Article (Scientific journals)
Surgery of the ascending aorta via a right anterior minithoracotomy: initial surgical experience of a single center.
Tchana-Sato, Vincent; Brüls, Samuel; Minga Lowampa, Elie et al.
2022In Acta Chirurgica Belgica, p. 1 - 7
Peer reviewed
 

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Keywords :
Right anterior mini-thoracotomy; aortic valve replacement; ascending aorta replacement; minimally invasive cardiac surgery; Surgery; General Medicine
Abstract :
[en] [en] OBJECTIVES: Full median sternotomy (FMS) is the common surgical access for patients undergoing replacement of the ascending aorta (AA) with or without aortic valve replacement (AVR). The right anterior mini-thoracotomy (RAMT) approach has been increasingly adopted for AVR. This approach has been shown to decrease blood loss and hospital length of stay (LOS) compared with FMS. The RAMT approach may also be beneficial in selected patients requiring AA procedures with or without AVR. We present our initial clinical experience of patients who have undergone a RAMT for supracommissural replacement of the tubular AA with or without AVR. METHODS: This is a single-center retrospective review of 10 patients who underwent an elective RAMT for replacement of the tubular AA with or without AVR between November 2019 and January 2022. Clinical outcomes evaluated include 30-day mortality, intensive care and hospital LOS, time to extubation, operative times, as well as postoperative complications such as stroke and bleeding. RESULTS: Median cross-clamp and cardiopulmonary bypass times were 109 and 148 min, respectively. Median time to extubation was 2.5 h and median intensive care unit and hospital stay were 2 and 10 days, respectively. There were two re-thoracotomies for postoperative bleeding and two cases of sub-xiphoidal pericardial drainage for pericardial effusion. There were no strokes and no in-hospital nor 30-day mortalities. CONCLUSIONS: The replacement of the AA with or without concomitant AVR can be performed through a RAMT in carefully selected patients. However, the safety of this approach, as compared to full/partial median sternotomy, remains to be proven.
[en] Key questions: Can ascending aorta surgery with or without aortic valve replacement be safely performed via right thoracotomy?Key Findings: A good experience of right thoracotomy approach helps performing ascending aorta surgery via that access in carefully selected patients.Take home message: Center with expertise in right thoracotomy can performed ascending aorta surgery through that access in carefully selected patients. However, the safety of this approach, as compared to full or partial median sternotomy, remains to be proven.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Tchana-Sato, Vincent  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique
Brüls, Samuel  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique
Minga Lowampa, Elie;  Department of Cardiovascular Surgery, CHU Liege, Liege, Belgium
Houben, Alan ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
DESIRON, Quentin ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique
Hans, Grégory ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Lagny, Marc-Gilbert ;  Centre Hospitalier Universitaire de Liège - CHU > > Bloc opératoire chirurgie cardio-vasculaire (+1BC)
Jaquet, Océane ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Defraigne, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique
LAVIGNE, Jean-Paul ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique
Language :
English
Title :
Surgery of the ascending aorta via a right anterior minithoracotomy: initial surgical experience of a single center.
Publication date :
01 December 2022
Journal title :
Acta Chirurgica Belgica
ISSN :
0001-5458
Publisher :
Taylor and Francis Ltd., England
Pages :
1 - 7
Peer reviewed :
Peer reviewed
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