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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
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Minithoracotomy versus ministernotomy aortic valve replacement.
Rong Hui Misté Chia1,2,3,4,5, Pragnesh Joshi1,2,3,4,5
1Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA 6009 Australia.
Indian Journal of Thoracic and Cardiovascular Surgery
|March 27, 2025
Summary
Right anterior minithoracotomy (RAT) and ministernotomy offer similar outcomes for aortic valve replacement (AVR). RAT showed reduced blood loss, while ministernotomy was slightly faster for isolated AVR, with both techniques demonstrating good clinical results.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Aortic Valve Replacement
Background:
- Aortic valve replacement (AVR) can be performed using various minimally invasive techniques.
- The optimal minimally invasive approach for AVR remains a subject of debate.
- Right anterior minithoracotomy (RAT) and ministernotomy are two common minimally invasive AVR strategies.
Purpose of the Study:
- To compare the perioperative outcomes of AVR performed via RAT versus ministernotomy.
- To evaluate mortality, operative time, stroke incidence, and blood loss between the two techniques.
Main Methods:
- A retrospective analysis of 162 consecutive patients undergoing minimally invasive AVR (107 RAT, 55 ministernotomy) between August 2013 and May 2022.
- Primary outcome: perioperative mortality. Secondary outcomes: operative time, perioperative stroke, and blood loss.
- Patient characteristics, including operative risk and body mass index, were assessed.
Main Results:
- No significant difference in perioperative mortality or major morbidity, including stroke, was observed between RAT and ministernotomy groups.
- Right anterior minithoracotomy was associated with significantly lower blood loss (p=0.02).
- Ministernotomy demonstrated a slightly shorter operative time for isolated AVR (p=0.02), while both techniques showed decreasing operative times over the study period.
Conclusions:
- Both RAT and ministernotomy are effective minimally invasive AVR approaches with comparable safety profiles.
- RAT may be favored for its sternal-sparing benefits, despite a potentially longer operative time.
- Ministernotomy offers an advantage for concomitant procedures, while RAT excels in reducing blood loss.
Keywords:
Aortic valve replacementHemi-sternotomyMinimally invasiveMinisternotomyRight anterior thoracotomyMore Related Videos
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