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Mini-Bentall: An Interesting Approach for Selected Patients
Elisa Mikus1, Antonio Micari, Simone Calvi
1From the Departments of *Cardiovascular Surgery and †Cardiology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna, Italy; and ‡ES Health Science Foundation, Cotignola, Ravenna, Italy.
Innovations (Philadelphia, Pa.)
|January 28, 2017
Summary
Minimally invasive aortic valve and ascending aorta replacement using a J-shaped partial upper sternotomy is safe and effective. This approach offers excellent outcomes, comparable to traditional sternotomy, with potential benefits in operative times and recovery.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Aortic Valve and Root Surgery
Background:
- Minimally invasive surgery for aortic valve replacement is established.
- Its application for complex ascending aorta procedures is less common.
- The Bentall technique is a standard for aortic valve and ascending aorta replacement.
Purpose of the Study:
- To evaluate the safety and efficacy of a minimally invasive approach for aortic valve and ascending aorta replacement using the Bentall technique.
- To compare outcomes with traditional full sternotomy.
Main Methods:
- Retrospective study of 53 patients undergoing minimally invasive aortic valve and ascending aorta replacement (Jan 2010-Nov 2015).
- Utilized a J-shaped partial upper sternotomy (6-cm incision).
- Excluded patients with prior cardiac surgery or active endocarditis.
Main Results:
- Zero hospital and 30-day mortality.
- Median cardiopulmonary bypass and cross-clamp times were 84 and 73 minutes, respectively.
- Minimally invasive group showed similar postoperative outcomes, with advantages in operative times, atrial fibrillation incidence, and ventilation duration compared to full sternotomy.
Conclusions:
- Partial upper sternotomy is a safe approach for aortic valve replacement.
- Minimally invasive Bentall procedure using a partial upper J-shaped sternotomy is a viable alternative for selected patients with complex aortic root pathology.
