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Updated: Feb 11, 2026
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Technical points for aortic valve replacement through right anterior minithoracotomy
Olivier Bouchot1, Andranik Petrosyan1, Marie Catherine Morgant1
1Department of Cardiovascular and Thoracic Surgery, Dijon University Hospital, Dijon, France.
Summary
This study details a safe and reproducible minimally invasive aortic valve replacement technique using right anterior minithoracotomy. It is suitable for most patients and surgeons, offering a viable alternative to traditional methods.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
Background:
- Traditional aortic valve replacement often requires a sternotomy.
- Minimally invasive approaches aim to reduce surgical trauma and improve recovery.
Purpose of the Study:
- To present a standardized technique for minimally invasive aortic valve replacement (AVR) via right anterior minithoracotomy.
- To demonstrate the safety and reproducibility of this approach after extensive practice.
Main Methods:
- Access to the aorta is achieved through the 2nd or 3rd right anterior intercostal space.
- Cardiopulmonary bypass is established via femoral artery and vein cannulation.
- Direct aortic clamping and standard AVR are performed, with options for rapid-deployment valves and automated knotting systems to minimize cross-clamp time.
Main Results:
- The technique has been refined over 8 years with over 400 patients operated.
- Right anterior minithoracotomy for AVR is demonstrated to be safe and reproducible.
- The use of rapid-deployment valves and automated knotting systems can further optimize procedure times.
Conclusions:
- Minimally invasive aortic valve replacement via right anterior minithoracotomy is a safe and reproducible technique.
- This approach is suitable for a wide range of patients and can be adopted by many surgeons.
- Optimizations like rapid-deployment valves can enhance efficiency and patient outcomes.
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