Use of three-dimensional computed tomography images in deciding the approach for ministernotomy operations.

Abstract

In ministernotomy operations for valvular and congenital heart diseases, several approaches exist. Because topographical relationships of the sternum, ribs, heart, and great vessels differ slightly with each patient, three-dimensional (3D) computed tomography (CT) images are valuable in deciding the best approach for each patient. Ministernotomy patients were studied preoperatively using 3D-CT images. By subtracting some parts of the sternum and the ribs from the 3D images, the topographical relationships of the structures were revealed. Different methods of approach (ie, the site, shape, and length of partial sternotomy) were compared on the 3D images of each patient to decide the most appropriate incision. The images were shown to resemble closely the actual operative field. Three-dimensional CT images are valuable in preoperative planning of ministernotomy, and are essential to individualized planning for each operation.