Key result
Right anterior thoracotomy aortic valve replacement was successfully performed in over 1000 cases, utilizing total central cannulation and right internal thoracic artery sparing.
Aortic valve replacement via right anterior mini-thoracotomy can be optimized through total central cannulation and sutureless prostheses to minimize surgical trauma and simplify perfusion.
May support optimized mini-thoracotomy AVR at experienced centers; leaves open need for prospective trials to confirm safety and outcomes.
Minimally invasive aortic valve replacement has gained consent due to its good results in terms of minimized surgical trauma, faster rehabilitation, pain control and patient compliance. In our experience, we have tried to replicate the conventional and gold standard approach through a smaller incision. Sparing the right internal thoracic artery, avoiding rib fractures and performing total central cannulation is important to make this procedure minimally invasive from a biological point of view too. In addition, the total central cannulation is pivotal to simplify perfusion and drainage. Moreover, a complete step-by-step procedure optimization and-when possible-the use of sutureless prosthesis help to reduce the cross-clamping and perfusion times. After more than 1000 right anterior thoracotomy (RAT) aortic valve replacements, we have found tips and tricks to make our technique more effective.
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Tamagnini et al. (2020) studied Aortic valve disease requiring replacement (n=1,000). Right anterior thoracotomy (RAT) aortic valve replacement was evaluated. Right anterior thoracotomy aortic valve replacement was successfully performed in over 1000 cases, utilizing total central cannulation and right internal thoracic artery sparing.
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