Comparison of Right Anterolateral Thorocotomy with Standard Median Steronotomy for Mitral Valve Replacement

Zamir  Ahmad Shah; Abdual  Gani Ahangar; Farooq  Ahmad Ganie; Shadab  Nabi Wani; Mohd Lateef  Wani; Hafeezulla  Lone; Nasir&shy;ud&shy;din  Wani; Irteka  Muzamil; Masaratul  Gani

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Comparison of Right Anterolateral Thorocotomy with Standard Median Steronotomy for Mitral Valve Replacement

Author(s):

Zamir Ahmad Shah¹,

Abdual Gani Ahangar¹,

Farooq Ahmad Ganie^1,*,

Shadab Nabi Wani¹,

Mohd Lateef Wani¹,

Hafeezulla Lone²,

Nasiruddin Wani²,

Irteka Muzamil ³,

Masaratul Gani⁴

1Department of cardiovascular and thoracic surgery, SKIMS, Soura, Kashmir, India

2India

3Department of Anesthesia, SKIMS, Soura, Kashmir, India

4J and K Health services,. SKIMS, Soura, Kashmir, India

International Cardiovascular Research Journal:Vol. 7, issue 1; e12724

Published online:Mar 31, 2013

Article type:Research Article

Received:May 07, 2017

Accepted:Dec 17, 2012

How to Cite:Zamir Ahmad ShahAbdual Gani AhangarFarooq Ahmad Ganie Shadab Nabi WaniMohd Lateef Wani Hafeezulla Lone Nasiruddin Wani Irteka Muzamil Masaratul Ganiet al.Comparison of Right Anterolateral Thorocotomy with Standard Median Steronotomy for Mitral Valve Replacement.Int Cardiovasc Res J.7(1):e12724.

Abstract

Obejectives: The objectives of this study were to compare and analyze the results of right anterolateral thoracotomy and median sternotomy approach for primary mitral valve replacement with reference to the exposure during Valve Replacement , length of surgical incision, mean cross clamp time, mean bypass time, intensive care unit (ICU) stay, hospitalization, overall comorbidity with sternotomy; sepsis, dehiscence, healing cosmetic issues and cost effectiveness.

Methods: The present study comprised 68 patients with rheumatic mitral valve disease who underwent mitral valve replacement in the Department ofCardiovascular and Thoracic Surgery at Sher‑i‑Kashmir Institute of Medical Sciences from September 2009 to August 2011.

Results: This study comprised 64 patients with 23 (35.9%) males and 41 (64.1%) females. Sternotomy group had 10 males (31.3%) and 22 females (68.7%). Thoracotomy group had 13 males (40.6%) and 19(59.4%) females. The length of incision between the two groups was statistically significant (P<0.0001). Mean incision length were 24.6±2.1 cm and 14.8±2.3 cm in sternotomy and thoracotomy respectively. Statistically significant difference regarding duration of ICU stay was found between the two groups (P<0.0001). Scar visibility was 100% in sternotomy and around 25% in thoracotomy( P<0.0001).

Conclusions: Thoracotomy through a right anterolateral aspect was easy to perform while maintaining maximum security for the patients. Besides its satisfactory cosmetic result especially in female patients, this approach proved to have several advantages. It offers a better exposure to the mitral apparatus even in patients with small left, allowing easy mitral valve replacement which is apparent from the lower cross‑clamp time in the test group. The invaluable advantage of the above- mentioned thoracotomy is total eradication of the risk of deep sternal infection. The shorter hospital stay and cost effectiveness of thoracotomy approach are additional relief to the family.

Keywords

Thoracotomy

Median Sternotomy

Mitral Valve

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