Aortic valve replacement by a transaxillary, anterior, mini-thoracotomy approach.

Abstract A modified transaxillary approach for aortic valve disease to obtain the same exposure as the anterior mini-thoracotomy approach and to preserve the pectoralis major muscle is presented. When the patient's right shoulder is adducted horizontally, or the right arm is flexed anteriorly 90 degrees and adducted to the left, the right axilla comes close to the chest midline. This means that a right anterior thoracotomy can be made through the right axilla when the arm position is adjusted appropriately. The modified new approach is safe and faster than the conventional transaxillary approach, and it provides cosmetic advantages to the patients.