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Russo MJ, Gnezda J, Merlo A, et al. The arrowhead ministernotomy with rigid sternal plate fixation: a minimally invasive approach for surgery of the ascending aorta and aortic root. Minim Invasive Surg. 2014;2014:681371doi: 10.1155/2014/681371.
Russo, M. J., Gnezda, J., Merlo, A., Johnson, E. M., Hashmi, M., & Raman, J. (2014). The arrowhead ministernotomy with rigid sternal plate fixation: a minimally invasive approach for surgery of the ascending aorta and aortic root. Minimally invasive surgery, 2014681371. https://doi.org/10.1155/2014/681371
Russo, Mark J, et al. "The arrowhead ministernotomy with rigid sternal plate fixation: a minimally invasive approach for surgery of the ascending aorta and aortic root." Minimally invasive surgery vol. 2014 (2014): 681371. doi: https://doi.org/10.1155/2014/681371
Russo MJ, Gnezda J, Merlo A, Johnson EM, Hashmi M, Raman J. The arrowhead ministernotomy with rigid sternal plate fixation: a minimally invasive approach for surgery of the ascending aorta and aortic root. Minim Invasive Surg. 2014;2014:681371. doi: 10.1155/2014/681371. Epub 2014 Nov 18. PMID: 25485148; PMCID: PMC4251070.
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Minim Invasive Surg. 2014;2014:681371. doi: 10.1155/2014/681371. Epub 2014 Nov 18.

The arrowhead ministernotomy with rigid sternal plate fixation: a minimally invasive approach for surgery of the ascending aorta and aortic root.

Minimally invasive surgery

Mark J Russo, John Gnezda, Aurelie Merlo, Elizabeth M Johnson, Mohammad Hashmi, Jaishankar Raman

Affiliations

  1. Barnabas Heart Hospitals, Newark Beth Israel Medical Center, 201 Lyons Avenue, Suite G5, Newark, NJ 07112, USA ; Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, Newark, NJ 07112, USA.
  2. Section of Cardiac and Thoracic Surgery, University of Chicago, Chicago, IL 60637, USA.
  3. Cardiovascular Clinical Research Unit, Barnabas Heart Hospitals, Newark, NJ 07112, USA.
  4. Division of Cardiac Surgery, Rush University, Chicago, IL 60612, USA.

PMID: 25485148 PMCID: PMC4251070 DOI: 10.1155/2014/681371

Abstract

Background. Ministernotomy incisions have been increasingly used in a variety of settings. We describe a novel approach to ministernotomy using arrowhead incision and rigid sternal fixation with a standard sternal plating system. Methods. A small, midline, vertical incision is made from the midportion of the manubrium to a point just above the 4th intercostal mark. The sternum is opened in the shape of an inverted T using two oblique horizontal incisions from the midline to the sternal edges. At the time of chest closure, the three bony segments are aligned and approximated, and titanium plates (Sternalock, Jacksonville, Florida) are used to fix the body of the sternum back together. Results. This case series includes 11 patients who underwent arrowhead ministernotomy with rigid sternal plate fixation for aortic surgery. The procedures performed were axillary cannulation (n = 2), aortic root replacement (n = 3), valve sparing root replacement (n = 3), and replacement of the ascending aorta (n = 11) and/or hemiarch (n = 2). Thirty-day mortality was 0%; there were no conversions, strokes, or sternal wound infections. Conclusions. Arrowhead ministernotomy with rigid sternal plate fixation is an adequate minimally invasive approach for surgery of the ascending aorta and aortic root.

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