This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Minimally Invasive Aortic Valve Replacement via Anterolateral Thoracotomy
This video depicts a minimally invasive aortic valve replacement (AVR) via a right anterolateral mini-thoracotomy (RAT), using the Edwards Intuity rapid deployment aortic valve system (Gen. 1), in a 75-year-old male patient with severe aortic stenosis. RAT access is performed in the second intercostal space over a 7 cm skin incision. A soft-tissue retractor and the ValveGate retractor are used for exposition. The authors use direct arterial cannulation of the ascending aorta with a 19 F uncoated ECMO cannula, as well as direct venous cannulation of the right atrial appendage with a 36 F angled cannula. Any groin cannulation is avoided. To overcome the limitations of this access, such as longer cross-clamp times and reduced exposure of the surgical field, the authors prefer to use the Edwards Intuity biological valve (in this case, 25 mm in size) in order to facilitate this procedure.