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, 鲍春荣, 张俊文, 等. 右胸前外侧小切口微创主动脉瓣置换的倾向评分匹配研究. 中国心血管病研究, 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.	季强, 王毓琳, 李军, 等. 右前胸第二肋间小切口升主动脉手术的单中心分析. 中国胸心血管外科临床杂志, 2021, 28(2): 202-207.
7.	魏来, 陈楠, 杨晔, 等. 2019年度中国微创心血管外科手术统计. 中国胸心血管外科临床杂志, 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.	李虔桢, 谢先标, 方冠华, 等. 胸骨上段小切口在急性Stanford A型主动脉夹层中的应用. 中华胸心血管外科杂志, 2021, 37(4): 224-226.
10.	陈磊, 李东, 姜伟, 等. 经胸骨上段小切口主动脉手术. 中华胸心血管外科杂志, 2021, 37(1): 10-13.
11.	张永会, 姜胜利, 张林, 等. 右胸肋间、胸骨上段与胸骨正中切口主动脉瓣置换术比较. 中华胸心血管外科杂志, 2019, 35(2): 94-98.
12.	高阳, 乔衍礼, 陈庆伟, 等. 经右侧胸骨旁第3肋间小切口与传统正中开胸行二尖瓣置换的对比研究. 中国胸心血管外科临床杂志, 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, Färber 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, 鲍春荣, 张俊文, 等. 右胸前外侧小切口微创主动脉瓣置换的倾向评分匹配研究. 中国心血管病研究, 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. 季强, 王毓琳, 李军, 等. 右前胸第二肋间小切口升主动脉手术的单中心分析. 中国胸心血管外科临床杂志, 2021, 28(2): 202-207.
7. 魏来, 陈楠, 杨晔, 等. 2019年度中国微创心血管外科手术统计. 中国胸心血管外科临床杂志, 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. 李虔桢, 谢先标, 方冠华, 等. 胸骨上段小切口在急性Stanford A型主动脉夹层中的应用. 中华胸心血管外科杂志, 2021, 37(4): 224-226.
10. 陈磊, 李东, 姜伟, 等. 经胸骨上段小切口主动脉手术. 中华胸心血管外科杂志, 2021, 37(1): 10-13.
11. 张永会, 姜胜利, 张林, 等. 右胸肋间、胸骨上段与胸骨正中切口主动脉瓣置换术比较. 中华胸心血管外科杂志, 2019, 35(2): 94-98.
12. 高阳, 乔衍礼, 陈庆伟, 等. 经右侧胸骨旁第3肋间小切口与传统正中开胸行二尖瓣置换的对比研究. 中国胸心血管外科临床杂志, 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, Färber 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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