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Updated: Jul 6, 2026
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Minimally invasive surgery with a partial sternotomy "J" approach
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH 44195, USA. svenssonl@ccf.org
Abstract:
The minimally invasive partial sternotomy "J" incision can be used for most isolated mitral valves, tricuspid valves, aortic valves, atrial septal defects, maze procedures, aortic repairs, and aortic valve reoperations. This article reviews the technical approaches and outcomes for various procedures. For 2,004 mitral valve repairs, our 30-day in-hospital mortality was 0.2% and for 1,103 aortic valve procedures, it was 0.8%. In addition to both a better cosmetic result and earlier return to work, the benefits include less blood loss, less pain, better respiratory function, and better 1-year survival for mitral valve procedures. Similar results have been obtained for aortic valve procedures. Thus, all patients undergoing isolated aortic or mitral valve repairs are offered a minimally invasive operation.
Insights
Minimally invasive partial sternotomy offers excellent outcomes for various heart surgeries, including mitral and aortic valve procedures. This approach provides benefits like faster recovery and improved survival rates.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Traditional sternotomy for cardiac surgery carries risks and prolonged recovery.
- Minimally invasive techniques are increasingly explored to improve patient outcomes and cosmesis.
Purpose of the Study:
- To review the technical approaches and outcomes of minimally invasive partial sternotomy for various cardiac procedures.
- To evaluate the safety and efficacy of the "J" incision for mitral valve, tricuspid valve, aortic valve, and other cardiac surgeries.
Main Methods:
- Review of technical approaches for minimally invasive partial sternotomy.
- Analysis of outcomes for 2,004 mitral valve repairs and 1,103 aortic valve procedures.
- Comparison of outcomes with traditional surgical methods.
Main Results:
- Low 30-day in-hospital mortality: 0.2% for mitral valve repairs and 0.8% for aortic valve procedures.
- Significant benefits including less blood loss, reduced pain, improved respiratory function, and better 1-year survival for mitral valve procedures.
- Comparable positive outcomes reported for aortic valve procedures.
Conclusions:
- Minimally invasive partial sternotomy "J" incision is a versatile approach for a wide range of isolated cardiac procedures.
- The technique demonstrates excellent safety, efficacy, and patient-centered benefits, including improved recovery and survival.
- All patients undergoing isolated aortic or mitral valve repairs are offered this minimally invasive option.
