Related Experiment Video
Updated: May 4, 2026
08:50
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
10.9K
Minimally invasive aortic valve replacement.
Tomislav Mihaljevic1, Marc A Gillinov, Delos M Cosgrove
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|January 14, 2014
Summary
This study details a partial upper sternotomy technique for aortic valve and ascending aorta surgery, offering excellent exposure and safety. The approach is easily adoptable using standard surgical tools.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
Background:
- Traditional sternotomy approaches can be invasive.
- Minimally invasive techniques are sought for cardiac valve surgery.
Purpose of the Study:
- To describe a partial upper sternotomy technique for aortic valve and ascending aorta procedures.
- To evaluate the safety and efficacy of this surgical approach.
Main Methods:
- A partial upper sternotomy extending to the right fourth intercostal space via an 8-10 cm incision.
- Direct cannulation of the aorta and right atrium after midline pericardiotomy.
- Oblique aortotomy for aortic valve exposure, debridement, and prosthesis insertion using pledgeted sutures.
Main Results:
- The partial upper sternotomy provides excellent surgical exposure.
- The technique ensures safe conduct of aortic valve and ascending aorta operations.
- The procedure is readily adoptable with standard surgical instrumentation.
Conclusions:
- Partial upper sternotomy is a safe and effective approach for aortic valve and ascending aorta surgery.
- This technique offers a viable alternative to more extensive sternotomies.
- Further discussion on indications, technique, and outcomes is warranted.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
535
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
535
01:25Aortic Regurgitation III: Medical Management
598
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
598
01:25Mitral Regurgitation III: Medical Management
686
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
686
01:22Mitral Valve Prolapse II: Assessment and Management
1.4K
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
1.4K