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Right Anterior Mini-Thoracotomy

  • Mauro Del Giglio
  • Elisa Mikus
Chapter

Abstract

Right anterior mini-thoracotomy (MIAVR) is a promising technique for isolated aortic valve replacement. We adopted this approach since January 2010 in more than 500 patients with encouraging results (hospital mortality 1.7%). In order to obtain reliable and reproducible outcomes, a standardized technique and adeguate learning curve are mandatory. Here it is described the surgical technique together with tips and tricks to obtain short operative times and a total central cannulationin a standard setting.

References

  1. 1.
    Rao PN, Kumar AS. Aortic valve replacement through right thoracotomy. Tex Heart Inst J. 1993;20:307–8.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Cosgrove DM III, Sabik JF. Minimally invasive approach for aortic valve operations. Ann Thorac Surg. 1996;62:596–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Murtuza B, Pepper JR, Satnbridge RD, Jone C, Rao C, Darzi A, et al. Minimal access aortic valve replacement: is it worth it? Ann Thorac Surg. 2008;85:1121–31.CrossRefPubMedGoogle Scholar
  4. 4.
    Tabata M, Umakanthan R, Cohn L, Bolmann RM II, Shekar PS, Chen FY, et al. Early and late outcomes of 1000 minimally invasive aortic valve replacement. Eur J Cardiothorac Surg. 2008;33:537–41.CrossRefPubMedGoogle Scholar
  5. 5.
    Gilmanov D, Bevilacqua S, Murzi M, Cerillo AG, Gasbarri T, Kallushi E, Miceli A, Glauber M. Minimally invasive and conventional aortic valve replacement: a propensity score analysis. Ann Thorac Surg. 2013;96:837–43.CrossRefPubMedGoogle Scholar
  6. 6.
    Plass A, Scheffel H, Alkadhi H, Kaufmann P, Genoni M, Falk V, Grünenfelder J. Aortic valve replacement through a minimally invasive approach: preoperative planning, surgical technique, and outcome. Ann Thorac Surg. 2009;88:1851–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Glower DD, Desai BS, Hughes GC, Milano CA, Gaca JG. Aortic valve replacement via right minithoracotomy versus full median sterenotomy: a propensity score analysis. Innovations (Phila). 2014;9(2):75–81.CrossRefGoogle Scholar
  8. 8.
    Phan K, Xie A, Di Eusanio M, Yan TD. A meta-analysis of minimally invasive versus conventional sternotomy for aortic valve replacement. Ann Thorac Surg. 2014;98(4):1499–511.CrossRefPubMedGoogle Scholar
  9. 9.
    Ruttmann E, Gilhofer TS, Ulmer H, Chevtchik O, Kocher A, Schistek R, et al. Propensity score-matched analysis of aortic valve replacement by mini-thoracotomy. J Heart Valve Dis. 2010;19:606–14.PubMedGoogle Scholar
  10. 10.
    Glauber M, Miceli A, Gilmanov D, Ferrarini M, Bevilacqua S, Farneti M, Solinas M. Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study. J Thorac Cardiovasc Surg. 2013;145:1222–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Sansone F, Punta Sansone F, Punta G, Parisi F, Dato GM, Zingarelli E, Flocco R, Forsennati PG, Bardi GL, del Ponte S, Casabona R. Right minithoracotomy versus full sternotomy for the aortic valve replacement: preliminary results. Heart Lung Circ. 2012;21:169–73.CrossRefPubMedGoogle Scholar
  12. 12.
    Mikus E, Turci S, Calvi S, Ricci M, Dozza L, Del Giglio M. Aortic valve replacement through right minithoracotomy: is it really biologically minimally invasive? Ann Thorac Surg. 2015;99(3):826–30.CrossRefPubMedGoogle Scholar
  13. 13.
    Glauber M, Miceli A, Bevilacqua S, Farneti PA. Minimally invasive aortic valve replacement via right anterior minithoracotomy: early outcomes and midterm follow-up. J Thorac Cardiovasc Surg. 2011;142:1577–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Murzi M, Cerillo AG, Bevilacqua S, Gilmanov D, Farneti P, Glauber M. Traversing the learning curve in minimally invasive heart valve surgery: a cumulative analysis of an individual surgeon’s experience with a right minithoracotomy approach for aortic valve replacement. Eur J Cardiothorac Surg. 2012;41(6):1242–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cardiovascular DepartmentMaria Cecilia Hospital, GVM Care and ResearchCotignola (RA)Italy

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