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Updated: Jun 5, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Surgery for asymptomatic degenerative aortic and mitral valve disease
Prashant Vaishnava1, Valentin Fuster, Martin Goldman
1Zena and Michael A. Wiener Cardiovascular Institute, Marie-Jose and Henry R. Kravis Cardiovascular Health Center, The Mount Sinai School of Medicine, New York, NY 10029, USA. prashant.vaishnava@mountsinai.org
Abstract:
Degenerative valvular heart disease, the most common form of valve disease in the Western world, can lead to aortic stenosis (AS) or mitral regurgitation (MR). In current guidelines for the management of patients with degenerative valvular disease, surgical intervention is recommended at the onset of symptoms or in the presence of left ventricular systolic impairment. Whether surgery is appropriate for asymptomatic patients remains a controversial issue. We argue the case for early pre-emptive intervention in selected, asymptomatic individuals with AS or MR, drawing on contemporary perioperative data, predictors of disease progression, and studies of the natural history of degenerative valvular heart disease.
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