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J Chest Surg

Published online May 12, 2021

Copyright © Journal of Chest Surgery.

Suspending Commissural Sutures for Aortic Valve Exposure in Minithoracotomy Aortic Valve Replacement

Eunji Kim , M.D., Joon Bum Kim , M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to:Joon Bum Kim
Tel 82-2-3010-3580
Fax 82-2-3010-6966
E-mail jbkim1975@amc.seoul.kr
ORCID
https://orcid.org/0000-0001-5801-2395

Received: February 8, 2021; Revised: April 1, 2021; Accepted: April 23, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although it is attractive, a limitation of aortic valve (AV) replacement (AVR) through a mini-thoracotomy approach (mini-AVR) is the limited exposure of the AV. Here, we present a simple exposure technique named “suspending commissural sutures” for a more efficient mini-AVR. The technique involves making 3 half-depth stitches with 1-0 silk at each of the commissures, which are anchored to each corresponding pericardial surface. These stitches are tightened up so that the aortic root is axially expanded and is pulled upward. The technique of suspending commissural stitches seems to offer reasonable exposure of the AV in mini-AVR, and shows excellent early surgical outcomes.

Keywords: Aortic valve replacement, Aortic valve exposure, Minimally invasive surgery

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J Chest Surg

Published online May 12, 2021

Copyright © Journal of Chest Surgery.

Suspending Commissural Sutures for Aortic Valve Exposure in Minithoracotomy Aortic Valve Replacement

Eunji Kim , M.D., Joon Bum Kim , M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to:Joon Bum Kim
Tel 82-2-3010-3580
Fax 82-2-3010-6966
E-mail jbkim1975@amc.seoul.kr
ORCID
https://orcid.org/0000-0001-5801-2395

Received: February 8, 2021; Revised: April 1, 2021; Accepted: April 23, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although it is attractive, a limitation of aortic valve (AV) replacement (AVR) through a mini-thoracotomy approach (mini-AVR) is the limited exposure of the AV. Here, we present a simple exposure technique named “suspending commissural sutures” for a more efficient mini-AVR. The technique involves making 3 half-depth stitches with 1-0 silk at each of the commissures, which are anchored to each corresponding pericardial surface. These stitches are tightened up so that the aortic root is axially expanded and is pulled upward. The technique of suspending commissural stitches seems to offer reasonable exposure of the AV in mini-AVR, and shows excellent early surgical outcomes.

Keywords: Aortic valve replacement, Aortic valve exposure, Minimally invasive surgery

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