Bentall procedure through the right anterior mini-incision: A clinical analysis in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GUO Fengwei , JIANG Yi , HAO Junjun , ZHONG Liang , LI Jing , LI Yongxin ,  YAN Yang

Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China;

Corresponding?author：

YAN Yang, Email: yyang376@126.com

Keywords：

Right anterior mini-incision; Bentall surgery; minimally invasive cardiac surgery

DOI：

10.7507/1007-4848.202110052

Video：

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Objective To summarize the effectiveness of Bentall procedure through the right anterior mini-incision. Methods The clinical data of patients who underwent Bentall via right anterior mini-incision from September 2020 to September 2021 in the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed. Results A total of 14 males with an average age of 55.1±9.3 years and body mass index of 24.7±2.8 kg/m² were enrolled. The cardiopulmonary bypass (CPB) time was 185.6±32.9 min, the aortic cross-clamping (ACC) time was 144.8±30.3 min, the ventilation time was 18.1±13.5 h, the time in the intensive care unit was 3.7±1.8 d, and the hospital stay time was 13.4±1.6 d. Postoperative complications occurred in 5 patients: 3 patients of pleural effusion, 1 patient of pericardial effusion and 1 patient of postoperative bleeding with secondary thoracotomy hemostasis. The median follow-up time was 4 (2, 6) months. There was no mortality in the hospital or during the follow-up. As for the learning curve, the ACC time, CPB time and operation time were significantly shortened after four cases (P<0.05). Conclusion The right anterior mini-incision for Bentall operation is safe and effective, and has clinical value.

Citation： GUO Fengwei, JIANG Yi, HAO Junjun, ZHONG Liang, LI Jing, LI Yongxin, YAN Yang. Bentall procedure through the right anterior mini-incision: A clinical analysis in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(9): 1295-1300. doi: 10.7507/1007-4848.202110052 Copy

1.	Tamagnini G, Biondi R, Giglio MD. Aortic valve replacement via right anterior mini-thoracotomy: The conventional procedure performed through a smaller incision. Braz J Cardiovasc Surg, 2021, 36(1): 120-124.
2.	朱家全, 鮑春榮, 張俊文, 等. 右胸前外側小切口微創主動脈瓣置換的傾向評分匹配研究. 中國心血管病研究, 2018, 16(4): 353-357.
3.	Shah VN, Kilcoyne MF, Buckley M, et al. The mini-Bentall approach: Comparison with full sternotomy. JTCVS Tech, 2021, 7: 59-66.
4.	Abjigitova D, Panagopoulos G, Orlov O, et al. Current trends in aortic root surgery: The mini-Bentall approach. Innovations (Phila), 2018, 13(2): 91-96.
5.	Johnson CA, Siordia JA, Wood KL, et al. Right mini-thoracotomy Bentall procedure. Innovations (Phila), 2018, 13(5): 328-331.
6.	季強, 王毓琳, 李軍, 等. 右前胸第二肋間小切口升主動脈手術的單中心分析. 中國胸心血管外科臨床雜志, 2021, 28(2): 202-207.
7.	魏來, 陳楠, 楊曄, 等. 2019年度中國微創心血管外科手術統計. 中國胸心血管外科臨床雜志, 2021, 28(2): 149-153.
8.	Di Eusanio M, Cefarelli M, Zingaro C, et al. Mini Bentall operation: Technical considerations. Indian J Thorac Cardiovasc Surg, 2019, 35(Suppl 2): 87-91.
9.	李虔楨, 謝先標, 方冠華, 等. 胸骨上段小切口在急性Stanford A型主動脈夾層中的應用. 中華胸心血管外科雜志, 2021, 37(4): 224-226.
10.	陳磊, 李東, 姜偉, 等. 經胸骨上段小切口主動脈手術. 中華胸心血管外科雜志, 2021, 37(1): 10-13.
11.	張永會, 姜勝利, 張林, 等. 右胸肋間、胸骨上段與胸骨正中切口主動脈瓣置換術比較. 中華胸心血管外科雜志, 2019, 35(2): 94-98.
12.	高陽, 喬衍禮, 陳慶偉, 等. 經右側胸骨旁第3肋間小切口與傳統正中開胸行二尖瓣置換的對比研究. 中國胸心血管外科臨床雜志, 2019, 26(12): 1204-1207.
13.	Johnson CA, Siordia JA, Robinson DA, et al. Right mini-thoracotomy Bentall with traditional and automated suturing devices. Multimed Man Cardiothorac Surg, 2018.
14.	Tkebuchava S, F?rber G, Sponholz C, et al. Minimally-invasive parasternal aortic valve replacement—A slow learning curve towards improved outcomes. J Card Surg, 2020, 35(3): 544-548.
15.	Ma M, Abdulkadir M, Li Y, et al. A modified wrapping-internal shunt method for hemostasis in Bentall procedure. Med Arch, 2016, 70(4): 321-323.

1. Tamagnini G, Biondi R, Giglio MD. Aortic valve replacement via right anterior mini-thoracotomy: The conventional procedure performed through a smaller incision. Braz J Cardiovasc Surg, 2021, 36(1): 120-124.
2. 朱家全, 鮑春榮, 張俊文, 等. 右胸前外側小切口微創主動脈瓣置換的傾向評分匹配研究. 中國心血管病研究, 2018, 16(4): 353-357.
3. Shah VN, Kilcoyne MF, Buckley M, et al. The mini-Bentall approach: Comparison with full sternotomy. JTCVS Tech, 2021, 7: 59-66.
4. Abjigitova D, Panagopoulos G, Orlov O, et al. Current trends in aortic root surgery: The mini-Bentall approach. Innovations (Phila), 2018, 13(2): 91-96.
5. Johnson CA, Siordia JA, Wood KL, et al. Right mini-thoracotomy Bentall procedure. Innovations (Phila), 2018, 13(5): 328-331.
6. 季強, 王毓琳, 李軍, 等. 右前胸第二肋間小切口升主動脈手術的單中心分析. 中國胸心血管外科臨床雜志, 2021, 28(2): 202-207.
7. 魏來, 陳楠, 楊曄, 等. 2019年度中國微創心血管外科手術統計. 中國胸心血管外科臨床雜志, 2021, 28(2): 149-153.
8. Di Eusanio M, Cefarelli M, Zingaro C, et al. Mini Bentall operation: Technical considerations. Indian J Thorac Cardiovasc Surg, 2019, 35(Suppl 2): 87-91.
9. 李虔楨, 謝先標, 方冠華, 等. 胸骨上段小切口在急性Stanford A型主動脈夾層中的應用. 中華胸心血管外科雜志, 2021, 37(4): 224-226.
10. 陳磊, 李東, 姜偉, 等. 經胸骨上段小切口主動脈手術. 中華胸心血管外科雜志, 2021, 37(1): 10-13.
11. 張永會, 姜勝利, 張林, 等. 右胸肋間、胸骨上段與胸骨正中切口主動脈瓣置換術比較. 中華胸心血管外科雜志, 2019, 35(2): 94-98.
12. 高陽, 喬衍禮, 陳慶偉, 等. 經右側胸骨旁第3肋間小切口與傳統正中開胸行二尖瓣置換的對比研究. 中國胸心血管外科臨床雜志, 2019, 26(12): 1204-1207.
13. Johnson CA, Siordia JA, Robinson DA, et al. Right mini-thoracotomy Bentall with traditional and automated suturing devices. Multimed Man Cardiothorac Surg, 2018.
14. Tkebuchava S, F?rber G, Sponholz C, et al. Minimally-invasive parasternal aortic valve replacement—A slow learning curve towards improved outcomes. J Card Surg, 2020, 35(3): 544-548.
15. Ma M, Abdulkadir M, Li Y, et al. A modified wrapping-internal shunt method for hemostasis in Bentall procedure. Med Arch, 2016, 70(4): 321-323.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Bentall procedure through the right anterior mini-incision: A clinical analysis in a single center

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