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. 2015 Jan;4(1):67-70.
doi: 10.3978/j.issn.2225-319X.2014.11.09.

Minimally invasive reoperative aortic valve replacement

Elisa Mikus  1 , Simone Calvi  1 , Alberto Tripodi  1 , Luca Dozza  1 , Mauro Lamarra  1 , Mauro Del Giglio  1
Affiliations

Minimally invasive reoperative aortic valve replacement

Elisa Mikus et al. Ann Cardiothorac Surg. 2015 Jan.

Abstract

The operative mortality associated with repeat heart valve surgery is supposedly higher than the mortality associated with the primary operation. However, controversy still surrounds the risk factors and optimal surgical approach for patients requiring repeat cardiac surgery, particularly for those requiring aortic valve replacements (AVR). While the standard approach generally utilizes full sternotomy and peripheral cannulation, alternative approaches such as minimally invasive sternotomy may play an increasingly important role in this field. This study compares the advantages and disadvantages of a minimally invasive approach in redo AVR with the standard approach, highlighting difficulties and potential solutions.

Keywords: Minimally invasive surgery; aortic valve reoperation; unclamped patent internal mammary artery.

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Figures

Figure 1
Figure 1
Surgical incision. The upper “J” shaped or “linear” re-hemisternotomy was performed down to the 4th right intercostal space through a 6 cm skin incision.
Figure 2
Figure 2
Prosthetic valve implantation. Surgical field with total central cannulation. The aorta is clamped in routine fashion. The mechanical aortic valve prosthesis has been implanted using three 3-0 prolene running sutures.
See this image and copyright information in PMC

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