Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Helms, Florian, Schmack, Bastian, Weymann, Alexander, Hanke, Jasmin Sarah, Natanov, Ruslan, Martens, Andreas, Ruhparwar, Arjang, Popov, Aron-Frederik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10534602/
https://www.ncbi.nlm.nih.gov/pubmed/37763737
http://dx.doi.org/10.3390/medicina59091618
_version_ 1785112433189191680
author Helms, Florian
Schmack, Bastian
Weymann, Alexander
Hanke, Jasmin Sarah
Natanov, Ruslan
Martens, Andreas
Ruhparwar, Arjang
Popov, Aron-Frederik
author_facet Helms, Florian
Schmack, Bastian
Weymann, Alexander
Hanke, Jasmin Sarah
Natanov, Ruslan
Martens, Andreas
Ruhparwar, Arjang
Popov, Aron-Frederik
author_sort Helms, Florian
collection PubMed
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.
format Online
Article
Text
id pubmed-10534602
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-105346022023-09-29 Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques Helms, Florian Schmack, Bastian Weymann, Alexander Hanke, Jasmin Sarah Natanov, Ruslan Martens, Andreas Ruhparwar, Arjang Popov, Aron-Frederik Medicina (Kaunas) Review 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. MDPI 2023-09-07 /pmc/articles/PMC10534602/ /pubmed/37763737 http://dx.doi.org/10.3390/medicina59091618 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Helms, Florian
Schmack, Bastian
Weymann, Alexander
Hanke, Jasmin Sarah
Natanov, Ruslan
Martens, Andreas
Ruhparwar, Arjang
Popov, Aron-Frederik
Expanding the Minimally Invasive Approach towards the Ascending Aorta—A Practical Overview of the Currently Available Techniques
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 Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10534602/
https://www.ncbi.nlm.nih.gov/pubmed/37763737
http://dx.doi.org/10.3390/medicina59091618
work_keys_str_mv AT helmsflorian expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT schmackbastian expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT weymannalexander expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT hankejasminsarah expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT natanovruslan expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT martensandreas expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT ruhparwararjang expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques
AT popovaronfrederik expandingtheminimallyinvasiveapproachtowardstheascendingaortaapracticaloverviewofthecurrentlyavailabletechniques