Our Summary

This research paper compares two methods of performing surgery on the upper part of the aorta, a major artery in the heart. One method is the conventional full sternotomy (cutting through the whole breastbone), and the other is a newer, less invasive method called a “J” hemi-sternotomy (cutting through only part of the breastbone).

The researchers studied 54 patients who had the “J” hemi-sternotomy and 75 patients who had the full sternotomy between 2010 and 2015. They compared the amount of blood loss, the need for blood transfusion, the time spent on a heart-lung machine, the duration of ventilation, and the length of stay in the intensive care unit and the hospital.

The results showed that those in the “J” hemi-sternotomy group had less blood loss, needed fewer ventilators, and had shorter stays in the intensive care unit and the hospital. In conclusion, the researchers believe that the “J” hemi-sternotomy is a safe, less invasive method that results in better post-surgery outcomes than the traditional full sternotomy.

FAQs

  1. What are the two methods of performing surgery on the upper part of the aorta discussed in the research paper?
  2. How did the outcomes of the “J” hemi-sternotomy compare to the full sternotomy in the research study?
  3. Why do the researchers believe that the “J” hemi-sternotomy is a better method than the traditional full sternotomy?

Doctor’s Tip

A doctor might tell a patient that opting for a “J” hemi-sternotomy instead of a full sternotomy can result in less blood loss, a decreased need for blood transfusion, a shorter time on a heart-lung machine, and a quicker recovery time. This less invasive approach may lead to a shorter stay in the intensive care unit and the hospital overall. It is important to discuss with your doctor which surgical approach is best for your specific case.

Suitable For

Patients who are recommended for sternotomy typically have conditions that require surgery on the heart or major blood vessels, such as coronary artery disease, heart valve disease, aortic aneurysm, or aortic dissection. Patients with complex or high-risk conditions may also be recommended for sternotomy, as it allows for better access to the heart and surrounding structures during surgery. Additionally, patients who are not candidates for less invasive procedures, such as transcatheter interventions, may be recommended for sternotomy.

Timeline

Before sternotomy:

  • Patient is diagnosed with a condition that requires surgery on the upper part of the aorta
  • Patient undergoes pre-operative assessments and tests to determine the best surgical approach
  • Patient is informed about the risks and benefits of the surgery and signs consent forms
  • Patient undergoes anesthesia and is prepared for surgery

After sternotomy:

  • Patient undergoes surgery, either through a full sternotomy or a “J” hemi-sternotomy
  • Post-surgery, patient is monitored closely in the intensive care unit for any complications
  • Patient may require ventilation to assist with breathing
  • Patient may receive blood transfusions if necessary
  • Patient gradually recovers and is eventually transferred to a regular hospital room
  • Patient undergoes physical therapy and rehabilitation to aid in recovery
  • Patient is discharged from the hospital and continues follow-up care with their healthcare provider.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a sternotomy procedure?

  2. How does the “J” hemi-sternotomy compare to the full sternotomy in terms of recovery time and post-surgery outcomes?

  3. Is the “J” hemi-sternotomy suitable for my specific condition and medical history?

  4. What are the steps involved in the “J” hemi-sternotomy procedure, and how does it differ from the full sternotomy?

  5. Will I require a blood transfusion during or after the “J” hemi-sternotomy procedure?

  6. How long can I expect to stay in the intensive care unit and the hospital following a “J” hemi-sternotomy?

  7. What are the long-term effects and benefits of opting for a “J” hemi-sternotomy over a full sternotomy?

  8. Are there any alternative treatment options to consider besides a sternotomy procedure?

  9. How often have you performed “J” hemi-sternotomy procedures, and what is your experience and success rate with this technique?

  10. Are there any specific post-operative care instructions or restrictions that I should be aware of after undergoing a “J” hemi-sternotomy?

Reference

Authors: Hastaoglu İO, Tokoz H, Ozgen A, Bilgen F. Journal: Heart Surg Forum. 2018 Jan 5;21(1):E004-E008. doi: 10.1532/hsf.1649. PMID: 29485956