Aortic Root Surgery through Right Anterolateral Minithoracotomy: Initial Experience
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0050
Submission Type:
Abstract Submission
Authors:
Anastasiia Karadzha (1), Alexander Bogachev-Prokophiev (1), Ravil Sharifulin (1)
Institutions:
(1) E. Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
Submitting Author:
Anastasiia Karadzha
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E. Meshalkin National Medical Research Center
E. Meshalkin National Medical Research Center
Co-Author(s):
Alexander Bogachev-Prokophiev
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E. Meshalkin National Medical Research Center
E. Meshalkin National Medical Research Center
Ravil Sharifulin
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E. Meshalkin National Medical Research Center
E. Meshalkin National Medical Research Center
Presenting Author:
Anastasiia Karadzha
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Mayo Clinic
Mayo Clinic
Abstract:
BACKGROUND: Right anterolateral thoracotomy, known for being a minimally invasive surgical approach, has been effectively and safely used for isolated aortic valve replacement. However, its application in aortic root surgery is not as common, with limited cases reported in medical literature. The purpose of this study is to evaluate the immediate outcomes of aortic root surgeries performed using the right anterolateral minithoracotomy approach.
METHODS: This observational descriptive study analyzed seven patients with aortic root pathologies who underwent surgery through right anterolateral minithoracotomy at our institution from 2021 to 2022. Each patient's results were evaluated sequentially.
RESULTS: The cohort included two women (28.6%) and five men (71.4%), aged 25 to 67 years (mean = 33.6 ± 13.09). Surgeries performed included aortic valve reimplantation (David procedure) in four patients, aortic valve and root replacement (Bentall de Bono operation) in two patients (one with a biological valve prosthesis), and a combination of aortic valve replacement and supracoronary aortic replacement in one patient. Two patients had a hemiarch prosthesis with open distal anastomosis and antegrade bilateral brain perfusion. Aortic occlusion times ranged from 110 to 228 minutes (mean = 166.5 ± 36.70), cardiopulmonary bypass from 155 to 470 minutes (mean = 252.7 ± 102.94), ICU stays from 1 to 6 days (mean = 2.2 ± 1.94), and hospital stays from 7 to 27 days (mean = 17.2 ± 7.05). Complications included a left-sided pneumothorax in one patient, bilateral polysegmental pneumonia in another, and one early postoperative death due to intraoperative right coronary artery dissection.
CONCLUSIONS: This case series suggests that aortic root reconstruction via right anterolateral minithoracotomy can be safely and effectively performed. However, this approach requires a longer learning curve and preparation time for surgeons. Further studies with a larger patient sample and a control group using standard or minimally invasive sternotomy are recommended for more comprehensive evaluations.
METHODS: This observational descriptive study analyzed seven patients with aortic root pathologies who underwent surgery through right anterolateral minithoracotomy at our institution from 2021 to 2022. Each patient's results were evaluated sequentially.
RESULTS: The cohort included two women (28.6%) and five men (71.4%), aged 25 to 67 years (mean = 33.6 ± 13.09). Surgeries performed included aortic valve reimplantation (David procedure) in four patients, aortic valve and root replacement (Bentall de Bono operation) in two patients (one with a biological valve prosthesis), and a combination of aortic valve replacement and supracoronary aortic replacement in one patient. Two patients had a hemiarch prosthesis with open distal anastomosis and antegrade bilateral brain perfusion. Aortic occlusion times ranged from 110 to 228 minutes (mean = 166.5 ± 36.70), cardiopulmonary bypass from 155 to 470 minutes (mean = 252.7 ± 102.94), ICU stays from 1 to 6 days (mean = 2.2 ± 1.94), and hospital stays from 7 to 27 days (mean = 17.2 ± 7.05). Complications included a left-sided pneumothorax in one patient, bilateral polysegmental pneumonia in another, and one early postoperative death due to intraoperative right coronary artery dissection.
CONCLUSIONS: This case series suggests that aortic root reconstruction via right anterolateral minithoracotomy can be safely and effectively performed. However, this approach requires a longer learning curve and preparation time for surgeons. Further studies with a larger patient sample and a control group using standard or minimally invasive sternotomy are recommended for more comprehensive evaluations.
Aortic Symposium:
Aortic Root
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