ISMICS - Minimally Invasive Surgery For Concomitantascending Aorta And Aortic Valve Replacement Via Right Infra-axillary Thoracotomy

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Minimally Invasive Surgery For Concomitantascending Aorta And Aortic Valve Replacement Via Right Infra-axillary Thoracotomy
Yong Cui, Shuwei Wang, Chentao Luo;
Zhejiang Provincial People's Hospital, Hangzhou, China

BACKGROUND: This study evaluates the safety, efficacy, and aesthetic outcomes of a novel 4-5cm right infra-axillary incision for concomitant ascending aorta and aortic valve replacement (AAR and AVR), focusing on sparing the sternum and reducing surgical surgical trauma.
METHODS: A retrospective analysis was conducted on elective AAR and AVR procedures at our center from July 2021 to March 2023. Excluded were cases involving emergency surgery, acute type A aortic dissection, active endocarditis, redo cardiac surgeries, concurrent mitral valve replacements, or left ventricular assist device implantations. Perioperative data were collected and analyzed.
RESULTS: The cohort included 24 patients. Average cardiopulmonary bypass and aortic cross-clamp times were 215.0 � 38.0 and 158.0 � 37.0 minutes, respectively. There were no reoperations for postoperative bleeding or permanent pacemaker implantations. Average initial 24-hour postoperative drainage was 186.9 � 76.9 ml. The mean follow-up period was 14.5 � 5.3 months, with no valve dysfunctions, paravalvular leaks, cardiovascular readmissions, or mortalities reported.
CONCLUSIONS:The right infra-axillary approach for commit t AAR and AVR is safe, effective, and aesthetically favorable. Further research is needed to substantiate these findings.

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