Usefulness of a partial median sternotomy for acute infectious endocarditis in patients with tracheostoma.

Infectious endocarditis patients occasionally need emergency cardiac surgery even if they have a tracheostoma. However, a median full-sternotomy approach carries increased risk for sternal infection and lethal mediastinitis in cardiac surgery for patients with tracheostomas. We successfully performed valve replacement procedures using a lower partial median sternotomy approach in 6 infectious endocarditis patients with tracheostomas. There were neither operative deaths nor complications related to wound infection in these cases. The partial sternotomy approach represents a safe alternative in cardiac surgery for acute infectious endocarditis patients with tracheostomas who need emergent surgery.