{"id":4957,"date":"2025-07-01T15:49:36","date_gmt":"2025-07-01T13:49:36","guid":{"rendered":"https:\/\/cvja.co.za\/journal\/?p=4957"},"modified":"2025-07-01T16:57:18","modified_gmt":"2025-07-01T14:57:18","slug":"cvja-2025-022","status":"publish","type":"post","link":"https:\/\/cvja.co.za\/journal\/cvja-2025-022\/","title":{"rendered":"Upper reversed-T mini-sternotomy for sutureless aortic valve replacement: an alternative for high-risk patients"},"content":{"rendered":"    <div id=\"article\">                                                                                                                        \r\n        <div id=\"title-container\">                                                                                                    \r\n        <div id=\"authors-title\">                                                                                                            \r\n        <!--Aurthors under Title-->                                                                                                            \r\n            Mustafa Mert Ozgur, Hakan Hancer, Baris Gurel, Ozge Altas, Halil \u02d9Ibrahim Bulut, Tolga Bas, Sabit Sarikaya, Kaan K\u0131rali                                                                                                           \r\n        <\/div>        \r\n<\/div>                                                                                                                            \r\n            <div id=\"copyright\">\r\n        <strong>Copyright:<\/strong> Clinics Cardive Publishing (Pty) Ltd. publisher\r\n        of Cardiovascular Journal of Africa.<\/div>\r\n    <div style=\"clear: both;\"><\/div>                                                                                                                                \r\n        <div id=\"article-abstract\">                                                                                                            \r\n            <div id=\"abstract-title\">                                                                                                        \r\n                    Abstract                                                                                                                \r\n                <\/div>                                                                                                                        \r\n                                                                                                                                \r\n            <div id=\"abstract-content\">                                                                                                        \r\n            <!--Content of Abstract Article-->                                                                                                \r\n            <!--<strong>\"Abstract titles\":<\/strong>-->                                                                                        \r\n            <!--<br\/> at the end of each section!!-->                                                                                        \r\n                                                                                                                                            \r\n        <strong>Background:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\n        Sutureless aortic prostheses are designed to make aortic valve replacement easier than stented or stentless prostheses in patients with significant aortic stenosis. Recently, a more minimally invasive approach combining sutureless aortic valve replacement with small incisions has emerged, but concerns remain about reduced surgical visibility and the risk of permanent pacemaker implantation.                                                                                                                   \r\n                <br \/>                                                                                                                            \r\n                                                                                                                                                \r\n        <strong>Methods:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\n        Between 2015 and 2023, 216 patients underwent sutureless aortic valve replacement; of these, only 124 patients who underwent isolated primary aortic valve replacement surgery for severe calcific aortic valve stenosis were included in this study to compare in-hospital outcomes between the upper reversed-T mini-sternotomy and full sternotomy approaches.                                                                                                                    \r\n                <br \/>                                                                                                                            \r\n                                                                                                                                                \r\n        <strong>Results:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\n        The mean age was 73.3 \u00b1 7.1 years for full sternotomy [NK2] and 71.9 \u00b1 5.7 years for mini sternotomy. The differences in preoperative risk factors, including associated cardiac pathologies, left ventricular functions, aortic valve pathologies, and aortic root status, were not significant. The mean aortic cross-clamp and associated total cardiopulmonary bypass times were higher in the ministernotomy group without any worsening of perioperative outcomes. Postoperative early complications were similar between the two groups, except for tube drainage and hospital stay, which were worse in the full sternotomy group.                                                                                                                    \r\n                <br \/>                                                                                                                            \r\n                                                                                                                                                \r\n        <strong>Conclusion:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\n         In elderly patients with severe calcific aortic stenosis, sutureless aortic valve replacement via the upper reversed-T mini-sternotomy approach is at least as successful as the full sternotomy method and can be preferred in this patient group due to advantages such as less drainage and faster recovery.                                                                                                                 \r\n                <br \/>                                                                                                                            \r\n                                                                                                                                                \r\n            <\/div>                                                                                                                            \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                        \r\n                                                                                                                                                \r\n        <div id=\"keywords\">                                                                                                                    \r\n                                                                                                                                            \r\n            <strong>Keywords:<\/strong>                                                                                                        \r\n                                                                                                                                            \r\n            <strong>aortic valve replacement,mini-sternotomy, sutureless valve<\/strong>                                                                                                                                                                                                                    \r\n                                                                                                                                                \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                                \r\n    <div id=\"publish-info\">                                                                                                                    \r\n                                                                                                                                \r\n    <strong>Submitted:<\/strong> May 20, 2024; <!--Month day, year; -->    \r\n    <strong>Accepted:<\/strong> November 18, 2024; <!--Month day, year; -->                                                                            \r\n    <strong>Published:<\/strong> June 30, 2025<!--Month day, year; -->                                                                                                                            <br \/>                                                            \r\n        <em>Cardiovasc J Afr 2025; <b>36<\/b>: 196-201<!--pg no. till pg no. \"eg. 4-7\"--><\/em>\r\n        <br \/><strong>Volume 36, Issue 2<\/strong> <br \/>                                                                            \r\n        <\/div>                                                                                                                            \r\n                                                                                                                                        \r\n    <div id=\"DOI\">                                                                                                                    \r\n            DOI Citation Reference: dx.doi.org\/10.5830\/CVJA-2025-022<!--DOI number-->                                                                \r\n        <\/div>                                                                                                                            \r\n                                                                                                                                      \r\n                                                                                                                                        \r\n            <div id=\"author-affiliation\">                                                                                                \r\n                                                                                                                                        \r\n                <strong>Kosuyolu High Specialization Education and Research Hospital, Kartal,\u02d9IstanbulTurkey<\/strong>    <br \/>                                                                            \r\n                                                                                                                                        \r\n                Mustafa Mert Ozgur<br \/>\r\nHakan Hancer<br \/>\r\nBaris Gurel<br \/>\r\nOzge Altas<br \/>\r\nTolga Bas<br \/>\r\nSabit Sarikaya<br \/>\r\nKaan K\u0131rali <br \/>                                                                                                \r\n                                                                                                                                        \r\n            <\/div>                                                                                                                        \r\n                                                                                                                                        \r\n            <div id=\"author-affiliation\">                                                                                                \r\n                                                                                                                                        \r\n                <strong>Istanbul University Cerrahpasa Faculty of Medicine, Fatih, IstanbulTurkey<\/strong>    <br \/>                                                                            \r\n                                                                                                                                        \r\n                Halil Ibrahim Bulut<br \/><br \/>\r\n\r\n                [soshsc hide=\"logged\"]\r\n                <strong>You need to be <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/member-login\/\" target=\"_blank\" rel=\"noopener\">logged in to view and download<\/a> the full text PDF version. <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/register\/\" target=\"_blank\" rel=\"noopener\">Register for a free account?<\/a><\/strong> <br \/><br \/>[\/soshsc]\r\n                \r\n                \r\n                \r\n                <\/div>\r\n    \r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Sutureless aortic prostheses are designed to make aortic valve replacement easier than stented or stentless prostheses in patients with significant aortic stenosis. Recently, a more minimally invasive approach combining sutureless aortic valve replacement with small incisions has emerged, but concerns remain about reduced surgical visibility and the risk of permanent pacemaker implantation. Between 2015 and 2023, 216 patients underwent sutureless aortic valve replacement; of these, only 124 patients who underwent isolated primary aortic valve replacement surgery for severe calcific aortic valve stenosis were included in this study to compare in-hospital outcomes between the upper reversed-T mini-sternotomy and full sternotomy approaches.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[44,101],"tags":[],"class_list":["post-4957","post","type-post","status-publish","format-standard","hentry","category-cardiovascular-topics","category-volume-36-issue-2"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Upper reversed-T mini-sternotomy for sutureless aortic valve replacement: an alternative for high-risk patients - Cardiovascular Journal of Africa<\/title>\n<meta name=\"description\" content=\"Sutureless aortic prostheses are designed to make aortic valve replacement easier than stented or stentless prostheses in patients with significant aortic stenosis. 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