BACKGROUND: Trans-right axillary aortic valve replacement (TAX-AVR) remains uncommon. We developed a special method to pull the heart closer to the right chest wall to make the surgery as easy and safe as aortic valve replacement via median sternotomy. Because the retraction sutures lifting the ascending aorta and aortic root are arranged circularly around the wound, we named this technique "Stonehenge technique". METHODS: We examined 47 patients who underwent aortic valve replacement through a small right infra-axillary thoracotomy as the initial surgical therapy. These patients were divided into two groups: the conventional TAX-AVR group that underwent AVR via the conventional small right axillary incision approach (n = 20) and the TAX-AVR with SH group that underwent AVR with the Stonehenge technique (n = 27). RESULTS: The aortic cross-clamp and the extracorporeal circulation time were significantly shorter in the TAX-AVR with SH group than in the conventional TAX-AVR group (conventional TAX-AVR group: 125.5 ± 47.9; TAX-AVR with SH group: 96.0 ± 14.0, p = 0.004, and conventional TAX-AVR group: 163.8 ± 55.9; TAX-AVR with SH group: 140.0 ± 16.8, p = 0.04). CONCLUSION: The outcomes of this technique depend on the site of the retraction sutures in the opened pericardium, direction of pull, amount of force applied, and precautions taken. If performed correctly, the ascending aorta and the root can be pulled from the wound to within the surgeon's fingers' reach, thereby reducing aortic cross-clamp and extracorporeal circulation times in group of minimally invasive aortic valve replacement via right infra-axillary thoracotomy.
BACKGROUND: Trans-right axillary aortic valve replacement (TAX-AVR) remains uncommon. We developed a special method to pull the heart closer to the right chest wall to make the surgery as easy and safe as aortic valve replacement via median sternotomy. Because the retraction sutures lifting the ascending aorta and aortic root are arranged circularly around the wound, we named this technique "Stonehenge technique". METHODS: We examined 47 patients who underwent aortic valve replacement through a small right infra-axillary thoracotomy as the initial surgical therapy. These patients were divided into two groups: the conventional TAX-AVR group that underwent AVR via the conventional small right axillary incision approach (n = 20) and the TAX-AVR with SH group that underwent AVR with the Stonehenge technique (n = 27). RESULTS: The aortic cross-clamp and the extracorporeal circulation time were significantly shorter in the TAX-AVR with SH group than in the conventional TAX-AVR group (conventional TAX-AVR group: 125.5 ± 47.9; TAX-AVR with SH group: 96.0 ± 14.0, p = 0.004, and conventional TAX-AVR group: 163.8 ± 55.9; TAX-AVR with SH group: 140.0 ± 16.8, p = 0.04). CONCLUSION: The outcomes of this technique depend on the site of the retraction sutures in the opened pericardium, direction of pull, amount of force applied, and precautions taken. If performed correctly, the ascending aorta and the root can be pulled from the wound to within the surgeon's fingers' reach, thereby reducing aortic cross-clamp and extracorporeal circulation times in group of minimally invasive aortic valve replacement via right infra-axillary thoracotomy.
Authors: Siavash Saadat; Molly Schultheis; Anthony Azzolini; Joseph Romero; Victor Dombrovskiy; Karen Odroniec; Peter Scholz; Anthony Lemaire; George Batsides; Leonard Lee Journal: Perfusion Date: 2015-06-01 Impact factor: 1.972
Authors: Nobuyuki Furukawa; Oliver Kuss; Eric Emmel; Smita Scholtz; Werner Scholtz; Buntaro Fujita; Stephan Ensminger; Jan F Gummert; Jochen Börgermann Journal: J Thorac Cardiovasc Surg Date: 2018-05-05 Impact factor: 5.209
Authors: Andreas Beckmann; Anne-Katrin Funkat; Jana Lewandowski; Michael Frie; Markus Ernst; Khosro Hekmat; Wolfgang Schiller; Jan F Gummert; Armin Welz Journal: Thorac Cardiovasc Surg Date: 2016-09-01 Impact factor: 1.827
Authors: Mattia Glauber; Simon C Moten; Eugenio Quaini; Marco Solinas; Thierry A Folliguet; Bart Meuris; Antonio Miceli; Peter J Oberwalder; Manfredo Rambaldini; Kevin H T Teoh; Gopal Bhatnagar; Michael A Borger; Denis Bouchard; Olivier Bouchot; Stephen C Clark; Otto E Dapunt; Matteo Ferrarini; Theodor J M Fischlein; Guenther Laufer; Carmelo Mignosa; Russell Millner; Philippe Noirhomme; Steffen Pfeiffer; Xavier Ruyra-Baliarda; Malakh Lal Shrestha; Rakesh M Suri; Giovanni Troise; Borut Gersak Journal: Innovations (Phila) Date: 2016 May-Jun