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allied
academies
International Surgery and Ortho Conference
October 25-26, 2017 | Toronto, Canada
Case Rep Surg Invasive Proced 2017 | Volume 1 Issue 3
Objective:
The objective of this study is to compare the
outcome in mitral valve replacement done through standard
median sternotomy versus right anterolateral thoracotomy
Methodology:
Retrospective study from Jan 2010 to Dec
2016 at Department of Cardiovascular Surgery, Govt. Lady
Reading Hospital Peshawar, Pakistan. Total 281 cases of
mitral valve replacement (MVR) done among them, 229 were
operated through Standard Median Sternotomy (SMS) and
157 were operated through Right Anterolateral thoracotomy
(RALT). Ethical committee approval was taken. An informed
consent was taken for all patients. Age, sex, mortality, total
cardiopulmonary bypass CPB time, time to establish CPB,
mediastinal/chest drainage, post op blood transfusion, total
hospital stay, ICU stay were analyzed and compared in the
two groups. Statistical analysis done by SPSS version 17 and
paired t test were applied to get p value. P value less than
0.05 was considered significant.
Results:
Females were predominant in both the groups (SMS
73.03% and RALT 77.07%). Mean body surface area was
1.34-meter square. Mean age was 28.65 years in SMS and
26.42 years in RALT. There was no significant difference in
mortality, cardiopulmonary bypass time, cross clamp time,
ventilator time, in the two groups. There was significant
difference in post op blood transfusion, chest drainage, ICU
stay and in total post op hospital stay.
Conclusion:
Sternum sparing mitral valve replacement can
be done safely in selected cases. It gives better cosmetic
results in females. RALT approach reduces hospital stay
of patients and he/she can return to work early. Besides
less pain, shorter skin incision and lower blood loss, it has
more advantages as reduced sternal infection and sternal
disruption.
e:
hamid797@yahoo.comComparative study of standard median sternotomy (SMS) vs right anterolateral thoracotomy (RALT)
for mitral valve replacement
Hamid Ahmad
Gov. Lady Reading Hospital, Pakista