Thorac Cardiovasc Surg 2021; 69(05): 461-465
DOI: 10.1055/s-0040-1713137
How to Do It

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

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.



Publication History

Received: 30 January 2020

Accepted: 20 April 2020

Article published online:
19 October 2020

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