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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Should minimally invasive aortic valve replacement be restricted to primary interventions?
I Bakir1, F P Casselman, R De Geest
1Department of Thoracic and Cardiovascular Surgery, OLV Clinic, Aalst, Belgium.
The Thoracic and Cardiovascular Surgeon
|July 17, 2007
Summary
Minimally invasive aortic valve replacement (MIAVR) is a feasible reoperative cardiac procedure. This technique avoids re-exposure of the heart, potentially protecting coronary grafts and offering significant advantages.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Cardiac Reoperations
Background:
- The role of minimally invasive aortic valve replacement (MIAVR) in cardiac reoperations remains undefined.
- This study reports the initial experience with MIAVR as a reoperative procedure.
Purpose of the Study:
- To evaluate the feasibility and outcomes of MIAVR in patients requiring repeat cardiac surgery.
- To assess the safety and efficacy of a minimally invasive approach in a reoperative setting.
Main Methods:
- Nineteen patients underwent MIAVR via J-sternotomy between 1999 and 2005.
- Patients had a mean age of 73.6 years, with prior surgeries including coronary artery bypass grafting and previous valve replacements.
- Retrospective analysis of medical records and follow-up data.
Main Results:
- All procedures were technically successful with acceptable cross-clamp and bypass times.
- Mean intensive care unit and hospital stays were 2.9 and 12.9 days, respectively.
- A 5% mortality rate was observed, with one late death due to cerebrovascular accident in a dialysis patient.
Conclusions:
- Minimally invasive aortic valve replacement is a feasible and advantageous reoperative option.
- The primary benefit is avoiding cardiac re-exposure, thus preserving coronary grafts.
- This technique warrants broader application in suitable reoperative cardiac surgery candidates.
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