Miami Minimally Invasive Valves
Joseph Lamelas, MD
Dedicated to the Advancement of Minimally Invasive Cardiac Surgery
September 4, 2013
TAVR, Direct Aortic, Mini-thoracotomy

Another reason to become comfortable with the mini – thoracotomy AVR’S is that it prepares you for a direct aortic TAVR.   This  DIRECT AORTIC access for a TAVR was performed via 3-4 cm mini-thoracotomy without rib dislocation. The 18 Fr. sheath was passed through a separate incision.  There is obviously a need for the sheath’s to be made shorter as well as the delivery device.

Becoming comfortable with this access will also prepare you for the sutureless valve implants.


1 thought on “TAVR, Direct Aortic, Mini-thoracotomy”

  1. Marc Sakwa says:

    Totally agree. We have done 12 TAVR with this approach. My only suggestion is using the first interspace. This allows for adequate length and perfect angle. Reports that the aorta needs to be right of the sternum are wrong. This is a safe and comfortable approach that achieves very good results

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