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277132

Mini-Sternotomy Aortic Valve Replacement in Morbid Obesity: Can The Little Offer the Greater?

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Last updated: 03 Jan 2025

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Abstract

Background: Obesity is linked to higher morbidity and death in cardiac surgery, and mini sternotomy is an established approach for aortic valve surgery (AVR). However, the use of this approach is still controversial in this group of patients. Objective: This study aimed to evaluate the potential benefits of this technique in this population. Patients and Methods: From June 2019 to June 2022, 40 morbid obese patients (body mass index ≥ 40) underwent isolated AVR surgery at the National Heart Institute. The surgical approach was median sternotomy (20 patients) and partial upper sternotomy (20 patients). Pre-, intra-, and post-operative data were gathered and analyzed. Results: Patients treated with mini sternotomy AVR had reduced post-operative ventilation time (p= 0.0001), less blood drainage (p= 0.0001), and a lower need for blood transfusion (p= 0.03). They also presented advantages in terms of shorter intensive care unit and hospital stay (p= 0.0001). However, the operative, cross-clamp, and bypass times were significantly longer (p= 0.0001) in the minimally invasive group, which can be dramatically reduced with the introduction of sutureless valves. Inotropic support, pacemaker requirement, cerebrovascular accidents, and wound infection were observed and compared between the two groups. Conclusion: Ministernotomy approach is safe for obese patients undergoing surgical AVR, offering them less biological insult and reduced incidence of postoperative complications.

DOI

10.21608/ejhm.2022.277132

Authors

First Name

Samer W. G.

Last Name

Girgis

MiddleName

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Affiliation

Departments of 1Cardiac Surgery and 2Cardiology, National Heart Institute, Egypt

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First Name

Khaled N.

Last Name

Leon

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Affiliation

Departments of 1Cardiac Surgery and 2Cardiology, National Heart Institute, Egypt

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Orcid

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First Name

Wael S. B.

Last Name

Nekhila

MiddleName

-

Affiliation

Departments of 1Cardiac Surgery and 2Cardiology, National Heart Institute, Egypt

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Volume

89

Article Issue

2

Related Issue

37472

Issue Date

2022-10-01

Receive Date

2022-12-30

Publish Date

2022-10-01

Page Start

7,745

Page End

7,748

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_277132.html

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https://ejhm.journals.ekb.eg/service?article_code=277132

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247

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Mini-Sternotomy Aortic Valve Replacement in Morbid Obesity: Can The Little Offer the Greater?

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Article

Created At

22 Jan 2023