Minimal access aortic valve replacement via limited skin incision and complete median sternotomy

Shahzad G. Raja, Umberto Benedetto


Surgical aortic valve replacement (AVR) via complete median sternotomy is a safe and time-tested technique associated with excellent short- and long-term outcome. Over the last two decades, different minimally-invasive approaches for AVR have been developed and are increasingly being utilized. All these approaches have been developed with the main objective of decreased invasiveness and less surgical trauma. Advantages of minimal invasive AVR have been shown as better cosmesis, shorter ventilation time, decreased blood loss, shorter intensive care unit and hospital length of stay, and less postoperative pain with mortality and morbidity comparable to conventional complete median sternotomy. One well-recognized but less practiced surgical technique for surgical AVR is the complete median sternotomy via limited skin incision. This review article provides a detailed insight into the technical aspects, outcomes, advantages and disadvantages associated with minimal access AVR via limited skin incision and complete median sternotomy.