A simpler minimal

Abstract

et al 1 recently published the interesting "RALT approach" for minimally invasive aortic valve replacement.

Aortic Valve replacement via Right Anterior mini-Thoracotomy: a simpler minimal

“…The second or third intercostal space is opened through a 5-cm skin incision, paying attention to preserve the right mammary artery and avoiding any rib damage. We do not perform routinely a CT-scan to plan the operation: the chest X-ray and the aortography during the coronary artery catheterization, in our experience, are reliable to highlight the presence of worrisome aortic calcification or unusual anatomic variants; on the other hand, we do recognize the value of a pre-operative CT-scan when starting a MiAVR program: in the first cases, that allows to rule out patients who are more demanding in terms of surgical skills [5]. The correct site to carry out the thoracotomy is identified looking for position of the angle of Louis and, from there, that of the third rib: we perform a 5 cm long incision along its edge, starting at a distance of 5 cm from the jugular-xiphoid line (Fig.…”