Evaluation of Recovery Rates After Open Heart Surgery in Children Undergoing Mini-Sternotomy Versus Full Sternotomy

Abstract

Background: With the reduced rate of complications and mortality associated with open-heart surgeries in children, the focus has shifted towards addressing cosmetic concerns, minimizing pain, and enhancing quality of life. Mini-sternotomy has emerged as a less invasive alternative to full sternotomy. Objectives: This clinical trial was designed to evaluate the outcomes of these two sternal incision techniques in pediatric patients. Methods: In this randomized, single-blind clinical trial, 78 patients aged 1 to 25 years who were candidates for open-heart surgery were allocated into two groups: Mini-sternotomy and full sternotomy. Postoperative outcomes, including analgesic consumption, infection rate, antibiotic therapy, surgical site debridement, surgical complications (such as pneumonia, pleural effusion, atelectasis, atrial fibrillation), inotrope administration (including norepinephrine and milrinone), mortality, pain level, bypass time, ventilation time, extubation time, ICU length of stay, hospital length of stay, bleeding rate, and transfusion rate, were compared between the groups. Results: There were no infections, surgical site openings within the first 48 hours post-surgery, or mortalities in either group. All patients received antibiotic therapy within the first 6 hours postoperatively. Comparison of recovery parameters revealed that analgesic consumption within the first 6 and 24 hours, antibiotic therapy at discharge, surgical complications, pain scores within the first 6 hours, bypass time, ventilation time, hospital length of stay, bleeding rate, and transfusion rate were significantly higher in the full sternotomy group. Conclusions: Mini-sternotomy is as safe and effective as full sternotomy for cardiac surgeries in children. Moreover, it reduces initial pain and bleeding, shortens hospital stay, and offers superior cosmetic outcomes.