Related Experiment Video
Updated: Apr 29, 2026
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Video-assisted minithoracotomy approach: technical developments towards totally endoscopic sutureless aortic valve
Marco Vola1, Salvatore Campisi, Amedeo Anselmi
1Cardiovascular Surgery Unit, Saint-Etienne University Hospital, St. Etienne, France.
Background And Aim Of The Study:
Interest in sutureless aortic bioprostheses is growing because of the potential advantages that such devices can bring in facilitating minimally invasive approaches. Video assistance can potentially enhance details of decalcification and sutureless valve sizing. We review the feasibility of sutureless aortic valve replacement (AVR) via a minimally invasive video-assisted (MIVA) right anterior minithoracotomy.
Methods:
Between November 2012 and November 2013, 21 patients were selected to undergo an AVR using the Enable sutureless device (Medtronic, Minneapolis, MN, USA) via a video-assisted right second space minithoracotomy.
Results:
Procedural success of the MIVA approach was 95.3% (one conversion to median sternotomy due to severe pleural adhesions). Average aortic clamp time was 72.1 ± 22.1 min. No paravalvular leakage was detected at discharge. Thirty-day mortality was 4.7% (one patient, pulmonary embolism).
Conclusions:
The described approach appears to be safe and feasible with adequate clamp times. Video assistance allows optimal visualization of the aortic root and accurate valve delivery, without conflict between the device, the camera, and the instruments, making this setting an encouraging baseline towards the assessment of the totally endoscopic approach.
