{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:40:42Z","timestamp":1779273642163,"version":"3.51.4"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The benefits of minimally invasive techniques in cardiac surgery remain poorly defined. We evaluated the short- and mid-term outcomes after surgical aortic valve replacement through partial upper versus complete median sternotomy (MS) in a large, German multicenter cohort.<\/jats:p><jats:p>\n          Methods\u2003A total of 2,929 patients underwent isolated surgical aortic valve replacement via partial upper sternotomy (PUS, n\u2009=\u20091,764) or MS (n\u2009=\u20091,165) at nine participating heart centers between 2016 and 2020. After propensity-score matching, 1,990 patients were eligible for analysis. The primary end point was major adverse cardiac and cerebrovascular events (MACCE), a composite of death, myocardial infarction, and stroke at 30 days and in follow-up, up to 5 years. Secondary end points were acute kidney injury, length of hospital stay, transfusions, deep sternal wound infection, Dressler's syndrome, rehospitalization, and conversion to sternotomy.<\/jats:p><jats:p>\n          Results\u2003Unadjusted MACCE rates were significantly lower in the PUS group both at 30 days (p\u2009=\u20090.02) and in 5-year follow-up (p\u2009=\u20090.01). However, after propensity-score matching, differences between the groups were no more statistically significant: MACCE rates were 3.9% (PUS) versus 5.4% (MS, p\u2009=\u20090.14) at 30 days, and 9.9 versus 11.3% in 5-year follow-up (p\u2009=\u20090.36). In the minimally invasive group, length of intensive care unit (ICU) stay was shorter (p\u2009=\u20090.03), Dressler's syndrome occurred less frequently (p\u2009=\u20090.006), and the rate of rehospitalization was reduced significantly (p\u2009&lt;\u20090.001). There were 3.8% conversions to full sternotomy.<\/jats:p><jats:p>\n          Conclusion\u2003In a large, German multicenter cohort, MACCE rates were comparable in surgical aortic valve replacement through partial upper and complete sternotomies. Shorter ICU stay and lower rates of Dressler's syndrome and rehospitalization were in favor of the partial sternotomy group.<\/jats:p>","DOI":"10.1055\/s-0044-1782685","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T23:23:32Z","timestamp":1713309812000},"page":"272-278","source":"Crossref","is-referenced-by-count":2,"title":["Partial versus Complete Sternotomy for Aortic Valve Replacement\u2014Multicenter Study"],"prefix":"10.1055","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7692-3480","authenticated-orcid":false,"given":"Nora","family":"Goebel","sequence":"additional","affiliation":[{"name":"Robert-Bosch-Krankenhaus GmbH, Stuttgart, Baden-Wuerttemberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Stankowski","sequence":"additional","affiliation":[{"name":"Sana-Herzzentrum Cottbus GmbH, Cottbus, Brandenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Pollari","sequence":"additional","affiliation":[{"name":"Klinikum N\u00fcrnberg - Paracelsus Medizinische Universit\u00e4t, Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kambiz","family":"Hassan","sequence":"additional","affiliation":[{"name":"Asklepios Klinik Sankt Georg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Jueckstock","sequence":"additional","affiliation":[{"name":"Klinikum Passau, Passau, Bayern, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Schubel","sequence":"additional","affiliation":[{"name":"MediClin Herzzentrum Coswig, Coswig, Sachsen-Anhalt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Sellin","sequence":"additional","affiliation":[{"name":"Klinikum Fulda gAG, Fulda, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Zielezinski","sequence":"additional","affiliation":[{"name":"Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Rheinland-Pfalz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yacine","family":"Elhmidi","sequence":"additional","affiliation":[{"name":"Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Rheinland-Pfalz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Falk-Udo","family":"Sack","sequence":"additional","affiliation":[{"name":"Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Rheinland-Pfalz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Feyrer","sequence":"additional","affiliation":[{"name":"Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Rheinland-Pfalz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilmar","family":"Doerge","sequence":"additional","affiliation":[{"name":"Klinikum Fulda gAG, Fulda, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harald","family":"Hausmann","sequence":"additional","affiliation":[{"name":"MediClin Herzzentrum Coswig, Coswig, Sachsen-Anhalt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4022-4298","authenticated-orcid":false,"given":"Parwis","family":"Massoudy","sequence":"additional","affiliation":[{"name":"Klinikum Passau, Passau, Bayern, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schmoeckel","sequence":"additional","affiliation":[{"name":"Asklepios Klinik Sankt Georg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samer","family":"Hakmi","sequence":"additional","affiliation":[{"name":"Asklepios Klinik Sankt Georg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-3590","authenticated-orcid":false,"given":"Theodor","family":"Fischlein","sequence":"additional","affiliation":[{"name":"Klinikum N\u00fcrnberg - Paracelsus Medizinische Universit\u00e4t, Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Fritzsche","sequence":"additional","affiliation":[{"name":"Sana-Herzzentrum Cottbus GmbH, Cottbus, Brandenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich F. 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