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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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Ministernotomy in Aortic Root and Arch Surgery: Early Outcomes
Ulku Kafa Kulacoglu1, Mehmet Kaya1
1Department of Cardiovascular Surgery, Republic of Turkey Ministry of Health, University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital.
Brazilian Journal of Cardiovascular Surgery
|September 16, 2022
Summary
Minimally invasive cardiac surgery using ministernotomy for aortic procedures shows promising results. This technique offers reduced ventilation and ICU stay with zero 30-day mortality compared to full sternotomy.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Minimally invasive cardiac surgery is increasingly preferred.
- Aortic root, arch, and hemiarch replacements are critical procedures.
Purpose of the Study:
- To compare outcomes of aortic replacement surgeries performed via ministernotomy versus full sternotomy.
- To evaluate the safety and efficacy of the ministernotomy approach.
Main Methods:
- Retrospective analysis of 278 patients undergoing aortic procedures (root, ascending aorta, arch) between January 2017 and October 2019.
- Comparison between 25 patients treated with ministernotomy and 20 matched patients treated with full sternotomy.
Main Results:
- Ministernotomy group had longer cross-clamping time (128.3 min vs. 104.7 min) but similar total operating time.
- Full sternotomy group required more red blood cell (RBC) transfusions (4.65 units vs. 2.44 units).
- Ministernotomy significantly reduced ventilation time (7.6 h vs. 32.3 h) and ICU stay (1.56 days vs. 3.35 days), with 0% 30-day mortality.
Conclusions:
- Ministernotomy is a safe and effective approach for aortic root, ascending aorta, and aortic arch surgeries.
- The technique is associated with lower morbidity and mortality rates.
- Early results support the wider adoption of ministernotomy in selected aortic surgeries.
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