Aortic valve replacement using a stentless bioprosthesis through right minithoracotomy: an initial experience.

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Aortic valve replacement (AVR) is a standard procedure with low mortality and morbidity.
• Increasing demand for less invasive surgical approaches drives innovation in AVR techniques.

Purpose of the Study:

• To describe the initial experience and assess the safety and applicability of stentless aortic valve replacement (AVR) using a right mini-thoracotomy approach.
• To evaluate the feasibility of this minimally invasive technique for aortic stenosis treatment.

Main Methods:

• Seven female patients (mean age 79.9 years) underwent stentless-AVR via right mini-thoracotomy (RM).
• Procedures involved cannulation between the ascending aorta and femoral vein; transverse sternotomy was used in two cases.
• RM was performed through the second or third intercostal space.

Main Results:

• No in-hospital deaths were observed.
• Mean extracorporeal circulation time was 110 min; aortic cross-clamp time was 80 min.
• Mean hospital stay was 11.6 days, with a mean ICU stay of 3.3 days.

Conclusions:

• Right mini-thoracotomy is a safe and applicable approach for stentless AVR.
• Surgical exposure challenges can be managed by converting to transverse sternotomy.
• Valve implantation may be more challenging, requiring experienced surgeons skilled in standard stentless AVR.