References
1] J. Lamelas and T. C. Nguyen, “Minimally Invasive Valve Surgery: When Less Is More.,” Semin Thorac Cardiovasc Surg , vol. 27, no. 1, pp. 49–56, 2015.
[2] E. Mikus, S. Calvi, M. Panzavolta, J. Luis Zulueta, L. Dozza, A. Cavallucci, and M. Del Giglio, “Right Anterior Mini-Thoracotomy: A ‘New Gold Standard’ for Aortic Valve Replacement?,” J. Heart Valve Dis. , vol. 24, no. 6, pp. 693–698, Nov. 2015.
[3] E. Mikus, S. Turci, S. Calvi, M. Ricci, L. Dozza, and M. Del Giglio, “Aortic valve replacement through right minithoracotomy: is it really biologically minimally invasive?,” The Annals of Thoracic Surgery , vol. 99, no. 3, pp. 826–830, Mar. 2015.
[4] K. Bedeir, M. Reardon, M. Ramchandani, K. Singh, and B. Ramlawi, “Elevated Stroke Risk Associated With Femoral Artery Cannulation During Mitral Valve Surgery.,” Semin Thorac Cardiovasc Surg , vol. 27, no. 2, pp. 97–103, 2015.
[5] M. Del Giglio, G. Gabriele, R. Biondi, and M. Di Mauro, “A simpler minimal,” Journal of Cardiac Surgery , vol. 106, no. 6, pp. 1782–1, Sep. 2020.
Central Picture: Our usual approach: Right Anterior mini-Thoracotomy and total central cannulation.
Fig. 1: Site selection for the thoracotomy
Fig. 2: The configuration of the three pericardial stitches to optimize the exposure
Fig. 3: The direct arterial cannulation
Fig. 4: The rounded shaped venous cannula to engage easier the inferior cava vein
Fig. 5: The cross-clamp manoeuvre: a separate skin incision gives a less crowded surgical field
Fig. 6: The native aortic valve from the surgeon’s point of view