyi bir alternatif olabileceğini göstermektedir.Anah tarsöz cük ler: Koroner arter baypas greftleme; minimal invaziv cerrahi işlem; sternotomi. ABSTRACT Background:In this study, we aimed to compare early outcomes of lower ministernotomy (manubrium-sparing sternotomy) and standard median sternotomy in coronary artery bypass grafting surgery. Methods:Between January 2015 and December 2016, a total of 28 patients (15 males, 13 females; mean age 64.5±10.1 years; range 43 to 82 years) who underwent coronary artery bypass grafting surgery at the Department of Cardiovascular Disease were retrospectively analyzed. Of these patients, 14 patients were operated with lower ministernotomy (manubrium-sparing sternotomy; group 1) and 14 patients were operated using standard median sternotomy (group 2). Data including age, gender, body surface area, preoperative clinical findings, intraoperative variables, postoperative complications, the amount of transfusion products, hemoglobin and hematocrit values, drainage volumes, intubation duration, mortality, and length of intensive care unit and hospital stay of both groups were compared retrospectively.Results:There was no statistically significant difference in the crossclamp time, cardiopulmonary bypass time, and total procedure time between the groups. There was a statistically significant difference in the amount of chest tube drainage, the need for blood transfusion which was lower in the ministernotomy group, and postoperative hematocrit levels, postoperative hemoglobin levels and postoperative SaO 2 levels which were higher in the ministernotomy group. There was a statistically significant difference in the ventilation time and length of stay in the intensive care unit and hospital in favor of the ministernotomy group. The study showed no statistically significant difference in the mortality rate between the two groups. Conclusion:Our study results show that the manubrium-sparing sternotomy may be a feasible alternative to surgery through classical median sternotomy for, pa...

Coronary Artery Bypass Surgery in a Preoperative Total Laryngectomy Patient

“…The preservation of the manubrio-clavicular osteo-ligamentous arch will put the patient in a better position for early mobilisation following cardiac surgery [ 8 ]. It will permit a stronger cough through better chest wall stability and less pain [ 8 ].…”

“…The preservation of the manubrio-clavicular osteo-ligamentous arch will put the patient in a better position for early mobilisation following cardiac surgery [ 8 ]. It will permit a stronger cough through better chest wall stability and less pain [ 8 ]. For the patient awaiting urgent major head and neck cancer surgery, it leaves the root of the neck untouched by surgical scars so that all options remain open at the time of subsequent surgery including rare situations such as the need for mediastinal tracheostomy [ 9 ].…”