OBJECTIVE

To evaluate the effectiveness and safety of aortic valve replacement through upper partial J-shaped sternotomy compared to conventional sternotomy.

MATERIAL AND METHODS

There were 240 procedures of isolated aortic valve replacement for the period 2012—2017. According to inclusion criteria, 112 patients were randomized into 2 groups: group I — median sternotomy, group II — upper partial J-shaped sternotomy. Mean age of patients was 56.1±14.3 and 53.1±14.9 years, respectively (p=0.284). Females prevailed in both groups (55.4% vs. 57.1%, p=0.848). Peak pressure gradient on the aortic valve was 106.2±23.9 and 102.8±25.3 mm Hg, respectively (p=0.484).

RESULTS

In-hospital mortality was 1.8% (n=1) in group I (p=0.315). Incidence of postoperative complications (complete atrioventricular blockade, ventricular septal defect) was similar (p=1.0). Mean time cross clamping in I and II groups was 65.5±12.5 and 64.7±13.1 min (p=0.729). Mean follow-up period was 31.6 and 33.5 months, respectively. Kaplan—Meier survival rate was 92.6 and 93.0%, respectively (log-rank test=0,767). Freedom from thromboembolic events was 91.7 and 90% (log-rank test=0.213).

CONCLUSION. U

Pper partial J-shaped sternotomy is safe and effective for aortic valve surgery and characterized by similar outcomes compared to conventional sternotomy.