A first-of-its-kind procedure in Poland – a simultaneous replacement of the aortic valve and a segment of the ascending aorta – has been performed at the Department of Cardiac Surgery of the University Clinical Centre in Gdańsk. This operation was carried out using a minimally invasive method – through a small incision under the armpit. This is a procedure performed in only a few centres around the world, emphasises Maciej Brzeziński, M.D., Ph.D., D.Sc., Head of the Department of Cardiac Surgery.
The aortic valve replacement is indicated in patients suffering from stenosis or insufficiency of the valve, whereas the replacement of part of the ascending aorta is performed in patients with aneurysm or other lesions of that segment of the artery. In some cases, both conditions coexist – and it was in such a patient that the UCK team carried out this novel surgery, replacing both the valve and the aorta in one procedure.
This was the first such procedure in Poland. At UCK, we perform a wide range of minimally invasive procedures via the so-called sub-axillary mini-thoracotomy – a 5- to 6-centimetre incision on the right side of the chest near the armpit. This approach spares bone structures, does not require cutting the sternum or ribs, enables rapid rehabilitation, introduces minimal pain, and yields very favourable cosmetic results, says Maciej Brzeziński, M.D., Ph.D., D.Sc.
Valve replacement, repair, or replacement in the mitral and tricuspid positions via a minimally invasive approach is already standard in our centre. In 2021, we were the first to perform a concomitant aortic and mitral valve operation through a small access. Now, we have advanced to treating aortic aneurysm via the same route. We prepared for this surgery for some time, drawing on experience gained during international courses. This is a procedure performed in only a few centres worldwide.
The operation was performed by a team headed by Andrzej Klapkowski, M.D., Ph.D. with the participation of Radosław Jaworski, M.D., Ph.D., Wojciech Karolak, M.D., Ph.D. perfusionist Agata Piechowska, scrub nurse Małgorzata Żyto, and anaesthesiology nurse Anna Rurys. The surgery proceeded without complications, and the patient was discharged in very good condition after 8 days.
At the UCC, minimally invasive cardiac operations via axillary access are carried out by Wojciech Karolak, M.D., Ph.D., Maciej Duda, M.D., Ph.D., Nikodem Ulatowski, M.D., Ph.D. and Andrzej Klapkowski, M.D., Ph.D. The team continuously develops its skills, drawing, among other sources, on experiences obtained from foreign training courses.
This pioneering surgery — the first of its kind in Poland — marks a significant advancement in the development of minimally invasive cardiac surgery at the University Clinical Centre, hospital of the Medical University of Gdańsk. For patients, it means greater safety, a faster return to health, and access to the most modern treatment methods.
