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International Society For Minimally Invasive Cardiothoracic Surgery

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Combined Valve and Ascending Aorta Procedure through Right Anterolateral Minithoracotomy
Vincenzo Smorto, Enrico Ramoni, Diego Magnano, Roberto Ceresa, Mauro Del Giglio, PhD
Villa Torri Hospital, Bologna, Italy

BACKGROUND: Nowadays minimally invasive cardiac surgery treats different type of valve and ascending aorta diseases, sometimes even combined. In our video, we show a combined procedure of mitral valve repair (MVR) and Bentall operation through a right anterior minithoracotomy (RAT).
METHODS: A young male patient, with no significant comorbidities, was selected as a candidate for the procedure. After RAT approach, cardiopulmonary bypass was ensured with central arterial cannulation at the aortic arch and percutaneous venous cannulation through the right femoral vein. MVR was performed first, through a standard left atrial access we implanted a pair of artificial chordae tendineae on P2 and a semi-rigid annuloplasty ring, thereafter a modified Bentall operation by implanting a mechanical valved conduit was carried out.
RESULTS: The good result of the procedure is showed by intraoperative transesophageal echocardiography. The operation and hospital stay were uneventful.
CONCLUSIONS: RAT could become the routine approach for valve operations, even when combined with ascending aorta surgery.


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