Thorac Cardiovasc Surg
DOI: 10.1055/s-0040-1713137
How to Do It
Georg Thieme Verlag KG Stuttgart · New York

Surgery without Scars: Right Lateral Access for Minimally Invasive Aortic Valve Replacement

Manuel Wilbring
1  Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
Klaus Ehrhard Matschke
1  Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
Konstantin Alexiou
1  Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
Marco Di Eusanio
2  Department of Cardiac Surgery, Polytechnic University of Marche, Ospedale Riuniti, Ancona, Italy
,
Utz Kappert
1  Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
› Author Affiliations
Further Information

Publication History

30 January 2020

20 April 2020

Publication Date:
19 October 2020 (online)

Abstract

As part of an institutionally driven holistic concept, named the “360-degree approach,” all established surgical access routes —full sternotomy, partial upper sternotomy, and right anterolateral thoracotomy using the second interspace—are supported. The surgical toolbox now is completed by adding a further approach: through a 5- to7-cm skin incision in the right anterior axillary line, the third interspace is used for a minimally invasive aortic valve surgery providing striking exposition of the aortic valve and resulting in superior cosmetics with nearly no visible scars. The choice for the one or other method is institutionally driven and based on risk profiles, as well as anatomical and physiognomic considerations.