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Related Concept Videos

Heart Valves01:16

Heart Valves

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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
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Continuous Renal Replacement Therapy01:30

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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Mitral Valve Prolapse I: Introduction01:27

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IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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Aortic Regurgitation I: Introduction01:15

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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Related Experiment Video

Updated: Feb 13, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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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 right mini-thoracotomy for aortic valve replacement.

Carl A Johnson1, Amber L Melvin1, Brandon F Lebow2

  • 1Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.

Journal of Visualized Surgery
|March 20, 2018
PubMed
Summary

Minimally invasive aortic valve replacement using the right anterior mini-thoracotomy (RAM) approach is feasible. Advanced camera and automated suturing technology can overcome technical challenges, making this less invasive option more accessible.

Keywords:
Right mini-thoracotomyaortic valve replacementautomated suturing devicevideo-assisted

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Procedures

Background:

  • Minimally invasive aortic valve replacement (AVR) offers benefits over sternotomy, including shorter hospital stays and reduced ventilation time.
  • The right anterior mini-thoracotomy (RAM) approach spares the sternum, improving cosmesis and patient satisfaction, but is underutilized due to technical difficulties.

Purpose of the Study:

  • To evaluate the safety and feasibility of AVR using the RAM approach.
  • To assess the utility of camera and automated suturing technology in overcoming RAM challenges.

Main Methods:

  • A RAM approach was performed via a 5 cm incision with a separate camera port.
  • Standard cannulation techniques and Histidine Tryptophan Ketoglutarate (HTK) cardioplegia were used.
  • Annular and prosthetic sutures were placed using shafted instruments or automated suturing technology.

Main Results:

  • Aortic valve replacement was successfully performed safely through the RAM approach.
  • The use of camera and automated suturing technology facilitated visualization and suture placement.
  • This approach potentially enables wider adoption of less invasive AVR.

Conclusions:

  • The RAM approach for AVR is safe and feasible.
  • Integrated camera and automated suturing systems enhance the technique, potentially increasing its utilization.
  • This facilitates offering less invasive surgical options to more patients.