Analysis of 85 Cases of Minimal Media Lower Hemisternotomy for Congenital Cardiac Surgery Under Cardiopulmonary Bypass in Infants.

OBJECTIVE To investigate the feasibility and effect of minimal media lower hemisternotomy for cardiac surgery under cardiopulmonary bypass (CPB) in infant congenital heart disease. METHODS In our hospital from May 2019 to October 2019, 170 infants with congenital heart disease underwent surgical treatment (median age 6.6 months; weight 6.0 kg). They were divided into 2 groups: those with conventional chest median incision and those with minimal sternotomy. Minimal lower hemisternotomy began from the third intercostal level and ended 0.5 cm above the xiphoid, just enough to insert a small sternal distractor. RESULTS There was no significant difference between the 2 groups in CPB time. The operation time of small incision group was slightly longer (P < .05). There was no difference in prognosis between the 2 groups, but the wound length of the small incision group was significantly reduced (4.0 ± 0.5 versus 7.8 ± 0.8 cm, P < .05). Time of intensive care unit and hospital stay was shorter among hemisternotomy patients at a statistically significant level (P < .05). CONCLUSION Minimal media lower hemisternotomy with the basic advantages of the sternal incision can expose the various parts of the heart, which meets most cardiac exploration and surgical operation needs, and the incision may still be extended if necessary. Lower hemisternotomy appears to be a safe, effective, and versatile alternative for many surgical interventions in infants with congenital heart disease.