Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques
Minimally invasive techniques have gained immense importance in cardiovascular surgery. While minimal access strategies for coronary and mitral valve surgery are already widely accepted and often used as standard approaches, the application of minimally invasive techniques is currently expanded towa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/9/1618 |
| _version_ | 1797578910412570624 |
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| author | Florian Helms Bastian Schmack Alexander Weymann Jasmin Sarah Hanke Ruslan Natanov Andreas Martens Arjang Ruhparwar Aron-Frederik Popov |
| author_facet | Florian Helms Bastian Schmack Alexander Weymann Jasmin Sarah Hanke Ruslan Natanov Andreas Martens Arjang Ruhparwar Aron-Frederik Popov |
| author_sort | Florian Helms |
| collection | DOAJ |
| description | Minimally invasive techniques have gained immense importance in cardiovascular surgery. While minimal access strategies for coronary and mitral valve surgery are already widely accepted and often used as standard approaches, the application of minimally invasive techniques is currently expanded towards more complex operations of the ascending aorta as well. In this new and developing field, various techniques have been established and reported ranging from upper hemisternotomy approaches, which allow even extensive operations of the ascending aorta to be performed through a minimally invasive access to sternal sparing thoracotomy strategies, which completely avoid sternal trauma during ascending aorta replacements. All of these techniques place high demands on patient selection, preoperative planning, and practical surgical implementation. Application of these strategies is currently limited to high-volume centers and highly experienced surgeons. This narrative review gives an overview of the currently available techniques with a special focus on the practical execution as well as the advantages and disadvantages of the currently available techniques. The first results demonstrate the practicability and safety of minimally invasive techniques for replacement of the ascending aorta in a well-selected patient population. With success and complication rates comparable to classic full sternotomy, the proof of concept for minimally invasive replacement of the ascending aorta is now achieved. |
| first_indexed | 2024-03-10T22:29:24Z |
| format | Article |
| id | doaj.art-d010d240cd8a4804b941c933fa0f2319 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T22:29:24Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-d010d240cd8a4804b941c933fa0f23192023-11-19T11:52:30ZengMDPI AGMedicina1010-660X1648-91442023-09-01599161810.3390/medicina59091618Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available TechniquesFlorian Helms0Bastian Schmack1Alexander Weymann2Jasmin Sarah Hanke3Ruslan Natanov4Andreas Martens5Arjang Ruhparwar6Aron-Frederik Popov7Division for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDivision for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyMinimally invasive techniques have gained immense importance in cardiovascular surgery. While minimal access strategies for coronary and mitral valve surgery are already widely accepted and often used as standard approaches, the application of minimally invasive techniques is currently expanded towards more complex operations of the ascending aorta as well. In this new and developing field, various techniques have been established and reported ranging from upper hemisternotomy approaches, which allow even extensive operations of the ascending aorta to be performed through a minimally invasive access to sternal sparing thoracotomy strategies, which completely avoid sternal trauma during ascending aorta replacements. All of these techniques place high demands on patient selection, preoperative planning, and practical surgical implementation. Application of these strategies is currently limited to high-volume centers and highly experienced surgeons. This narrative review gives an overview of the currently available techniques with a special focus on the practical execution as well as the advantages and disadvantages of the currently available techniques. The first results demonstrate the practicability and safety of minimally invasive techniques for replacement of the ascending aorta in a well-selected patient population. With success and complication rates comparable to classic full sternotomy, the proof of concept for minimally invasive replacement of the ascending aorta is now achieved.https://www.mdpi.com/1648-9144/59/9/1618minimally invasive surgeryaortic surgeryascending aorta |
| spellingShingle | Florian Helms Bastian Schmack Alexander Weymann Jasmin Sarah Hanke Ruslan Natanov Andreas Martens Arjang Ruhparwar Aron-Frederik Popov Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques Medicina minimally invasive surgery aortic surgery ascending aorta |
| title | Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques |
| title_full | Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques |
| title_fullStr | Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques |
| title_full_unstemmed | Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques |
| title_short | Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques |
| title_sort | expanding the minimally invasive approach towards the ascending aorta a practical overview of the currently available techniques |
| topic | minimally invasive surgery aortic surgery ascending aorta |
| url | https://www.mdpi.com/1648-9144/59/9/1618 |
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