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Minimally invasive surgical aortic valve replacement: The RALT approach
Author(s) -
Praet Karel M.,
Kampen Antonia,
Kofler Markus,
Richter Gregor,
Sündermann Simon H.,
Meyer Alexander,
Unbehaun Axel,
Kurz Stephan,
Jacobs Stephan,
Falk Volkmar,
Kempfert Jörg
Publication year - 2020
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.14756
Subject(s) - medicine , ascending aorta , surgical planning , aortic valve replacement , sternum , surgery , cardiothoracic surgery , radiology , median sternotomy , computed tomographic , computed tomography , aorta , stenosis
Less‐invasive techniques for cardiothoracic surgical procedures are designed to limit surgical trauma, but the technical requirements and preoperative planning are more demanding than those for conventional sternotomy. Patient selection, interdisciplinary collaboration, and surgical skills are key factors for procedural success. Aortic valve replacement is frequently performed through an upper hemisternotomy, but the right anterior minithoracotomy represents an even less traumatic, technical advancement. Preoperative assessment of the ascending aorta in relation to the sternum is mandatory to select patients and the intercostal access site. This description of the surgical technique focuses on the specific procedural details including the obligatory planning with computed tomography and our cannulation strategy. We also sought to define the anatomical ascending aorta‐sternal relationship, as it is of utmost importance in preoperative computed tomographic planning.