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New approach for extended thoracic aortic repair: anterolateral thoracotomy with partial sternotomy.

PURPOSE
We have introduced a new surgical approach for extended thoracic aortic repair, anterolateral thoracotomy with partial sternotomy (ALPS).


DESCRIPTION
The surgical approach to the chest was made via left anterolateral thoracotomy and lower median sternotomy through the third or fourth intercostal space. All cannulations (arterial, venous, venting, and cardioplegia) could be easily performed using a retractor in this approach.


EVALUATION
From November 2005 to December 2010, we performed surgical treatment in 12 patients by employing the ALPS approach for a complex, extended thoracic aortic diseases with different pathologies, i.e., arteriosclerotic aneurysms in 5, acute type B dissection in 5, and chronic type B dissection in 2 patients. One patient died in the hospital, and 1 had temporary spinal cord injury.


CONCLUSION
The ALPS approach might become an alternative for a complex, extended thoracic aortic replacement.