Our Summary

This research paper is about comparing two types of heart surgeries: Minimally Invasive Surgery (MIS) and Median Sternotomy (MS). These surgeries are performed on patients with multiple valvular disease (MVD), a heart condition where more than one heart valve is affected.

Researchers looked at studies from the beginning of record-keeping until August 2019. They were particularly interested in surgery time, whether a patient needed to be operated on again due to bleeding, and whether the surgical site got infected.

The findings showed that five previous studies met their criteria, which included 340 patients who underwent MIS and 414 patients who had MS. The quality of these studies was found to be good.

The results showed that the time taken for MIS was longer than MS. However, there was no difference in death rates during the surgery, the need for reoperation due to bleeding, surgical site infection, or hospital stay duration.

In simple terms, MIS may take longer, but it has similar short-term outcomes as MS. This makes MIS an attractive option for multivalvular surgery. But, there’s still a need for more research, specifically randomized control trials, to confirm these findings.

FAQs

  1. What are the two types of heart surgeries discussed in this research paper?
  2. What were the key outcomes compared between Minimally Invasive Surgery (MIS) and Median Sternotomy (MS)?
  3. What conclusions were drawn about the effectiveness of MIS compared to MS?

Doctor’s Tip

A helpful tip a doctor might give a patient about sternotomy is to follow post-operative care instructions carefully to help promote healing and reduce the risk of complications. This may include avoiding certain activities, taking prescribed medications, attending follow-up appointments, and practicing good wound care. It’s important to communicate any concerns or changes in symptoms to your healthcare provider.

Suitable For

Patients with multiple valvular disease (MVD) who are candidates for heart surgery are typically recommended sternotomy, particularly for those undergoing Median Sternotomy (MS). This is because sternotomy allows for better access to the heart and valves, making it easier for the surgeon to perform the necessary repairs or replacements. Patients who are deemed suitable for Minimally Invasive Surgery (MIS) may also be recommended sternotomy, depending on the specifics of their condition and the expertise of the surgical team. Ultimately, the choice of surgical approach will depend on the individual patient’s medical history, anatomy, and overall health.

Timeline

Before sternotomy, a patient would typically undergo diagnostic tests and consultations with their healthcare team to determine the best course of action. They may also undergo pre-operative preparations such as fasting and medication adjustments. After sternotomy, the patient would be monitored in the intensive care unit for a period of time before being transferred to a regular hospital room. They would undergo post-operative care, including pain management, physical therapy, and monitoring for complications such as infection or bleeding. Finally, the patient would be discharged from the hospital and continue with follow-up appointments and rehabilitation as needed.

What to Ask Your Doctor

  1. What are the potential risks and benefits of sternotomy compared to minimally invasive surgery for my specific case of multiple valvular disease?
  2. How does the recovery process differ between sternotomy and minimally invasive surgery?
  3. Are there any long-term effects or complications associated with sternotomy that I should be aware of?
  4. How experienced are you and your team in performing sternotomies for multiple valvular disease cases?
  5. Are there any alternative surgical options available for treating my condition?
  6. How likely is it that I will need a reoperation due to bleeding or develop a surgical site infection after a sternotomy?
  7. Can you provide me with any additional information or resources to help me make an informed decision about my surgical treatment options?

Reference

Authors: Mohammed H, Yousuf Salmasi M, Caputo M, Angelini GD, Vohra HA. Journal: J Card Surg. 2020 Jun;35(6):1209-1219. doi: 10.1111/jocs.14558. Epub 2020 Apr 19. PMID: 32306504