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Updated: May 3, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Direct aortic transcatheter valve implantation via mini-thoracotomy using the Medtronic CoreValve
Giuseppe Bruschi1, Luca Botta, Federico De Marco
1'A. De Gasperis' Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Milan, Italy.
Abstract:
Transcatheter aortic valve implantation using the Medtronic CoreValve is a well-established procedure. Although previously carried out only through the common femoral artery, today it is possible to perform the procedure through different arterial alternative access sites. A direct aortic approach through the ascending aorta could be carried out via a right anterior mini-thoracotomy in the second intercostal space. The pericardium is opened to expose the aorta. Two purse-string sutures are then placed on the ascending aorta and a standard retrograde CoreValve implantation is performed with the standard delivery system. Advantages, contraindications, surgical technique and results are discussed.
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