Cardiac surgery dilemmas: evaluating outcomes of sternotomy versus thoracotomy

TL;DR

This study compares sternotomy and thoracotomy in cardiac surgery, finding higher reoperation rates with sternotomy but similar mortality rates.

Contribution

The study provides new insights into the comparative outcomes of two surgical approaches for tricuspid valve replacement.

Findings

Reoperation rates were significantly higher in the sternotomy group.

Larger valves were used in sternotomy cases compared to thoracotomy.

Mortality rates did not differ significantly between the two surgical approaches.

Abstract

This retrospective study aimed to compare the clinical outcomes, including reoperation rates, mortality, and valve size measurements, in patients undergoing sternotomy and thoracotomy for cardiac surgery, particularly focusing on tricuspid valve replacements. The study sought to highlight differences in surgical approaches and their impact on patient outcomes.

A total of 107 patients were included, with 82 undergoing sternotomy and 25 undergoing thoracotomy. Preoperative right ventricular function parameters (mean pulmonary artery pressure, tissue Doppler imaging, and tricuspid annular plane systolic excursion), valve sizes, and other clinical data were recorded. Statistical analyses were performed to assess differences in outcomes between the two surgical groups.

Reoperation rates were significantly higher in the sternotomy group than in the thoracotomy group. Additionally, there were notable differences in valve sizes between the groups, with larger valves being used in sternotomy cases. However, mortality rates did not differ significantly between the groups.

This study suggests that while sternotomy may lead to higher reoperation rates, the two surgical approaches yield comparable mortality outcomes. Further prospective studies are needed to fully understand the long-term implications of these findings.

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