Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany.
Department of Medicine, Faculty of Medicine, Imperial College London, Great Britain.
Braz J Cardiovasc Surg. 2021 Jun 1;36(3):420-423. doi: 10.21470/1678-9741-2020-0393.
In the growing era of transcatheter aortic valve implantation, it is crucial to develop minimally invasive surgical techniques. These methods enable easier recovery from surgical trauma, especially in elderly and frail patients. Minimally invasive aortic valve replacement (MIAVR) is frequently performed via upper hemisternotomy. We describe MIAVR via right anterior thoracotomy, which is associated with less trauma, rapid mobilization, lower blood transfusion rates, and lower risk of postoperative wound infections. As minimally invasive procedures tend to take longer operative times, we suggest using rapid-deployment valve prostheses to overcome this limitation. This description focuses on the technical aspects and preoperative assessment.
在经导管主动脉瓣植入术日益发展的时代，开发微创外科技术至关重要。这些方法使患者更容易从手术创伤中恢复，特别是对于老年和体弱患者。微创主动脉瓣置换术（MIAVR）通常通过上半胸骨切开术进行。我们描述了通过右前开胸进行 MIAVR，这种方法创伤较小，术后恢复较快，输血率较低，术后伤口感染风险较低。由于微创程序往往需要更长的手术时间，我们建议使用快速部署瓣膜假体来克服这一限制。本描述侧重于技术方面和术前评估。
