Upper hemisternotomy

Abstract

Minimally invasive approaches are increasingly used in cardiac surgical procedures. Common approaches include upper hemisternotomy and right anterolateral thoracotomy. The additional exposure gained from conventional sternotomy does not greatly improve the access to the aortic valve and proximal thoracic aorta. Minimal access approaches have an equivalent safety profile when compared to conventional sternotomy, and are associated with reduced post-operative pain, reduced transfusion requirement, reduced respiratory complications and shorter hospital stays. Hemisternotomy offers a versatile access to supra-cardiac structures, with a shorter learning curve compared to anterolateral thoracotomy. We describe the procedural steps in performing a safe hemisternotomy.