SURGICAL ANATOMY OF AORTIC VALVE
- After the sternum is retracted and the presternal fat tissue is dissected away, the anterior sheath of the pericardium is brought into the sight.
- The pericardial incision begins just inferior to the brachiocephalic vein.
- In the superior part of the pericardium, the incision runs between the pulmonary artery and the aortic root.
- Inferiorly, the pericardial incision is extended to a point two finger-breaths over the diaphragm.
- From here on, the incision is extended on the right toward the inferior vena cava and on the left toward the left apex.
- The edges of the pericardium are fixed with pericardial stitches to the sternal spreader.
- The aortic root is located behind the right lateral wall of the infundibulum.
- It is very important to realize that the aortic root and the superior vena cava are not in the same plane. The vein is superficial relative to the aortic root.