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Updated: Nov 26, 2025
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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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Right Mini-Thoracotomy for Aortic Plus Mitral with or without Tricuspid Valve Surgery
Gloria Faerber1, Sophie Tkebuchava1, André Scherag2
1Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
The Thoracic and Cardiovascular Surgeon
|December 14, 2020
Summary
Combined minimally invasive aortic and mitral valve surgery via right-sided mini-thoracotomy (RMT) is safe and effective. This approach shows a trend toward better mid-term outcomes compared to traditional sternotomy for complex valve procedures.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Thoracic Surgery
Background:
- Minimally invasive surgery (MIS) is common for isolated aortic or mitral valve procedures.
- Combined minimally invasive aortic and mitral valve surgery remains rare.
- This study evaluates the feasibility and outcomes of combined valve surgery via a right-sided mini-thoracotomy (RMT).
Purpose of the Study:
- To compare the outcomes of combined aortic and mitral valve surgery performed through RMT versus traditional sternotomy.
- To assess the safety and efficacy of RMT for complex, multiple valve procedures.
- To evaluate mid-term results and survival probabilities following RMT versus sternotomy.
Main Methods:
- A retrospective analysis of 264 patients undergoing combined aortic and mitral valve surgery.
- Patients were divided into two groups: RMT (n=25) and sternotomy (n=239).
- Propensity score matching was employed for robust outcome comparison between the groups.
Main Results:
- RMT procedures were performed without intraoperative complications or conversions.
- Despite longer cardiopulmonary bypass times, RMT showed no significant difference in 30-day mortality compared to sternotomy.
- Five-year follow-up revealed durable results, with reoperations only in the sternotomy group and a trend towards higher survival in the RMT group.
Conclusions:
- Combined aortic and mitral valve surgery can be safely performed using RMT.
- The RMT approach demonstrates a trend towards improved mid-term outcomes.
- RMT represents a viable alternative for complex multiple valve surgeries.
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