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Related Experiment Video

Updated: Oct 26, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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The mini-Bentall approach: Comparison with full sternotomy.

Vishal N Shah1, Maxwell F Kilcoyne2, Meghan Buckley2

  • 1Department of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, Neb.

JTCVS Techniques
|July 28, 2021
PubMed
Summary

The upper mini sternotomy Bentall (mini-Bentall) procedure leads to significantly less ventilation time and fewer reoperations for bleeding compared to the full sternotomy Bentall (full Bentall) procedure. Both procedures demonstrate excellent 1- and 3-year survival rates.

Keywords:
ACC, aortic cross-clampARR, aortic root replacementCI, confidence intervalCPB, cardiopulmonary bypassFS, full sternotomyICS, intercostal spaceICU, intensive care unitIQR, interquartile rangeLOS, length of stayPVS, prolonged ventilatory supportTEE, transesophageal echocardiographyUMS, upper mini-sternotomyaortic root replacementfull sternotomymini-Bentallupper mini-sternotomy

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Background:

  • The Bentall procedure is a complex aortic surgery.
  • Minimally invasive approaches like the upper mini sternotomy Bentall (mini-Bentall) may offer advantages over the traditional full sternotomy Bentall (full Bentall).

Purpose of the Study:

  • To compare the outcomes of the mini-Bentall procedure versus the full Bentall procedure.
  • To evaluate immediate and 1- and 3-year survival rates between the two surgical approaches.

Main Methods:

  • A retrospective analysis of 97 patients (48 mini-Bentall, 49 full Bentall) between 2009 and 2019.
  • Exclusion criteria included concomitant procedures, reoperations, or hypothermic circulatory arrest.
  • Mean patient age was comparable between groups (60.7 years for mini-Bentall, 59.0 years for full Bentall).

Main Results:

  • No in-hospital mortalities were observed in either group.
  • The mini-Bentall group showed significantly shorter ventilation times (5.5 vs 17 hours) and fewer reoperations for bleeding (0% vs 8.2%).
  • No significant differences were found in cardiopulmonary bypass time, aortic cross-clamp time, or hospital length of stay; 1- and 3-year survival was 100% for both.

Conclusions:

  • The mini-Bentall procedure is associated with reduced postoperative ventilation time and bleeding complications.
  • Both mini-Bentall and full Bentall procedures offer comparable survival rates.
  • The mini-Bentall approach presents a viable option with low morbidity and mortality.