Mini-Sternotomy Versus Conventional Sternotomy for Aortic Valve Replacement

• Published in: Journal of the American College of Cardiology Vol. 73; no. 19; pp. 2491 - 2492
• Main Authors: Hancock, Helen C., Maier, Rebecca H., Kasim, Adetayo S., Mason, James M., Murphy, Gavin J., Goodwin, Andrew T., Owens, W. Andrew, Kirmani, Bilal H., Akowuah, Enoch F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 21.05.2019; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Aortic valve; Aortic Valve - surgery; Cardiology; Confidence intervals; Durability; Female; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation - methods; Hemoglobin; Humans; Laparoscopy; Male; Manubrium - surgery; Middle Aged; Minimally Invasive Surgical Procedures - methods; Morbidity; Single-Blind Method; Sternotomy - methods; Sternum - surgery; Surgery; Transfusion; Trauma; United Kingdom > UK
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2019.03.462

Minimally invasive surgery combines the durability of surgical repair with reductions in surgical trauma, which together should reduce perioperative morbidity. MAVRIC (Manubrium-limited ministernotomy versus conventional sternotomy for aortic valve replacement) was a single-center, single-blind, randomized superiority trial comparing AVR via manubrium-limited mini-sternotomy using a 5- to 7-cm midline incision (intervention) and conventional median sternotomy using a midline incision from the sternal notch to the xiphisternum (usual care) assessing post-operative red cell transfusion. No difference between the mini-sternotomy and conventional groups in red cell transfusion within 7 days was found; 23 of 135 patients in each group received a transfusion, odds ratio: 1.0 (95% confidence interval: 0.5 to 2.0), risk difference 0.0 (95% confidence interval: −0.1 to 0.1) (Table 1).