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Minimally aortic valve surgery avoiding sternotomy.

F Benetti1, J L Rizzardi, C Concetti

  • 1Benetti Foundation, Rosario, Santa Fe, Argentina. fbenetti@infovia.com.ar

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|December 29, 1999
PubMed
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Minimally invasive aortic valve surgery via right anterior minithoracotomy offers a safe, less traumatic approach. This technique provides adequate views for complex procedures, benefiting patients with sternal issues or those requiring repeat surgeries.

Area of Science:

  • Cardiac Surgery
  • Minimally Invasive Procedures
  • 3-D Video-Assisted Surgery

Background:

  • Minimally invasive valve surgery is an evolving field with potential to advance cardiac procedures.
  • A novel approach for aortic valve surgery using a right anterior minithoracotomy was developed.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of aortic valve replacement through a right anterior minithoracotomy.
  • To assess the safety and efficacy of a 3-D video-assisted approach for this procedure.

Main Methods:

  • Aortic valve replacement was performed in seven patients (14% female, mean age 58) using a right thoracotomy, avoiding sternotomy.
  • Central aortic and right atrium cannulation was used in four patients; femoral artery return in three.
  • Antegrade cardioplegia was administered to all patients.

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Main Results:

  • Zero operative mortality was observed.
  • Patients received mechanical valves (n=4), biological valves (n=2), or valve decalcification (n=1).
  • Mean pump time was 110 minutes, cross-clamp time 72 minutes, and hospital stay 7.7 days. All surviving patients showed clinical improvement.

Conclusions:

  • The right anterior minithoracotomy provides adequate visualization for safe aortic valve surgery.
  • This approach is less traumatic and painful, avoiding rib removal.
  • It is a viable option for patients with sternal issues, previous cardiac surgery, or specific anatomical characteristics.