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Updated: Dec 5, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Threshold for intervention upon ascending aortic aneurysms: an evolving target and implication of bicuspid aortic
Shinichi Fukuhara1, Michael Ibrahim2, Daniel Dohle2
1Department of Cardiac Surgery, University of Michigan Cardiovascular Center, Ann Arbor, MI USA.
Abstract:
With the proliferation of non-invasive thoracic imaging modalities, the question of when to operate on asymptomatic ascending aortic aneurysms for non-syndromic patients is becoming increasingly relevant. Operation is extensive, often involves circulatory arrest, and subjects the patient to significant risk of mortality and morbidity. Surgery is performed to avert fatal aortic adverse events, which carry a markedly poor prognosis. The question of when the balance is tipped toward preemptive surgical repair is challenging and is centered around predicting the risk of an acute aortic syndrome. Size of the aneurysm has been the traditional guide for decision-making but how this is measured, what risks it truly predicts, the influence of the patient's size, valve morphology, genetic profile, and other risk factors for non-syndromic patients are poorly understood. We here review this issue in detail.
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