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Video‐Assisted Minithoracotomy Approach: Technical Developments Towards Totally Endoscopic Sutureless Aortic Valve Replacement
Author(s) -
Vola Marco,
Campisi Salvatore,
Anselmi Amedeo,
Faure Michael,
Fuzellier JeanFrancois,
Gerbay A.
Publication year - 2014
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12368
Subject(s) - medicine , aortic valve replacement , surgery , clamp , radiology , clamping , stenosis , mechanical engineering , engineering
Background and Aim of the Study Interest in sutureless aortic bioprostheses is growing because of the potential advantages that such devices can bring in facilitating minimally invasive approaches. Video assistance can potentially enhance details of decalcification and sutureless valve sizing. We review the feasibility of sutureless aortic valve replacement (AVR) via a minimally invasive video‐assisted (MIVA) right anterior minithoracotomy. Methods Between November 2012 and November 2013, 21 patients were selected to undergo an AVR using the Enable sutureless device (Medtronic, Minneapolis, MN, USA) via a video‐assisted right second space minithoracotomy. Results Procedural success of the MIVA approach was 95.3% (one conversion to median sternotomy due to severe pleural adhesions). Average aortic clamp time was 72.1 ± 22.1 min. No paravalvular leakage was detected at discharge. Thirty‐day mortality was 4.7% (one patient, pulmonary embolism). Conclusions The described approach appears to be safe and feasible with adequate clamp times. Video assistance allows optimal visualization of the aortic root and accurate valve delivery, without conflict between the device, the camera, and the instruments, making this setting an encouraging baseline towards the assessment of the totally endoscopic approach. doi: 10.1111/jocs.12368 (J Card Surg 2014;29:494–496)