Right Anterior Minithoractomy Aortic Valve Replacement, Ascending Aorta, and Hemiarch Repair

The authors present a case of a patient who underwent right anterior thoracotomy aortic valve replacement with concomitant ascending and hemiarch replacement. This video demonstrates the feasibility of combining a minimally invasive thoracotomy approach with complex aortic surgery. Key technical aspects included femoral cannulation, limited thoracotomy exposure, safe myocardial and cerebral protection strategies, and meticulous graft and valve implantation through a confined operative field. This case highlights techniques to optimize exposure, manage the arch under circulatory arrest, and avoid complications in a minimally invasive setting. This approach offers patients the benefits of reduced surgical trauma while maintaining the safety and durability expected of conventional sternotomy. The video is intended to serve as an educational resource for surgeons interested in expanding minimally invasive techniques to complex aortic pathology. 

References

1. Lamelas J, LaPietra A. Right Minithoracotomy Approach for Replacement of the Ascending Aorta, Hemiarch, and Aortic Valve. Innovations (Phila). 2016 Jul-Aug;11(4):301-4. doi: 10.1097/IMI.0000000000000292. PMID: 27643976.

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