Aortic Valve Replacement via Minimal-Access Complete Sternotomy

Minimally invasive approaches to the chest for aortic valve replacement have been proposed recently in an attempt to reduce postoperative pain, length of hospital stay, and scarring. An alternative approach entailing a minimal skin incision and a complete median sternotomy is presented herein. This technique combines the advantage of limited cosmetic impact with the pattern of postoperative pain and the ventilatory mechanics typical of the sternotomy, which enables extubation upon skin closure and early discharge from the hospital.

近年来，为减轻术后疼痛、缩短住院时长并减少瘢痕形成，学界已提出用于主动脉瓣置换术（aortic valve replacement）的胸部微创入路方案。本文介绍一种替代术式：该术式仅需极小皮肤切口，并配合完全正中胸骨切开术（complete median sternotomy）。该术式兼具美容影响有限的优势，同时保留了正中胸骨切开术典型的术后疼痛模式与呼吸力学特征，可实现皮肤缝合即刻拔管，并助力患者早期出院。