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Minimally Invasive Surgical Aortic Valve Replacement: the RALT approach
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  • Karel Van Praet,
  • Antonia van Kampen,
  • Markus Kofler,
  • Gregor Richter,
  • Simon Suendermann,
  • Alexander Meyer,
  • Axel Unbehaun,
  • Stephan Kurz,
  • Stephan Jacobs,
  • Volkmar Falk,
  • Jörg Kempfert
Karel Van Praet
German Heart Center Berlin
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Antonia van Kampen
Deutsches Herzzentrum Berlin
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Markus Kofler
Deutsches Herzzentrum Berlin
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Gregor Richter
Deutsches Herzzentrum Berlin
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Simon Suendermann
Charité Universitätsmedizin Berlin
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Alexander Meyer
Deutsches Herzzentrum Berlin
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Axel Unbehaun
Deutsches Herzzentrum Berlin
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Stephan Kurz
Charité Universitätsmedizin Berlin, Charité - Universitätsmedizin Berlin
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Stephan Jacobs
Deutsches Herzzentrum Berlin
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Volkmar Falk
Deutsches Herzzentrum Berlin
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Jörg Kempfert
Deutsches Herzzentrum Berlin
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Abstract

Less invasive techniques for cardiothoracic surgical procedures are designed to limit surgical trauma, but technical requirements and preoperative planning are more demanding than those for conventional sternotomy. Patient selection, interdisciplinary collaboration, and surgical skills are key factors for procedural success. Aortic valve replacement is frequently performed through an upper hemisternotomy, but the right anterior minithoracotomy represents an even less traumatic, technical advancement. Preoperative assessment of the ascending aorta in relation to the sternum is mandatory to select patients and the intercostal access site. This description of the surgical technique focuses on the specific procedural details including the obligatory planning with computed tomography, and our cannulation strategy. We also sought to define the anatomical ascending aorto-sternal relationship, as it is of utmost importance in preoperative computed tomographic planning.

Peer review status:Published

18 May 2020Submitted to Journal of Cardiac Surgery
19 May 2020Submission Checks Completed
19 May 2020Assigned to Editor
19 May 2020Reviewer(s) Assigned
22 May 2020Review(s) Completed, Editorial Evaluation Pending
25 May 2020Editorial Decision: Revise Minor
26 May 20201st Revision Received
30 May 2020Submission Checks Completed
30 May 2020Assigned to Editor
30 May 2020Reviewer(s) Assigned
31 May 2020Review(s) Completed, Editorial Evaluation Pending
31 May 2020Editorial Decision: Accept
09 Jul 2020Published in Journal of Cardiac Surgery. 10.1111/jocs.14756