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Alon Aharon1, Oleg Orlov2, Ioannis Paralikas3, Matthew Thomas3, Joshua Wong4, Amber Melvin4, Konstadinos Plestis3.
1Lankenau medical center, philadelphia, PA, USA, 2Lankenau medical center, Philadelphia, PA, USA, 3Lankenau medical center, philadelphia, NY, USA, 4Division of Cardiac Surgery University of Rochester Medical Center, rochester, NY, USA.

OBJECTIVE: Traditionally, proximal aortic surgery has been performed through a midline sternotomy. We describe our outcomes in patients who underwent aortic root surgery via an upper hemi-sternotomy (mini-Root).
METHODS: This is a retrospective analysis of 13 mini-Roots performed from June 2014- October 2015 at our institution. A minimal invasive approach was achieved through a standard hemisternotomy with lateral extension to the 4th intercostal space. Central aortic and femoral venous cannulation were employed using the Seldinger technique with TEE guidance. Antegrade HTK-Custodial cardioplegia was utilized in all patients. There were 10 Bentall and 3 David procedures.
RESULTS: There was no in hospital mortality or post-operative strokes. Median ICU stay was 2 days, and median hospital stay was 5 days. Ventilatory support was 7.5+ 16 hours. Three patients has postoperative atrial fibrillation (23%), and 5 (38%) required transfusion.
CONCLUSIONS: A minimal invasive approach can be safely applied in proximal aortic surgery with excellent outcomes.

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