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Aneurysm IV: Nursing Management01:22

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Updated: Oct 1, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Minimal access compared to sternotomy for aortic root and arch surgery.

Anastasia Boudart1, Alaaddin Yilmaz1, Abdullah Kaya1

  • 1Cardiothoracic Surgery, Hasselt, Belgium.

Acta Chirurgica Belgica
|March 8, 2022
PubMed
Summary

Partial upper sternotomy is a safe approach for aortic root and arch surgery, showing similar mortality to full sternotomy but with reduced complications. This minimally invasive technique offers benefits like less blood loss and shorter hospital stays.

Keywords:
Minimally invasive surgeryantegrade selective cerebral perfusionaortic arch replacementmini-sternotomyroot replacement

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Background:

  • Partial upper sternotomy is an established technique for aortic valve surgery.
  • Its application is being explored for more complex proximal aortic procedures.

Purpose of the Study:

  • To assess and compare the outcomes of aortic root and arch surgery using partial upper sternotomy versus full sternotomy.

Main Methods:

  • Retrospective analysis of 100 patients undergoing proximal aortic surgery from January 2013 to December 2020.
  • Comparison of operative variables and outcomes between minimal access (partial upper sternotomy) and full sternotomy groups.

Main Results:

  • No significant differences in cross-clamping time, extracorporeal circulation time, or major postoperative complications (renal failure, stroke, myocardial infarction, re-exploration).
  • Partial upper sternotomy group showed significantly less red blood cell transfusion, lower postoperative drainage, shorter ventilation time, reduced sepsis rates, and shorter intensive care unit and hospital stays.
  • 30-day mortality rates were similar between both surgical approaches.

Conclusions:

  • Partial upper sternotomy is a safe and feasible approach for aortic root and arch surgery.
  • It offers comparable morbidity and mortality to full sternotomy.
  • Advantages include reduced blood loss, fewer transfusions, faster extubation, and shorter hospital stays.