Related Experiment Video
Updated: May 23, 2026
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Aortic valve replacement through a mini lateral thoracotomy with high thoracic epidural anesthesia
Siclari Francesco1, Demertzis Stefanos, Mauri Romano
1From the *Department of Cardiac Surgery Cardiocentro Ticino, Lugano, Switzerland; †Department of Cardiac Anesthesia Cardiocentro Ticino, Lugano, Switzerland; ‡Department of Cardiology, Cardiocentro Ticino, Lugano, Switzerland.
This study shows that aortic valve replacement using a video-assisted right lateral thoracotomy (RLT) is feasible and safe. Patients experienced rapid recovery with minimal complications, making it a viable alternative to traditional sternotomy.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Thoracic Surgery
Background:
- Traditional aortic valve surgery often involves right parasternal or partial sternotomy incisions.
- This study investigates the feasibility of a video-assisted small right lateral thoracotomy (RLT) for aortic valve access.
Purpose of the Study:
- To evaluate the safety and feasibility of aortic valve replacement (AVR) via a video-assisted right lateral thoracotomy (RLT).
- To compare outcomes of RLT AVR with conventional surgical approaches.
Main Methods:
- 12 patients with aortic stenosis or regurgitation underwent AVR through an 8 cm RLT.
- Procedures utilized endotracheal narcosis with epidural anesthesia, transesophageal echocardiography, femoral/jugular cannulation, moderate hypothermia, and transthoracic aortic clamping.
Main Results:
- Mean operative, perfusion, and clamping times were 223, 132, and 73 minutes, respectively.
- No mortality occurred; one patient required conversion to sternotomy, and another developed a groin seroma.
- Most patients were extubated in the operating room and recovered uneventfully.
Conclusions:
- Aortic valve replacement through a right lateral thoracotomy (RLT) is a feasible and safe minimally invasive surgical option.
- While operative times are marginally longer than conventional sternotomy, recovery is rapid.
- Video-assisted RLT offers a promising alternative for selected patients requiring aortic valve surgery.
