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Updated: Jan 25, 2026
08:50
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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Concomitant Annular Enlargement in Minimally Invasive Aortic Valve Replacement
Davida A Robinson1, Carl A Johnson1, Ariana M Goodman1
11 Department of Surgery, University of Rochester, Rochester, NY, USA.
Innovations (Philadelphia, Pa.)
|May 2, 2019
Summary
Annular enlargement during minimally invasive aortic valve replacement is feasible, allowing for proper valve sizing and avoiding patient-prosthetic mismatch. This technique is recommended for surgeons proficient in basic minimally invasive procedures.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Aortic Valve Surgery
Background:
- Aortic root enlargement is crucial for implanting appropriately sized valves, preventing patient-prosthetic mismatch.
- Minimally invasive aortic valve replacement (MIAVR) offers potential benefits but may pose challenges in achieving adequate annular size.
Purpose of the Study:
- To assess the feasibility of performing aortic annular enlargement during MIAVR.
- To evaluate the safety and efficacy of this combined approach.
Main Methods:
- Retrospective review of 12 consecutive patients undergoing MIAVR with annular enlargement.
- Procedures performed via right anterior minithoracotomy.
- Analysis of cardiopulmonary bypass and crossclamp times, length of stay, complications, reoperation rates, echocardiographic data, and mortality.
Main Results:
- No postoperative mortality or reoperations were observed.
- Mean cardiopulmonary bypass and crossclamp times were 144.7 ± 14.7 and 111.7 ± 10.6 minutes, respectively.
- Postoperative echocardiography showed acceptable valve gradients and no perivalvular leaks.
Conclusions:
- Aortic annular enlargement is a feasible technique during MIAVR.
- Proficiency in basic minimally invasive surgery is recommended before adopting this advanced procedure.
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