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Current Trends in Cardiology | Volume: 03
10th WORLD HEART CONGRESS
&
6 th International Congress on
CARDIOLOGY AND CARDIAC SURGERY
December 02-03, Dubai, UAE
Joint event on
Curr Trend Cardiol, Volume: 03
Minimal Access Aortic Arch Surgery
Risteski P 1, Razan Salem1, Medhad Radwan1, Thomas Walther1, Giampiero Esposito2
1 University Hospital Frankfurt, Germany
2 Mater Dei Hospital C. B. H., Italy
Introduction and Aim: Reports of minimal access aortic arch
surgery are scarce. We review our experience with minimally
invasive aortic arch surgery performed through an upper
mini-sternotomy, with emphasis on details of operative
technique, early and late outcomes.
Material and Methods : The medical records of 123 adult
patients (mean age 66±12 years) who underwent minimal
access aortic arch surgery in two aortic referral centers were
reviewed. Most common indication was degenerative aortic
arch aneurysm in 92 (75%) patients. Standard operative
and organ protection techniques were used in all patients
and included an upper mini-sternotomy, uninterrupted
antegrade cerebral perfusion and moderate systemic
hypothermia (27.4±1°C).
Results : A partial aortic arch replacement was performed in
68 (55%) patients; the rest 55 (45%) patients received total
arch replacement, further extended with either a frozen
elephant trunk in 43 (35%) patients, or a conventional
elephant trunk procedure in 9 (7%) patients. No conversion
to full sternotomy and no wound dehiscence were observed.
New permanent renal failure occurred in 1 (0.8%) patient,
stroke in 2 (1.6%) and spinal cord injury in 4 (3.3%) patients.
Early mortality was observed in 4 (3.3%) patients. Survival
was 91 ± 6 % at 4 years and freedom from reoperations was
96 ± 3 % at 4 years.
Conclusion: Minimally invasive aortic arch repair through an
upper mini-sternotomy can be performed safely, with early
outcomes well comparable to series performed through a
standard median sternotomy. The less invasive incision does
not adversely influence the extent and the durability of aortic
arch repair.
Biography
Petar Risteski is the lead consultant aortic surgeon with the Thoracic
Aortic Surgery Unit, Department of Thoracic and Cardiovascular Surgery,
Johann Wolfgang Goethe University in Frankfurt amMain, a position he
has held since 2016. He completed his training at the University Hospital
Frankfurt under Prof. Dr. Anton Moritz. Since 2012 he is German board
certified cardiac surgeon, and in 2014 he was admitted as a Fellow of the
European Board of Thoracic and Cardiovascular Surgeons. His clinical
focus covers a wide range of contemporary, interventional, hybrid
and minimally invasive treatments for aortic diseases. His academic
interest focuses on organ protection during primary and reoperative
aortic procedures, hybrid treatment of extensive aortic pathologies and
minimally invasive approach for aortic and valvular procedures, where
he published extensively. He has authored or coauthored more than
70 original articles (43 Pubmed-indexed publications) that have been
cited over 620 times.
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