Minimally Invasive Approach to Aortic Root Surgery: History, State-Of-The-Art and Future Perspectives
Abstract
Over the past decade, minimally invasive procedures including partial upper mini-sternotomy and right mini-thoracotomy have become the «gold standard» for isolated aortic valve replacement. However, minimally invasive approach is not routinely performed in aortic root surgery, and median sternotomy remains the incision of choice. The review is aimed at assessing and commenting on the surgical techniques and the current evidence on minimally invasive aortic root surgery with a particular focus to their evolution, and future perspectives. The literature search was carried out in international databases - Medline, Google Scholar and the Cochrane Library, as well as in the domestic source - «eLibrary.Ru - Russian scientific electronic library».
Recent studies have shown promising clinical results of minimally invasive aortic root surgerycomparable to median sternotomy in terms of safety and efficacy. Minimally invasive approaches are associated with low blood loss, quicker healing, a reduced risk of infectious complications, and superior cosmetic results. However, the reported studies have a low level of evidence. Randomized clinical trials with a long-term follow-up are required to validate these results and motivate the surgeons to routinely apply minimally invasive procedures to the majority of patients requiring intervention on the aortic root.
About the Authors
A. V. Karadzha
E.N. Meshalkin National Medical Research Centre
Russian Federation
Russian Federation
Karadzha Anastasia V., M.D., research assistant, at the Department of Novel Surgical Technologies
15, Rechkunovskaya St., Novosibirsk, 630055
R. M. Sharifulin
E.N. Meshalkin National Medical Research Centre
Russian Federation
Russian Federation
Sharifulin Ravil M., M.D., Ph.D., cardiovascular surgeon at the Department of Acquired Heart Diseases
15, Rechkunovskaya St., Novosibirsk, 630055
A. V. Bogachev-Prokophiev
E.N. Meshalkin National Medical Research Centre
Russian Federation
Russian Federation
Bogachev-Prokofiev Alexander V., M.D., Ph.D., Director of the Institute of Circulatory Pathology
15, Rechkunovskaya St., Novosibirsk, 630055
A. M. Chernyavskiy
E.N. Meshalkin National Medical Research Centre
Russian Federation
Russian Federation
Chernyavsky Alexander M., M.D., Ph.D., Prof., Corresponding Member of the Russian Academy of Sciences, Director General
15, Rechkunovskaya St., Novosibirsk, 630055
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Karadzha A.V., Sharifulin R.M., Bogachev-Prokophiev A.V., Chernyavskiy A.M. Minimally Invasive Approach to Aortic Root Surgery: History, State-Of-The-Art and Future Perspectives. Minimally Invasive Cardiovascular Surgery. 2022;(1):63-77. (In Russ.)
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