Minimally Invasive Access Aortic Arch Surgery

Goebel, Nora; Bonte, Daniel; Salehi-Gilani, Schahriar; Nagib, Ragi; Ursulescu, Adrian; Franke, Ulrich

doi:10.1177/155698451701200507

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…In 2001, Svensson et al [12] evaluated 54 patients undergoing minimally invasive valve surgery; of these, 36 patients underwent ascending aorta replacement, of whom 18 underwent aortic arch repair through a mini-sternotomy. In 2017, Goebel et al [13] reported the outcomes of 21 patients who underwent non-emergency total aortic arch surgery through an upper mini-sternotomy. These patients' results were equivalent to those of patients who underwent the standard procedure in terms of both safety and the risk of major adverse cardiac and cerebrovascular events.…”

Section: Discussionmentioning

confidence: 99%

Surgery of ascending aorta with complex procedures for aortic dissection through upper mini-sternotomy versus conventional sternotomy

Jiang

Liu

et al. 2020

J Cardiothorac Surg

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Background: Use of minimally invasive approaches for isolated aortic valve or ascending aorta surgery is increasing. However, total arch replacement or aortic root repair through a minimally invasive incision is rare. This study was performed to report our initial experience with surgery of the ascending aorta with complex procedures through an upper mini-sternotomy approach. Methods: We retrospectively analyzed 80 patients who underwent ascending aorta replacement combined with complex procedures including hemi-arch, total arch, and aortic root surgeries from September 2010 to May 2018. Using standard propensity score-matching analysis, 36 patients were matched and divided into 2 groups: the upper mini-sternotomy group (n = 18) and the median sternotomy group (n = 18). The preoperative assessment revealed no statistically significant differences between the two groups. Results: Hospital mortality occurred in one patient (2.8%). The mini-sternotomy group showed a longer crossclamping time (160 ± 38 vs. 135 ± 36 min, p = 0.048) due to higher rate of valve-sparing aortic root replacement and total arch repair. The cardiopulmonary bypass time in mini-sternotomy group was shorter than that of full sternotomy group (209 ± 47 min vs 218 ± 62 min, p = 0.595) but fell short of significance. There was no significant difference in lower body hypothermia circulatory arrest time between the two groups (40 ± 10 min vs 48 ± 20 min, p = 0.139). The upper mini-sternotomy group displayed a shorter ventilation time (22 vs. 45 h, p = 0.014), intensive care unit stay (4.6 ± 2.7 vs. 7.9 ± 3.7 days, p = 0.005), and hospital stay (8.2 ± 3.8 vs. 21.4 ± 11.9 days, p = 0.001). The upper mini-sternotomy group showed a lower postoperative red blood cell transfusion volume (4.6 ± 3.3 vs. 6.7 ± 5.7 units, p = 0.042) and postoperative drainage volume (764 ± 549 vs. 1255 ± 745 ml, p = 0.034). The rates of dialysis for newly occurring renal failure, neurological complications, and re-exploration were similar between the two groups (p = 1.000). Conclusion: The upper mini-sternotomy approach is safe and beneficial in ascending aorta surgery with complex procedures for aortic dissection, including total arch replacement and aortic root repair.

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Section: Discussionmentioning

confidence: 99%

Surgery of ascending aorta with complex procedures for aortic dissection through upper mini-sternotomy versus conventional sternotomy

Jiang

Liu

et al. 2020

J Cardiothorac Surg

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“…Iba et al reported no early deaths, permanent neurological deficits, or spinal cord injuries; a 5% intraoperative conversion rate to full sternotomy due to bleeding; and a 14% rate of re-exploration due to bleeding [108]. Following this line, Goebel et al reported no conversions to MS during the initial surgery, a 9.5% rate of rethoracotomy due to bleeding, no permanent strokes, and in-hospital mortality of 4.8% [109]. Even though minimally invasive aortic surgery still lacks a large study series and long-term follow-up, the existing studies suggest that MIAS could be performed safely and with superior early results compared to aortic surgery via MS.…”

Section: Minimally Invasive Aortic Surgery (Mias)mentioning

confidence: 96%

“…After five years, the survival rate was estimated at 80%, and the freedom from reoperation was 96% [107]. Two smaller series on this topic were published by Iba et al (22 patients) and Goebel et al (21 patients) [108,109]. Iba et al reported no early deaths, permanent neurological deficits, or spinal cord injuries; a 5% intraoperative conversion rate to full sternotomy due to bleeding; and a 14% rate of re-exploration due to bleeding [108].…”

Section: Minimally Invasive Aortic Surgery (Mias)mentioning

confidence: 99%

Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

Ilcheva,

Risteski,

Tudorache

et al. 2023

JCM

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Over the past two decades, minimally invasive cardiac surgery (MICS) has gained a significant place due to the emergence of innovative tools and improvements in surgical techniques, offering comparable efficacy and safety to traditional surgical methods. This review provides an overview of the history of MICS, its current state, and its prospects and highlights its advantages and limitations. Additionally, we highlight the growing trends and potential pathways for the expansion of MICS, underscoring the crucial role of technological advancements in shaping the future of this field. Recognizing the challenges, we strive to pave the way for further breakthroughs in minimally invasive cardiac procedures.

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Minimally Invasive Access Aortic Arch Surgery

Cited by 2 publications

References 13 publications

Surgery of ascending aorta with complex procedures for aortic dissection through upper mini-sternotomy versus conventional sternotomy

Surgery of ascending aorta with complex procedures for aortic dissection through upper mini-sternotomy versus conventional sternotomy

Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

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