Tilted t ministernotomy : a new approach in cardiac surgery

Abstract EN

Objective : To describe Tilted T ministernotomy, a new surgical sternotomy procedure, and compare this procedure with standard sternotomy incision and other forms of ministernotomies at Queen Alia Heart Institute Methods : Between June 2006 and July 2008, 50 patients underwent open heart surgery at Queen Alia Heart Institute using Tilted T ministernotomy for congenital heart disease, heart valves surgery, coronary artery bypass, and combined surgery and bypass.

These patients (group I) were followed up during hospitalization for pain, wound infections, and shoulder stability.

This procedure was compared with the standard sternotomy which was performed among 200 patients (group II).

All performed procedures are described in the text.

A specially designed medical record form was used to describe immediate outcomes.

Simple descriptive statistics were used to analyze the results.

Results : A comparison between both groups during surgery and the post operative period was done including time of surgery, cross clamp time, surgical difficulty, post operative pain, intensive care unit stay, total hospital stay, respiratory function, and pain killer usage.

Most patients in group I used both shoulder girdles freely, resumed driving their cars after two weeks of operation and returned back to their jobs earlier than the standard sternotomy (group II).

The draw -backs of Tilted T ministernotomy included small surgical field, tension on the costochondral junction and more rib fractures.

Conclusion : Tilted T ministernotomy achieves standard sternotomy advantages and allows the use of standard operative instruments and techniques.

It also permits rapid, easy conversion to normal sternotomy exposure, it is easy to learn, there is reduced trauma, pain, post operative morbidity and improved respiratory function, faster rehabilitation, and on general improved patient quality of life.