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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2025; 17(9): 110838
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.110838
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.110838
Partial upper sternotomy vs full median sternotomy in obese patients undergoing aortic valve replacement: A meta-analysis
Aarushi Gupta, Zainab Khan, Department of Cardiology, Avalon University School of Medicine, Willemstad 4797, Netherlands
Tinatin Chikhradze, Cheryl Lewis, Department of Cardiology, Tbilisi State Medical University, Tbilisi 0144, Georgia
Afrah Arshad, Department of Medicine, Medway Maritime Hospital NHS Foundation Trust, Gillingham ME7 5NY, United Kingdom
Rahmah Ashar Sakrani, Department of Cardiology, Dow International Medical College, Karachi 05444, Sindh, Pakistan
Melake Getahun, Department of Cardiology, University of Gondar, Adama 1200, Ethiopia
Samreen Rizwan Ahmed Shaikh, Department of Cardiology, Ivane Javakhishvili Tbilisi State University, Tbilisi 0144, Georgia
Wajiha Syed, Muneeb Khawar, Muhammad Muneeb Khawar, Department of Cardiology, King Edward Medical University, Lahore 05450, Punjab, Pakistan
Tanish Baweja, Department of Cardiology, Hamdard Institute of Medical Sciences and Research, New Delhi 110001, Delhi, India
Abhijith Remesan, Department of Cardiology, St Martinus University, Willemstad 4797, Netherlands
Joy Doshi, Department of Cardiology, University Hospital Lewisham, London NW1, United Kingdom
Muneeb Khawar, Department of Medicine, King Edward Medical University, Lahore 05450, Punjab, Pakistan
Asraf Hussain, Department of Cardiology, Chitwan Medical College, Bharatpur 33915, Nepal
Co-first authors: Aarushi Gupta and Tinatin Chikhradze.
Author contributions: Gupta A, Arshad A, Sakrani RA, Khan Z, Getahun M, Shaikh SRA, and Syed W performed the data extraction; Baweja T, Remesan A, and Lewis C contributed to data analysis tools and quality assessment; Chikhradze T, Doshi J, Khawar M, Hussain A, and Khawar MM analyzed the data; Gupta A, Chikhradze T, Arshad A, and Khawar MM wrote the manuscript; All authors designed the research study. All authors have read and approved the final manuscript. Gupta A and Chikhradze T contributed equally to this work as co-first authors.
Conflict-of-interest statement: The authors disclose that they have no conflict of interest related to the subject of this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Asraf Hussain, MD, Department of Cardiology, Chitwan Medical College, Bharatpur-10, Chitwan, Bharatpur 33915, Nepal. drasrafcardiology@gmail.com
Received: June 17, 2025
Revised: June 25, 2025
Accepted: August 15, 2025
Published online: September 26, 2025
Processing time: 92 Days and 21.5 Hours
Revised: June 25, 2025
Accepted: August 15, 2025
Published online: September 26, 2025
Processing time: 92 Days and 21.5 Hours
Core Tip
Core Tip: This meta-analysis innovatively demonstrates that partial upper sternotomy (PUS) is a safe and effective alternative to full median sternotomy for obese patients (body mass index ≥ 30 kg/m²) undergoing aortic valve replacement, uniquely reducing intensive care unit stay by approximately 2.67 days. Despite a trend toward longer cardiopulmonary bypass times, PUS maintains equivalent safety profiles across major complications, offering a compelling minimally invasive option to enhance recovery in this high-risk population.