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. 2022 Apr;38(Suppl 1):171-182.
doi: 10.1007/s12055-021-01258-2. Epub 2021 Dec 6.

Minimally invasive approach: is this the future of aortic surgery?

Paolo Berretta  1 , Michele Galeazzi  1 , Mariano Cefarelli  1 , Jacopo Alfonsi  1 , Veronica De Angelis  1 , Michele Danilo Pierri  1 , Sacha M L Matteucci  1 , Eugenio Alessandroni  1 , Carlo Zingaro  1 , Filippo Capestro  1 , Alessandro D'Alfonso  1 , Marco Di Eusanio  1
Affiliations

Minimally invasive approach: is this the future of aortic surgery?

Paolo Berretta et al. Indian J Thorac Cardiovasc Surg. 2022 Apr.

Abstract

Median sternotomy incision has shown to be a safe and efficacious approach in patients who require thoracic aortic interventions and still represents the gold-standard access. Nevertheless, over the last decade, less invasive techniques have gained wider clinical application in cardiac surgery becoming the first-choice approach to treat heart valve diseases, in experienced centers. The popularization of less invasive techniques coupled with an increased patient demand for less invasive therapies has motivated aortic surgeons to apply minimally invasive approaches to more challenging procedures, such as aortic root replacement and arch repair. However, technical demands and the paucity of available clinical data have still limited the widespread adoption of minimally invasive thoracic aortic interventions. This review aimed to assess and comment on the surgical techniques and the current evidence on mini thoracic aortic surgery.

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-021-01258-2.

Keywords: Mini-Bentall operation; Mini-David operation; Minimally invasive cardiac surgery; Thoracic aortic surgery.

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Conflict of interest statement

Conflict of interestThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
J-shaped upper mini-sternotomy
Fig. 2
Fig. 2
Mini-David operation through MS. a Aortic valve exposure. b Implantation of the Valsalva Dacron graft. c Aortic valve reimplantation. d Re-attachment of the left coronary ostium. c Final result
Fig. 3
Fig. 3
Anterior right mini-thoracotomy access
Fig. 4
Fig. 4
Lateral right mini-thoracotomy access
See this image and copyright information in PMC

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