Ministernotomy

Mini-invasive cardiac surgery is an attractive option for many patients, and ministernotomy (MS) has become one of the most popular minimally invasive cardiac surgery approach and is today routinely performed. The term ministernotomy was coined in 1994 to describe a series of sternal incisions for cardiac surgery other than the complete median sternotomy. An upper MS can be used for all the operations on the aortic and mitral valves, as well as on the aortic root and the ascending aorta and several variations have been proposed over the years. The main principles of anesthesia for routine full sternotomy apply to an MS approach, but the limited nature of the incision presents some specific challenges of which the anesthesiologist must be aware, starting from the perioperative assessment and including intraoperative and postoperative management, as well as postoperative care and pain management.