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Updated: Apr 29, 2026
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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
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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.
Journal of Cardiac Surgery
|May 28, 2014
Summary
Sutureless aortic valve replacement using a minimally invasive video-assisted approach is safe and feasible. This technique offers good visualization and accurate valve delivery, paving the way for further endoscopic procedures.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Medical Device Technology
Background:
- Growing interest in sutureless bioprostheses for minimally invasive cardiac surgery.
- Potential of video assistance to improve decalcification and valve sizing in sutureless aortic valve replacement (AVR).
Purpose of the Study:
- To review the feasibility of sutureless AVR using a minimally invasive video-assisted (MIVA) right anterior minithoracotomy approach.
Main Methods:
- 21 patients underwent AVR with the Enable sutureless device via video-assisted right second space minithoracotomy between November 2012 and November 2013.
Main Results:
- Achieved 95.3% procedural success, with one conversion to median sternotomy.
- Average aortic clamp time was 72.1 ± 22.1 minutes.
- No paravalvular leakage observed; 30-day mortality was 4.7% (one case of pulmonary embolism).
Conclusions:
- The MIVA approach for sutureless AVR is safe and feasible with acceptable clamp times.
- Video assistance enhances visualization of the aortic root and facilitates accurate valve delivery.
- This approach serves as a promising foundation for developing totally endoscopic procedures.
