Van Praet Karel M, van Kampen Antonia, Kofler Markus, Richter Gregor, Sündermann Simon H, Meyer Alexander, Unbehaun Axel, Kurz Stephan, Jacobs Stephan, Falk Volkmar, Kempfert Jörg
Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.
J Card Surg. 2020 Sep;35(9):2341-2346. doi: 10.1111/jocs.14756. Epub 2020 Jul 9.
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.
心胸外科手术的微创技术旨在限制手术创伤，但技术要求和术前规划比传统胸骨切开术更为苛刻。患者选择、多学科协作和手术技能是手术成功的关键因素。主动脉瓣置换术通常通过上半胸骨切开术进行，但右前小切口开胸术是一种创伤更小的技术进步。术前评估升主动脉与胸骨的关系对于选择患者和肋间入路部位至关重要。本手术技术描述重点关注具体的手术细节，包括使用计算机断层扫描进行必要的规划以及我们的插管策略。我们还试图定义升主动脉与胸骨的解剖关系，因为这在术前计算机断层扫描规划中至关重要。
