Minimally invasive approach to ascending aorta and aortic root surgery

Minimally invasive aortic valve surgery has become a widely accepted alternative to standard sternotomy. Despite a potential reduction in morbidity, this approach is not routinely performed in aortic surgery. Minimally invasive aortic surgery performed through a ‘V’-shaped partial upper sternotomy is feasible and safe in selected patients regardless of the extent of repair, from supracoronary aorta replacements to complex root repairs. We hereby present our surgical technique to obtain access to the aortic root and ascending aorta, as well as a successful case of minimally invasive David aortic root repair procedure.