Right Anterior Mini-Thoracotomy for Aortic Valve Replacement

2018 ◽  
pp. 259-273
Author(s):  
Marco Solinas ◽  
Giacomo Bianchi
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mini Thoracotomy

scholarly journals Cerebral microemboli in mini-sternotomy compared to mini- thoracotomy for aortic valve replacement: a cross sectional cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marija Bozhinovska ◽  
Matej Jenko ◽  
Gordana Taleska Stupica ◽  
Tomislav Klokočovnik ◽  
Juš Kšela ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Surgical Techniques ◽  
Aortic Valve Area ◽  
Link Type ◽  
Microembolic Signal ◽  
Mini Thoracotomy ◽  
Addenbrooke’S Cognitive Examination

Abstract Background Recently adopted mini-thoracotomy approach for surgical aortic valve replacement has shown benefits such as reduced pain and shorter recovery, compared to more conventional mini-sternotomy access. However, whether limited exposure of the heart and ascending aorta resulting from an incision in the second intercostal space may lead to increased intraoperative cerebral embolization and more prominent postoperative neurologic decline, remains inconclusive. The aim of our study was to assess potential neurological complications after two different minimal invasive surgical techniques for aortic valve replacement by measuring cerebral microembolic signal during surgery and by follow-up cognitive evaluation. Methods Trans-cranial Doppler was used for microembolic signal detection during aortic valve replacement performed via mini-sternotomy and mini-thoracotomy. Patients were evaluated using Addenbrooke’s Cognitive Examination Revised Test before and 30 days after surgical procedure. Results A total of 60 patients were recruited in the study. In 52 patients, transcranial Doppler was feasible. Of those, 25 underwent mini-sternotomy and 27 had mini-thoracotomy. There were no differences between groups with respect to sex, NYHA class distribution, Euroscore II or aortic valve area. Patients in mini-sternotomy group were younger (60.8 ± 14.4 vs.72 ± 5.84, p = 0.003), heavier (85.2 ± 12.4 vs.72.5 ± 12.9, p = 0.002) and had higher body surface area (1.98 ± 0.167 vs. 1.83 ± 0.178, p = 0.006). Surgery duration was longer in mini-sternotomy group compared to mini-thoracotomy (158 ± 24 vs. 134 ± 30 min, p < 0.001, respectively). There were no differences between groups in microembolic load, length of ICU or total hospital stay. Total microembolic signals count was correlated with cardiopulmonary bypass duration (5.64, 95%CI 0.677–10.60, p = 0.027). Addenbrooke’s Cognitive Examination Revised Test score decreased equivalently in both groups (p = 0.630) (MS: 85.2 ± 9.6 vs. 82.9 ± 11.4, p = 0.012; MT: 85.2 ± 9.6 vs. 81.3 ± 8.8, p = 0.001). Conclusion There is no difference in microembolic load between the groups. Total intraoperative microembolic signals count was associated with cardiopulmonary bypass duration. Age, but not micorembolic signals load, was associated with postoperative neurologic decline. Trial registry number clinicaltrials.gov, NCT02697786 14.

scholarly journals Right anterior mini-thoracotomy vs. conventional sternotomy for aortic valve replacement: a propensity-matched comparison

2018 ◽  
Vol 10 (3) ◽  
pp. 1588-1595 ◽  
Author(s):  
Mauro Del Giglio ◽  
Elisa Mikus ◽  
Roberto Nerla ◽  
Antonio Micari ◽  
Simone Calvi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Matched Comparison ◽  
Mini Thoracotomy

scholarly journals Epicardial radiofrequency ablation and aortic valve replacement through right mini-thoracotomy

2010 ◽  
Vol 11 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Stefano Bevilacqua ◽  
Alfredo Giuseppe Cerillo ◽  
Marco Solinas ◽  
Mattia Glauber
Keyword(s):  
Radiofrequency Ablation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mini Thoracotomy

scholarly journals 014 * RIGHT ANTERIOR MINI-THORACOTOMY FOR ISOLATED AORTIC VALVE REPLACEMENT: TEN-YEAR EXPERIENCE IN 484 PATIENTS

2014 ◽  
Vol 19 (suppl 1) ◽  
pp. S5-S5 ◽  
Author(s):  
M. Glauber ◽  
D. S. Gilmanov ◽  
A. Miceli ◽  
P. A. Farneti ◽  
M. Ferrarini ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mini Thoracotomy

scholarly journals Mini Sternotomy and Mini Thoracotomy for Aortic Valve Replacement: Is There a Difference?

2021 ◽  
Vol 24 (5) ◽  
pp. E855-E859
Author(s):  
Faisal Mourad ◽  
Mohamed Abd Al Jawad
Keyword(s):  
Postoperative Pain ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Female Gender ◽  
The Other ◽  
Safety And Efficacy ◽  
Pain Scores ◽  
Mini Thoracotomy

Background: Minimally invasive valve replacement is increasingly accepted among surgeons and patients alike. Ministernotomy and minithoracotomy are the most used incisions in the minimally aortic valve replacement. The superiority of one incision over the other still is debatable with a few centers having the opportunity to compare them head-to-head. Methods: A retrospective analysis of 260 patients, who underwent mini AVR, with 132 patients in the ministernotomy group and 128 patients in the minithoracotomy group. Operative details, mortality, wound cosmetics, and postoperative pain were among the primary end points. Results: A predominance of female gender has been observed in both groups. The cross-clamp and total bypass times were significantly lower in MS compared with the MT approach (63.61±16.115 vs. 70.75±33.274 min, P = 0.028, and 91.90±26.365 vs. 112.24±51.634 min, P < 0.001, respectively). The minithoracotomy group had significantly shorter lengths of wounds (5.1 ± 0.6 vs. 8.48±0.344 cm, P < 0.001). The ministernotomy group had significantly lower postoperative pain scores either in the ICU, at hospital discharge, or after 30 days at the outpatient clinic, where scores compared with MT (4.46±1.23 vs. 5.23±1.12, P < 0.001, 1.6±0.84 vs. 1.83±0.72, P = 0.019, and 1.28±0.67 vs. 1.47±0.53, P = 0.012, respectively). Conclusion: Both minimally invasive incisions for AVR proved their safety and efficacy. While the ministernotomy has the advantage of less postoperative pain and pleural complications, the minithoracotomy incision has its unmatched aesthetic appeal.

Minimally invasive aortic valve replacement through a right anterolateral mini-thoracotomy for the treatment of octogenarians with aortic valve stenosis

2018 ◽  
Vol 34 (3) ◽  
pp. 462-469 ◽  
Author(s):  
Toshinori Totsugawa ◽  
Arudo Hiraoka ◽  
Kentaro Tamura ◽  
Hidenori Yoshitaka ◽  
Taichi Sakaguchi
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Mini Thoracotomy

scholarly journals 302 * FULL STERNOTOMY VERSUS RIGHT ANTERIOR MINI-THORACOTOMY FOR ISOLATED AORTIC VALVE REPLACEMENT IN OCTOGENARIANS: A PROPENSITY MATCHED STUDY

2014 ◽  
Vol 19 (suppl 1) ◽  
pp. S90-S90
Author(s):  
D. S. Gilmanov ◽  
P. A. Farneti ◽  
M. Ferrarini ◽  
F. Santarelli ◽  
M. Murzi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Matched Study ◽  
Mini Thoracotomy
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