[Limited upper sternotomy for minimally invasive aortic valve replacement].

The practice of minimally invasive valve surgery remains controversial. From May 1998, we began minimal invasive aortic valve replacement through the limited upper sternotomy. This technique is simple and provides and easy approach for the aortic valve. From May 1998 to Jan 2000, we performed 15 cases of aortic valve replacement with the limited upper sternotomy approach. All patients received valve replacement with prosthetic valve. We also described a simple and easy air evacuation system to avoid air embolism, a serious problem with a limited operative field. Mean aortic cross clamping time was 79 min, mean cardiopulmonary bypass time was 106 min, and mean operation time was 207 min. It did not take too much time compared with the conventional approach. Mean extubation time was 62 min and mean bleeding 12 hours after the operation was 96 ml. No patient required blood transfusions. All patients but one walked the very next day after the operation. We believe this new method brings not only cosmetic benefits, but also results in excellent post-operative course.