Two surgical cases of right parasternal minimal incision for aortic valve replacement

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi
E TsujiiS Miki

Abstract

Although median sternotomy has been used as a good approach to all cardiac valves and coronary arteries, advantages of the minimal invasive cardiac operation have been reported recently. We employed the right parasternal minial incision, reported by Cosgrove et al. for two cases of aortic valve replacement. In the first case, we were able to get a good operation field and easily implanted a mechanical prosthesis. In contrast, we had some difficulties with the second case where in addition to the third and fourth cartilages, a second cartilage resection was necessary because the aortic root lay at a cephalic level. Moreover, the operation field was restricted because we left several rib cartilages to preserve the right internal thoracic artery. The cannula had to be inserted via the right atrium as we failed to insert it in the right femoral vein, and the aortic root deviated more medially than usual. From these experiences, it is important to check the position of aortic root, and if the cannula cannot be inserted in the femoral vein, cannulation via the right atrium can ve utilized in the minimal invasive cardiac operation.

References

Aug 1, 1996·The Annals of Thoracic Surgery·D M Cosgrove, J F Sabik
Aug 1, 1996·The American Journal of Cardiology·R KrittayaphongD S Sheps
Nov 1, 1996·The Annals of Thoracic Surgery·J L Navia, D M Cosgrove
Apr 1, 1997·The Journal of Thoracic and Cardiovascular Surgery·F J BenettiI Benetti

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Citations

Nov 14, 2002·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·Hiroshi OkamotoTakao Niimi

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