Video of the Week : Right Anterior Mini-Thoracotomy Sutureless AVR With MECC

Right anterior thoracotomy is a technique for aortic valve replacement. Minimal extracorporeal circulation (MECC) is known to reduce the deleterious effects of cardiopulmonary bypass. The authors present a sutureless aortic valve replacement via right anterior thoracotomy by using MECC in an 84-year-old patient with severe aortic stenosis.
Preoperative tomographic angiography showed a right sided aorta. A 4 cm transverse incision was made through the right second intercostal space. Rib resection was not used. A femoral arterial and venous cannulation was used. The main advantage of MECC is less inflammatory response and less hemodilution. By using standard surgical instruments a transverse aortotomy was made from the fat pad. Calcified leaflets are resected and small size. Perceval sutureless valve is inserted. Aortotomy was then closed.Postoperative TEE showed no leak and excellent hemodynamics. Patient recovery was uneventfull. 
Sutureless aortic valve replacement with mini cardiopulmonary bypass through the right anterior thoracotomy is a safe and feasible technique and provides an excellent result.