Aortic valve replacement via right-sided anterior minithoracotomy

Objective. To evaluate the effectiveness and safety of aortic valve replacement via right-sided anterior minithoracotomy. Material and methods. A retrospective analysis of surgical treatment of 9 patients with aortic insufficiency was performed. All patients underwent aortic valve replacement with mechanical prosthesis via right-sided anterior minithoracotomy. Results. Mean surgery time was 203±20.1 min (95% CI 190—216), cardiopulmonary bypass time — 92.9±18.5 min (95% CI 80.8—105), aortic cross-clamp time — 74.2±17.3 min (95% CI 62.9—85.5). None patient required postoperative inotropic and vasopressor support. Ventilation time was 4.9 hours (95% CI 3.3—6.4). Mean pressure gradient on the aortic valve prosthesis was 12.9±3.3 mm Hg (95% CI 10.7—15). There were no lethal outcomes. Mean length of postoperative hospital-stay was 6.1±1.8 days (95% CI 4.8—7.5). Conclusion. Aortic valve replacement via right-sided anterior minithoracotomy is safe and effective procedure. The main advantages of this method compared to median sternotomy are less blood loss, length of hospital- and ICU-stay. High patient satisfaction with early return to daily activity, less pain syndrome and good cosmetic results are also essential.