Analysis of 85 Cases of Minimal Media Lower Hemisternotomy for Congenital Cardiac Surgery Under Cardiopulmonary Bypass in Infants

Authors

  • Yuehu Han Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Jie Su Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Zhifa Wang Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Dongming Wei Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Yanjie Guo Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Shuaishuai Zhang Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Le Duan Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Langang Peng Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Chunhu Gu Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  • Tao Chen Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China

DOI:

https://doi.org/10.1532/hsf.3577

Keywords:

congenital heart disease, cardiac surgery, minimally invasive surgery, median sternotomy

Abstract

Objective: To investigate the feasibility and effect of minimal media lower hemisternotomy for cardiac surgery under cardiopulmonary bypass (CPB) in infant congenital heart disease.

Methods: In our hospital from May 2019 to October 2019, 170 infants with congenital heart disease underwent surgical treatment (median age 6.6 months; weight 6.0 kg). They were divided into 2 groups: those with conventional chest median incision and those with minimal sternotomy. Minimal lower hemisternotomy began from the third intercostal level and ended 0.5 cm above the xiphoid, just enough to insert a small sternal distractor.

Results: There was no significant difference between the 2 groups in CPB time. The operation time of small incision group was slightly longer (P < .05). There was no difference in prognosis between the 2 groups, but the wound length of the small incision group was significantly reduced (4.0 ± 0.5 versus 7.8 ± 0.8 cm, P < .05). Time of intensive care unit and hospital stay was shorter among hemisternotomy patients at a statistically significant level (P < .05).

Conclusion: Minimal media lower hemisternotomy with the basic advantages of the sternal incision can expose the various parts of the heart, which meets most cardiac exploration and surgical operation needs, and the incision may still be extended if necessary. Lower hemisternotomy appears to be a safe, effective, and versatile alternative for many surgical interventions in infants with congenital heart disease.

References

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Published

2021-06-10

How to Cite

Han, Y., Su, J., Wang, Z., Wei, D., Guo, Y., Zhang, S., Duan, L., Peng, L., Gu, C., & Chen, T. (2021). Analysis of 85 Cases of Minimal Media Lower Hemisternotomy for Congenital Cardiac Surgery Under Cardiopulmonary Bypass in Infants. The Heart Surgery Forum, 24(3), E502-E505. https://doi.org/10.1532/hsf.3577

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Articles