Publication Date

2019

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Vivian Wong

Second Advisor

Pervaiz Chaudhry

Third Advisor

Caralee Bromme

Keywords

comparing two surgical outcomes

Abstract

Cardiovascular diseases and heart-related conditions can be life-threatening; however, some cardiovascular conditions can be managed with open heart surgery. Coronary artery bypass grafting (CABG) is the most common type of heart surgery performed on adults. There are two different surgical procedures to correct cardiac defects: mini-thoracotomy and full sternotomy. Mini thoracotomy approach has been shown to reduce complications, such as pneumonia, excessive blood loss, and infection in mitral valve repair surgeries. However, little research has been done to compare these two surgical approaches performed for patients undergoing coronary artery bypass grafting (CABG).

Specifically, there is inadequate data to compare these two surgical approaches in relation to length of stay and duration of ventilator use. The purpose of this study was to compare the surgical outcomes of mini-thoracotomy and full sternotomy in patients undergoing CABG surgeries. A retrospective chart review was conducted from an archival data (2010 to 2016) in patients undergoing CABG surgeries with either a mini-thoracotomy or full sternotomy approach. Included were patients with coronary artery blockages who required CABG surgeries. A one-way ANOVA and independent sample t-test were used for statistical analysis.

Results showed that, there was no significant difference in days of hospitalization in those receiving mini-thoracotomy (M= 10.75, SD=10.25) as compared to those who receiving full- sternotomy (M=11.91, SD= 10.03), F (1,537) = 1.17, p = .23.There was no significant difference in number of hours of ventilation time for mini thoracotomy (M= 13.62, SD= 17.58) and full sternotomy (M= 22.33, SD= 95.96), F (1,537) = .90, p=.34.

As the length of hospitalization and duration of ventilation did not differ in both surgical approaches, we can conclude that mini-thoracotomy was very comparable to full-sternotomy in these two areas for patients undergoing coronary artery bypass grafting.

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