Periareolar Access for Minimally Invasive Cardiac Surgery: The Brazilian Technique

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Periareolar access has been the standard for minimally invasive cardiac surgery at our institution since 2006.
• Initially used for mitral valve surgery, its application expanded due to demonstrated feasibility and safety.

Purpose of the Study:

• To describe and advocate for the routine use of periareolar access in cardiac surgery.
• Highlight its effectiveness for diverse cardiac pathologies.

Main Methods:

• Video-assisted minithoracotomy via a periareolar incision in the 4th right intercostal space.
• Application in 214 patients for conditions including mitral valve disease, tricuspid valve disease, atrial septal defect, atrial fibrillation, and pacemaker lead endocarditis.

Main Results:

• Excellent aesthetic and functional outcomes observed.
• Low morbimortality rates and no long-term reoperations reported.
• Successful application across a range of cardiac pathologies.

Conclusions:

• Periareolar access is a safe and effective surgical technique for various cardiac conditions.
• Supports its routine adoption, particularly for female patients, due to superior cosmetic and functional results.