Minimally invasive ascending aortic surgery with partial upper sternotomy: Institutional experience and contemporary perspective

Background

Surgical replacement of the ascending aorta remains the gold standard therapy for ascending aortic aneurysm, chronic dissection, and selected aortic root pathologies. Traditionally performed through full median sternotomy, ascending aortic surgery has progressively evolved toward minimally invasive approaches aiming to reduce surgical trauma while preserving procedural safety and durability. Upper partial sternotomy has emerged as the most widely adopted mini-mally invasive access for ascending aortic surgery. This study presents the institutional experience of Acibadem City Clinic Vitosha Hospital with minimally invasive ascending aortic surgery via upper partial sternotomy and places these results in the context of contemporary literature.