Q: Mini-sternotomy AVR with Ascending Aortic Aneurysms?

[skeptic49]

Adam Pick has an interesting interview with Dr. Jai Raman of the University of Chicago posted on his blog today. Raman does most of his valve surgery via minimally invasive incisions.

Dr. Jai Raman: Through an upper mini-sternotomy, I have performed:

1.Complex aortic root reconstructions – using a valved conduit (both mechanical and tissue valves)
2.Valve sparing aortic root reconstructions (modified David procedure)
3.Redo aortic valve replacements
4.Redo aortic root reconstructions
5.Redo pulmonary valve replacements

Raman doesn't mention ascending aortic aneurysms in his interview. I asume that this is an exclusion...at least I have noted that other surgeons list an ascending aortic aneurysm as an exclusion for MICS. But he does "root reconstruction with a valved conduit"...which seems similar.

Can anyone shed any light on this?

Jim

 

[skeptic49]

Got An Answe - Good News!

Got An Answe - Good News!

Adam Pick has posted the transcript of a live chat session with Dr. Eric Roselli of the Cleveland Clinic. I sent in a question about whether aortic surgery can be done with minimally invasive techniques. Here is his answer:

Jim_K: Is a dilated ascending aorta (4.5 cm) a contraindication for AVR via minimally
invasive techniques?
Dr__Eric_Roselli: No. Not at all. Other surgeons and I who perform a lot of minimally
invasive aortic valve surgery will also perform more complicated operations involving
the aortic root, the ascending aorta, the aortic arch and the mitral or tricuspid valve
procedures all at the same time using minimally invasive techniques.

The entire transcript is very interesting and can be downloaded in PDF format from Pick's web site.

 

[Ross]

That's interesting. Too bad they didn't do those things 15 years ago. Might not have had such a hard time with my dissection, but they'd of probably had to do a full opening for that anyway.