In this video, the authors describe their endoscopic technique to perform a minimally invasive ascending aorta replacement. Cardiopulmonary bypass was achieved through the femoral artery and femoral venous cannulation. The working port was a 3-4 cm anterior mini-right thoracotomy in the second right intercostal space. Three additional 5 mm mini-ports were needed for the introduction of the vent line in the fourth intercostal space, a 30° thoracoscope in the second intercostal space, and the Chitwood clamp in the first intercostal space. A previous high experience in endoscopic surgery is mandatory to approach the ascending aorta surgery using this approach.
Suggested Reading
Cresce GD, Sella M, Hinna Danesi T, Favaro A, Salvador L. Minimally invasive endoscopic aortic valve replacement: Operative Results. Semin Thorac Cardiovasc Surg. 2020 Autumn;32(3):416-423.
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I think you would better excise more proximal part of ascending aorta .
MICS is definitely very good option, but its role has to be limited for safety and
perfect procedure.
I don’t agree with this approach for aortic procedure.
I agree — looks like a lot of aneurysm above STJ left behind.