Lower hemisternotomy: infrequently used but versatile

• DOI: 10.23736/s0021-9509.21.11670-2
• Publication Date: 2021-10-11T08:23:24Z
• Authors: Andreas VOETSCH; Andreas WINKLER; Philipp KROMBHOLZ...; Matthias NEUNER; Michael KIRNBAUER; Rainald SEITELBERGER; Roman GOTTARDI
• Keywords: Single Center; Mitral valve replacement; EuroSCORE

A lower hemisternotomy is an infrequently used approach in cardiac surgery. This single center report evaluates applicability and clinical outcomes of procedures performed through a hemisternotomy.The institutional database was reviewed. From 2014 to 2019, 55 consecutive patients had undergone minimally invasive (median follow-up 34 months). Demographic as well outcome data were retrieved from our prospectively maintained database.Performed included mitral tricuspid repairs, aortic valve replacement coronary artery bypass grafting. The median patient age 72 years. Out the patients, 55% male. Predominantly (11 isolated, 30 combined) been performed. Mitral (N.=41) consisted 36 repairs 5 replacements. Repair rate for degenerative insufficiency 97.6%. Median EuroScore II 3.4% (2.1-6.0). cross-clamp time 67 (44-99) min. procedural length 169 (138-201) Reoperation bleeding 1.8%. Major vascular complications occurred two patients. Freedom related reoperation 96.1% during follow-up. Thirty-day mortality overall 3.6% 10.9%.In properly selected cases allows variety procedures. It permits central cannulation direct vision intracardiac structures therefore should be kept mind alternative approach.