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Comparative Study
. 2024 Dec 24;55(2):482-487.
doi: 10.55730/1300-0144.5992. eCollection 2025.

Cardiac surgery dilemmas: evaluating outcomes of sternotomy versus thoracotomy

Muhammet Fethi Sağlam  1 , Emrah Uğuz  1 , Kemal Eşref Erdoğan  1 , Hüseyin Ünsal Erçelik  2 , Murat Yücel  2 , Mete Hidiroğlu  1 , Erol Şener  1
Affiliations
Comparative Study

Cardiac surgery dilemmas: evaluating outcomes of sternotomy versus thoracotomy

Muhammet Fethi Sağlam et al. Turk J Med Sci. .

Abstract

Background/aim: This retrospective study aimed to compare the clinical outcomes, including reoperation rates, mortality, and valve size measurements, in patients undergoing sternotomy and thoracotomy for cardiac surgery, particularly focusing on tricuspid valve replacements. The study sought to highlight differences in surgical approaches and their impact on patient outcomes.

Materials and methods: A total of 107 patients were included, with 82 undergoing sternotomy and 25 undergoing thoracotomy. Preoperative right ventricular function parameters (mean pulmonary artery pressure, tissue Doppler imaging, and tricuspid annular plane systolic excursion), valve sizes, and other clinical data were recorded. Statistical analyses were performed to assess differences in outcomes between the two surgical groups.

Results: Reoperation rates were significantly higher in the sternotomy group than in the thoracotomy group. Additionally, there were notable differences in valve sizes between the groups, with larger valves being used in sternotomy cases. However, mortality rates did not differ significantly between the groups.

Conclusion: This study suggests that while sternotomy may lead to higher reoperation rates, the two surgical approaches yield comparable mortality outcomes. Further prospective studies are needed to fully understand the long-term implications of these findings.

Keywords: Sternotomy; cardiac surgery; thoracotomy; tricuspid valve replacement.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

Figure
Figure
Comparison of reoperation and mortality rates. This figure illustrates the comparison of reoperation and mortality rates between patients undergoing sternotomy and thoracotomy. The reoperation rates were higher in both groups, with sternotomy having a reoperation rate of 86.6% and thoracotomy one of 92.0%. The mortality rates were relatively low and similar between the groups, with sternotomy showing a mortality rate of 8.5% and thoracotomy one of 8.0%. These findings suggest that while these surgical methods have comparable mortality rates, thoracotomy may be associated with slightly higher reoperation rates compared to sternotomy.
See this image and copyright information in PMC

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