American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What approach is commonly used to access the ascending aorta?

1. Right thoracotomy

2. Left thoracotomy

3. Median sternotomy

4. Posterior approach

The correct answer is: Median sternotomy

The median sternotomy is the preferred approach when accessing the ascending aorta due to its direct access to the heart and great vessels. This surgical technique involves making an incision along the midline of the sternum, providing ample exposure to the thoracic cavity. By splitting the sternum, surgeons can easily visualize the ascending aorta, as well as the aortic arch and heart structures, allowing for comprehensive evaluation and management of aortic conditions. In contrast, other approaches, such as right or left thoracotomy, do not provide the same level of access to the ascending aorta. A right thoracotomy primarily offers access to structures on the right side of the chest, and while it may allow some visualization of the aorta, it is not ideal for procedures that require thorough examination or intervention on the ascending aorta. Similarly, a left thoracotomy provides access mainly to the left side and may also limit access to the ascending aorta. The posterior approach is generally not used for accessing the ascending aorta, as it does not facilitate the necessary exposure for surgical intervention in the anterior mediastinum where the ascending aorta resides. Therefore, the median sternotomy is the approach of choice for effectively accessing the ascending aorta, enabling surgeons