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Updated: Apr 4, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Concurrent Minimally Invasive Aortic Valve Replacement and Coronary Artery Bypass via Limited Right Anterior

Clifton T P Lewis1, Richard L Stephens, Jennifer L Cline

  • 1From the *Princeton Baptist Medical Center, Birmingham, AL USA; †Sarasota Memorial Hospital, Sarasota, FL USA; ‡Sarasota Vascular Specialists, Sarasota, FL USA; and §UAB Hospitals, Birmingham, AL USA.

Innovations (Philadelphia, Pa.)
|September 11, 2015
PubMed

Insights

Minimally invasive aortic valve replacement and coronary artery bypass grafting were successfully performed in elderly patients through a small right anterior thoracotomy. This approach offers a safe and effective treatment for severe aortic stenosis and coronary artery disease.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Interventional Cardiology

Background:

  • Senile calcific aortic disease causes critical aortic stenosis.
  • Coronary artery ostium calcification poses surgical challenges.
  • Combined aortic valve and coronary artery procedures are often necessary.

Observation:

  • Two elderly patients (89M, 80F) presented with critical aortic stenosis and significant coronary artery calcification.
  • A minimally invasive approach was chosen for simultaneous aortic valve replacement and coronary artery bypass grafting.
  • The procedure was performed via a limited 5-cm right anterior thoracotomy.

Findings:

  • The combined surgery was completed without complications or adverse events in both patients.
  • Midterm follow-up confirmed both patients were alive and well.
  • This demonstrates the feasibility of the minimally invasive technique.

Implications:

  • Concurrent minimally invasive aortic valve replacement and coronary artery bypass grafting is a viable option.
  • A limited right anterior thoracotomy can be safely utilized for complex cardiac procedures.
  • This approach may improve outcomes for patients with combined aortic and coronary disease.

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