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Updated: Feb 3, 2026
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Three-Dimensional Printing of a Complex Aortic Anomaly
Published on: November 1, 2018
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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
Summary
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.
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.
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