# Mini-Sternotomy for Aortic Valve Replacement with Concomitant Ablation of the Pulmonary Vein and Persistent Left Superior Vena Cava: A Case Report

## TL;DR

A 79-year-old man underwent a less invasive heart surgery combining aortic valve replacement and vein ablation through a small chest incision.

## Contribution

The paper presents a novel surgical approach combining aortic valve replacement and ablation via a lower mini-sternotomy.

## Key findings

- A lower mini-sternotomy allowed safe access for aortic valve replacement and vein ablation.
- The procedure was less invasive and effective for patients with persistent left superior vena cava and atrial fibrillation.

## Abstract

A 79-year-old man with severe aortic valve stenosis and atrial fibrillation was
referred to our department for surgery. Computed tomography revealed persistent
left superior vena cava. Lower mini-sternotomy was performed. The left atrial
appendage was amputated before ablation of the persistent left superior vena
cava. The jaw of the ablation device was passed behind the pulmonary veins using
a tip-lighted articulating dissector. Finally, aortic valve replacement was
completed. Aortic valve replacement with concomitant pulmonary vein and
persistent left superior vena cava ablation via lower mini-sternotomy is a safe
and less invasive alternative.