Straight Longitudinal Aortotomy for Aortic Valve Replacement Through Right Anterior Minithoracotomy

Conventional aortotomy in aortic valve replacement (AVR) is transverse or oblique. However, traditional aortotomy is difficult in patients with a high takeoff right coronary artery. Studies have reported aortotomy techniques for AVR through sternotomy, but not through right anterior minithoracotomy. We report 6 patients who underwent AVR by means of right anterior minithoracotomy through a straight longitudinal aortotomy, which provided good aortic valve exposure and facilitated hemostasis. The procedure was successfully performed without major complications, with favorable postoperative outcomes. This technique may be a viable alternative to traditional aortotomy, thus offering improved surgical field visibility and ease of closure.