This video demonstrates the feasibility and step-by-step technique of performing a Bentall procedure through a right axillary minithoracotomy in an adult patient with aortic root aneurysm and aortic valve disease. Cardiopulmonary bypass was established via femoral cannulation, and a 5–6 cm right axillary incision was used to access the ascending aorta and root with soft-tissue retraction and limited rib spreading. The operative steps included aortic cross-clamping, aortotomy, resection of the diseased root, composite valved conduit implantation, and coronary button reimplantation, all performed using long-shafted instruments and endoscopic assistance to preserve a fully minimally invasive approach. This video highlights key technical nuances related to exposure, myocardial protection, hemostasis, and de-airing, as well as strategies to avoid conversion to sternotomy. The postoperative course was uneventful, with excellent hemodynamic results and rapid recovery, supporting this right axillary access as a safe and reproducible minimally invasive option for selected Bentall procedures.
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References
- Di Eusanio M, Cefarelli M, Zingaro C, Capestro F, Matteucci SML, D’alfonso A, Pierri MD, Aiello ML, Berretta P. Mini Bentall operation: technical considerations. Indian J Thorac Cardiovasc Surg. 2019 Jun;35(Suppl 2):87-91. doi: 10.1007/s12055-018-0669-4. Epub 2018 Apr 2. PMID: 33061071; PMCID: PMC7525429.
- Ji Q, Wang Y, Liu F, Yang Y, Li J, Sun X, Yang Z, Pan S, Lai H, Wang C. Mini-Invasive Bentall Procedure Performed via a Right Anterior Thoracotomy Approach With a Costochondral Cartilage Sparing. Front Cardiovasc Med. 2022 Mar 2;9:841472. doi: 10.3389/fcvm.2022.841472. PMID: 35310990; PMCID: PMC8924284.
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