Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions
Aortic surgery is one of the most challenging areas in cardiovascular medicine because of the complexity of the procedure and the potential for life-threatening complications. Historically, median sternotomy has been the gold-standard approach for thoracic aortic interventions, providing excellent...
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2025-07-01
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| Series: | Swiss Medical Weekly |
| Online Access: | https://smw.ch/index.php/smw/article/view/4349 |
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| author | Laura Rings Petar Risteski Igor Tudorache Achim Häussler Nestoras Papadopoulos Hector Rodriguez Cetina Biefer Omer Dzemali |
| author_facet | Laura Rings Petar Risteski Igor Tudorache Achim Häussler Nestoras Papadopoulos Hector Rodriguez Cetina Biefer Omer Dzemali |
| author_sort | Laura Rings |
| collection | DOAJ |
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Aortic surgery is one of the most challenging areas in cardiovascular medicine because of the complexity of the procedure and the potential for life-threatening complications. Historically, median sternotomy has been the gold-standard approach for thoracic aortic interventions, providing excellent exposure to the entire ascending aorta and the distal aortic arch. This approach has yielded satisfactory postoperative results over the years. However, the invasiveness of median sternotomy is associated with significant surgical trauma, increased postoperative pain and prolonged recovery. Minimally invasive aortic surgery has emerged as a potential alternative to conventional approaches with the aim of combining the benefits of minimally invasive cardiac surgery with the demands of complex aortic interventions. In this review, we aimed to critically analyse the current experiences with minimally invasive aortic surgery via partial upper sternotomy for the treatment of aortic root, ascending aorta and aortic arch pathologies. The partial upper sternotomy (PUS), as a less invasive approach in minimally invasive aortic surgery, represents a substantial advancement in the field of aortic surgery. The current literature on minimally invasive aortic surgery via PUS is predominantly based on retrospective, single-centre studies with small sample sizes, which limits the strength of the conclusions and generalisability. Ventilation time, intensive care unit (ICU) stay, length of hospital stay and bleeding complications can be reduced using this approach. Survival was not negatively affected and cosmetic results were improved by minimally invasive aortic surgery.
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| format | Article |
| id | doaj-art-6bf159019bd04350832d0afa0c2af09e |
| institution | DOAJ |
| issn | 1424-3997 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj-art-6bf159019bd04350832d0afa0c2af09e2025-08-20T03:15:27ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972025-07-01155710.57187/s.4349Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directionsLaura Rings0Petar Risteski1Igor TudoracheAchim HäusslerNestoras PapadopoulosHector Rodriguez Cetina BieferOmer DzemaliDepartment of Cardiac Surgery University Hospital ZurichDepartment for Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland Aortic surgery is one of the most challenging areas in cardiovascular medicine because of the complexity of the procedure and the potential for life-threatening complications. Historically, median sternotomy has been the gold-standard approach for thoracic aortic interventions, providing excellent exposure to the entire ascending aorta and the distal aortic arch. This approach has yielded satisfactory postoperative results over the years. However, the invasiveness of median sternotomy is associated with significant surgical trauma, increased postoperative pain and prolonged recovery. Minimally invasive aortic surgery has emerged as a potential alternative to conventional approaches with the aim of combining the benefits of minimally invasive cardiac surgery with the demands of complex aortic interventions. In this review, we aimed to critically analyse the current experiences with minimally invasive aortic surgery via partial upper sternotomy for the treatment of aortic root, ascending aorta and aortic arch pathologies. The partial upper sternotomy (PUS), as a less invasive approach in minimally invasive aortic surgery, represents a substantial advancement in the field of aortic surgery. The current literature on minimally invasive aortic surgery via PUS is predominantly based on retrospective, single-centre studies with small sample sizes, which limits the strength of the conclusions and generalisability. Ventilation time, intensive care unit (ICU) stay, length of hospital stay and bleeding complications can be reduced using this approach. Survival was not negatively affected and cosmetic results were improved by minimally invasive aortic surgery. https://smw.ch/index.php/smw/article/view/4349 |
| spellingShingle | Laura Rings Petar Risteski Igor Tudorache Achim Häussler Nestoras Papadopoulos Hector Rodriguez Cetina Biefer Omer Dzemali Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions Swiss Medical Weekly |
| title | Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions |
| title_full | Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions |
| title_fullStr | Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions |
| title_full_unstemmed | Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions |
| title_short | Advancements in less-invasive aortic root, ascending aorta and arch surgery: current evidence and future directions |
| title_sort | advancements in less invasive aortic root ascending aorta and arch surgery current evidence and future directions |
| url | https://smw.ch/index.php/smw/article/view/4349 |
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