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Related Experiment Video

Updated: Feb 3, 2026

Three-Dimensional Printing of a Complex Aortic Anomaly
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Ministernotomy Versus Conventional Sternotomy for Complex Aortic Surgery.

Omar A Jarral1, Stevan S Pupovac1, Adam Kiridly1

  • 1Department of Cardiothoracic Surgery, Northwell Cardiovascular Institute, New Hyde Park, NY, USA.

Innovations (Philadelphia, Pa.)
|February 2, 2026
PubMed
Summary
This summary is machine-generated.

Minimally invasive ministernotomy is a safe approach for selected proximal aortic surgeries. Outcomes, including mortality and stroke, were comparable to traditional methods, supporting its effectiveness in complex cases.

Keywords:
aortaaortic arch replacementaortic root replacementminimal access surgeryministernotomyvalve-sparing root replacement

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Background:

  • Proximal aortic surgery traditionally involves a median sternotomy.
  • Minimally invasive approaches, such as ministernotomy, are gaining traction.
  • Assessing outcomes of ministernotomy for complex aortic procedures is crucial.

Purpose of the Study:

  • To evaluate institutional outcomes for proximal aortic surgery using a ministernotomy approach.
  • To compare outcomes between ministernotomy and conventional sternotomy for specific aortic procedures.

Main Methods:

  • Retrospective analysis of a prospectively maintained database (2015-2021).
  • Inclusion of adult patients undergoing elective proximal aortic surgery, excluding specific complex cases.
  • Multivariable regression analysis to assess the impact of surgical approach on composite outcomes (mortality, stroke, renal failure, reoperation) and secondary outcomes (blood transfusion, length of stay).

Main Results:

  • 74 out of 547 patients (13.5%) underwent ministernotomy.
  • Unadjusted outcomes for mortality, stroke, renal failure, and hospital stay were similar between groups.
  • Higher rates of reoperation for bleeding and blood transfusion in the ministernotomy group were noted, potentially due to concomitant arch procedures and learning curve effects.
  • Multivariable analysis showed no significant association between ministernotomy and primary or secondary outcomes.

Conclusions:

  • Ministernotomy is a safe and effective surgical approach for selected patients undergoing complex proximal aortic surgery.
  • These findings contribute to the growing evidence supporting minimally invasive aortic surgery.
  • The study highlights the feasibility of ministernotomy in complex proximal aortic procedures.