Mini-Invasive Bentall Procedure Performed via a Right Anterior Thoracotomy Approach With a Costochondral Cartilage...

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Aortic Root Surgery

Background:

• Aortic root surgery traditionally involves median sternotomy.
• Minimally invasive approaches are gaining traction for reduced patient trauma.
• The Bentall procedure is a standard for aortic root and ascending aorta replacement.

Purpose of the Study:

• To present initial clinical results of the right minithoracotomy Bentall procedure.
• To evaluate the safety and efficacy of this sternal-sparing technique.
• To assess perioperative outcomes and short-term follow-up.

Main Methods:

• Retrospective analysis of 15 patients undergoing right minithoracotomy Bentall procedure (Oct 2019 - Jun 2021).
• Incision via the second intercostal space, avoiding costochondral cartilage invasion.
• Analysis of operative time, ICU/hospital stay, perioperative outcomes, and follow-up.

Main Results:

• Median aortic cross-clamp time: 95.0 minutes.
• Low blood transfusion rates (21.4%) and no re-exploration for bleeding.
• Short median mechanical ventilation (12.5h) and ICU stay (1.5 days).
• All patients discharged (5.8 ± 1.2 days) with no mortality.
• Improved New York Heart Association (NYHA) functional class at 6-month follow-up.

Conclusions:

• The right minithoracotomy Bentall procedure is safe with low morbidity and mortality.
• This sternal-sparing approach is a viable option for selected aortic root replacement patients.
• Minimally invasive techniques can be successfully applied to complex aortic surgeries.