Minimally invasive surgical aortic valve replacement: The RALT approach. Issue 9 (9th July 2020)

• Record Type: Journal Article
• Authors: Van Praet, Karel M.; van Kampen, Antonia; Kofler, Markus; Richter, Gregor; Sündermann, Simon H.; Meyer, Alexander; Unbehaun, Axel; Kurz, Stephan; Jacobs, Stephan; Falk, Volkmar; Kempfert, Jörg
• Is Part Of: Journal of cardiac surgery. Volume 35:Issue 9(2020)
• Page Start: 2341
• Page End: 2346
• Publication Date: 2020-07-09
• Subjects: aortic valve stenosis -- cardiac surgery -- minimally invasive -- minimally invasive cardiac surgery -- minimally invasive surgical aortic valve replacement -- RALT -- right anterior minithoracotomy -- SAVR -- surgical aortic valve replacement; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.14756
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Less‐invasive techniques for cardiothoracic surgical procedures are designed to limit surgical trauma, but the technical requirements and preoperative planning are more demanding than those for conventional sternotomy. Patient selection, interdisciplinary collaboration, and surgical skills are key factors for procedural success. Aortic valve replacement is frequently performed through an upper hemisternotomy, but the right anterior minithoracotomy represents an even less traumatic, technical advancement. Preoperative assessment of the ascending aorta in relation to the sternum is mandatory to select patients and the intercostal access site. This description of the surgical technique focuses on the specific procedural details including the obligatory planning with computed tomography and our cannulation strategy. We also sought to define the anatomical ascending aorta‐sternal relationship, as it is of utmost importance in preoperative computed tomographic planning.