In times of expanding indications for transcatheter aortic valve replacement—justified or not—consistent implementation of minimally invasive strategies is needed to meet patients’ growing demands for improved quality of life and quicker postprocedural recovery. The main access routes for minimally invasive aortic valve surgeries do have their particular limitations, eg, sternal instability, lung herniation, rib luxation, or impaired wound healing induced by the loss of the right mammary artery. In this video, the authors present a more lateral access: a 5 cm skin incision in the right anterior axillary line using the third or fourth intercostal space. The technique is safe and reproducible, leaving the sternum and the ribs completely untouched and finally providing a superior cosmetic result with nearly no visible scars.
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Surgery Without Visible Scars: The Right Lateral Access for Minimally Invasive Aortic Valve Surgery
By: , , Marco Di Eusanio
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Wilbring M, Alexiou K, Matschke K, Eusanio MD, Kappert U. Surgery Without Visible Scars: The Right Lateral Access for Minimally Invasive Aortic Valve Surgery. July 2019. doi:10.25373/ctsnet.8986331.
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4 Comments
Excellent work. No drains?
Sorry for the late reply. We use a pleural drain on the right side. Best M
This really is a cool concept. The valve is not that much farther away from a lateral incision compared to a more anterior thoracotomy. This more lateral approach might also make robotic assisted AVR more feasible.
I saw your video in the DGTHG Jahestagung 2020 and this is a very nice concept.
Congratulations!