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Minimal Access Aortic Valve Surgery

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Minimally Invasive Thoracic and Cardiac Surgery

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Abstract

Aortic valve surgery is most commonly performed via a median sternotomy and on cardiopulmonary bypass. While a conventional aortic valve replacement which follows the excision of the native aortic valve can be performed solely on cardiopulmonary bypass, trans-aortic valve implantation (TAVI) has more recently allowed both cardiologists and surgeons to deploy sutureless aortic prosthesis leaving in situ the calcific native aortic valve without the need for cardiopulmonary bypass.

Minimal access aortic valve replacement (MA AVR) potentially offers several advantages to the patients but requires that the surgeons undergo a specific training. Since 1996, several reports have documented both feasibility and safety of minimal access aortic valve surgery which has been performed using at least four different surgical approaches. Nearly 15 years later, one of these surgical approaches constitutes the gold standard for minimal access aortic valve surgery, and the authors’ aim is to describe in detail its step-by-step surgical technique. In addition, we will review and discuss available data from large retrospective, randomised clinical series and meta-analysis in order to highlight any proven benefits compared to the traditional median sternotomy surgical approach.

Mini Abstract

Minimal access aortic valve surgery (MA AVs) can be safely performed via a limited upper sternotomy. It potentially offers several advantages to the patients while the surgeon requires a specific training and minimal changes in instrumentation. A detailed description of the surgical procedure is reported herein followed by a review and discussion of available data from large retrospective, randomised clinical series and meta-analysis.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, St. Mary’s Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK

    Roberto Pasquale Casula M.D., FRCS, FETCS

  2. Hammersmith Hospital, Imperial Healthcare College NHS Trust, London, UK

    Roberto Pasquale Casula M.D., FRCS, FETCS

Authors
  1. Roberto Pasquale Casula M.D., FRCS, FETCS
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Correspondence to Roberto Pasquale Casula M.D., FRCS, FETCS .

Editor information

Editors and Affiliations

  1. Klinik Hirslanden, Thoraxzentrum Zürich, Witellikerstr. 40, Zürich, 8008, Switzerland

    Rolf Gilbert Carl Inderbitzi

  2. , Division of General Thoracic Surgery, University Hospital Berne
, Freiburgstr. 2010, Berne, 3010, Switzerland

    Ralph Alexander Schmid

  3. , Department of Cardio-Thoracic Surgery, University of Pisa, Via Paradisa 2, Pisa, 56100, Italy

    Franca M. A. Melfi

  4. St. Mary's Hospital, Department of Cardio-Thoracic Surgery, Imperial College Healthcare NHS Trust, Praed Street, LONDON, W2 1NY, United Kingdom

    Roberto Pasquale Casula

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© 2012 Springer-Verlag Berlin Heidelberg

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Casula, R.P. (2012). Minimal Access Aortic Valve Surgery. In: Inderbitzi, R., Schmid, R., Melfi, F., Casula, R. (eds) Minimally Invasive Thoracic and Cardiac Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11861-6_42

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  • DOI: https://doi.org/10.1007/978-3-642-11861-6_42

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-11860-9

  • Online ISBN: 978-3-642-11861-6

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