A Novel Computed Tomography Scan Tool for Patient Selection in Minithoracotomy Aortic Replacement

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Right anterior minithoracotomy is increasingly adopted for isolated aortic valve replacement.
• Surgical exposure can be challenging during this minimally invasive procedure, even for experienced teams.
• Patient selection is crucial for successful outcomes.

Purpose of the Study:

• To highlight the importance of preoperative patient selection for right anterior minithoracotomy.
• To introduce a specific anatomical measurement using computed tomography scans to aid in patient selection.

Main Methods:

• Routine performance of right anterior minithoracotomy for isolated aortic valve replacement.
• Utilizing computed tomography scans for preoperative patient assessment.
• Measuring the angle between the right sternal border and the left aorta at the pulmonary artery level.

Main Results:

• Computed tomography-based patient selection is deemed mandatory for this approach.
• A specific angle measurement aids in determining surgical feasibility.
• This method assists surgeons in selecting appropriate candidates for the procedure.

Conclusions:

• Proper preoperative patient selection is essential for successful right anterior minithoracotomy.
• Computed tomography imaging, particularly the defined angle measurement, is a valuable tool for this selection process.
• This approach can help mitigate challenges associated with surgical exposure.