Comparison of the Outcomes of Aortic Valve Replacements (AVRs) Performed via Conventional Full Sternotomy and Upper Mini Sternotomy: Our Experience at Hayatabad Medical Complex, Pakistan

Introduction Aortic valve replacement (AVR) for severe symptomatic aortic stenosis is a commonly performed procedure, yielding excellent long-term outcomes. Comparing a mini sternotomy with a conventional sternotomy is essential to evaluate less invasive options that can improve patient recovery and reduce postoperative complications. This insight supports surgical decision-making for better AVR patient outcomes. Methodology This retrospective comparative study aims to compare clinical outcomes between mini sternotomy for aortic valve replacement (mini-AVR) and conventional full sternotomy for aortic valve replacement (FS-AVR). Patient records of isolated AVR from January 2021 to July 2023 were reviewed, excluding those with comorbidities or requiring concomitant procedures. Outcomes measured included sternal wound infections, operative time, length of ICU stay, cardiopulmonary bypass (CPB) time, and aortic cross-clamp time. Results The study included 65 patients (47 males and 18 females). Among the participants, 30 patients underwent AVR using full sternotomy, while 35 patients had the procedure performed via upper mini-sternotomy. The mini-AVR group experienced significantly less bleeding and a reduced need for blood transfusions compared to the FS-AVR group. Additionally, patients in the FS-AVR group had longer ICU stays and prolonged ventilation times. Notably, in contrast to findings from other studies, our research revealed that CPB time and aortic cross-clamp time were shorter in the mini-AVR group. Conclusion Mini-sternotomy has proven to be a safe and effective approach for AVR, with the mini-AVR group experiencing fewer complications, such as reduced bleeding and decreased need for blood transfusions. Additionally, patients benefit from shorter ICU stays, reduced ventilation time, and quicker overall recovery.