University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Multimed Man Cardiothorac Surg. 2024 Jul 9;2024. doi: 10.1510/mmcts.2024.041.
This study elucidates the efficacy and outcomes of a minimally invasive aortic valve replacement via a right anterior mini-thoracotomy, emphasizing its potential to minimize surgical trauma and expedite recovery while maintaining procedural integrity comparable to that of a traditional full sternotomy. This video tutorial demonstrates a successful aortic valve replacement procedure using the right anterior mini-thoracotomy approach, characterized by the absence of sutureless valves and specialized instruments. The detailed surgical procedure includes specific steps to optimize visibility and access through strategic incisions and rib dislocations, adhering to "the box principle" for effective exposure of the aortic valve. This video tutorial suggests that a right anterior mini-thoracotomy is a viable, cost-effective alternative to a conventional sternotomy for aortic valve replacement, offering significant patient benefits without compromising long-term valve function or safety. The broader implications for patient selection and surgical techniques highlight the need for meticulous preoperative planning and anatomical assessment to maximize the potential of a right anterior mini-thoracotomy in clinical practice.
本研究阐明了经右前胸小切口微创主动脉瓣置换术的疗效和结果,强调其具有最小化手术创伤和加速康复的潜力,同时保持与传统全胸骨切开术相当的手术完整性。本视频教程演示了一种成功的使用右前胸小切口入路的主动脉瓣置换术,其特点是无缝合瓣膜和专用器械。详细的手术过程包括通过策略性切口和肋骨脱位来优化可见度和进入的具体步骤,遵循“盒子原则”以有效暴露主动脉瓣。本视频教程表明,对于主动脉瓣置换术,右前胸小切口是一种可行的、具有成本效益的传统胸骨切开术替代方法,为患者带来显著获益,同时不影响长期瓣膜功能或安全性。对于患者选择和手术技术的更广泛影响强调了需要进行细致的术前规划和解剖评估,以最大限度地发挥右前胸小切口在临床实践中的潜力。