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Updated: Jan 22, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
[Comparison of Two Minimally Invasive Aortic Valve Replacement Approaches;Right Infra-axillary Thoracotomy versus
Ko Shibata1, Takuya Matsushiro, Yuta Murai
1Department of Cardiovascular Surgery, NTT Medical Center Tokyo, Tokyo, Japan.
Objectives:
Minimally invasive aortic valve replacement(AVR) is reported to show better postoperative outcomes than those associated with conventional AVR. We compared 2 minimally invasive approaches;right infra-axillary thoracotomy( TAX) and partial sternotomy( PS).
Methods:
From January 2013 to December 2017, 54 patients underwent isolated AVR, of whom 14 were in TAX group and 28 were in PS group. Operative outcomes were compared between the 2 groups.
Results:
Preoperative characteristics were similar between the groups. Cardiopulmonary bypass time and cross-clamp time were significantly longer in TAX group. Blood transfusion rates, however, were lower[ 5( 35.7%) versus 22 ( 78.6%):p=0.006] and ventilation time was shorter( median 4.0 versus 6.0 hours:p<0.001) in the TAX group. No mortality or stroke occurred in either group.
Conclusions:
Both TAX and PS AVR could be performed safely, with low mortality and morbidity. TAX was associated with a lower transfusion rate and a shorter ventilation time, and was supposed to be less invasive than PS.
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