Step-by-Step Minimally Invasive Aortic Valve Replacement: the RAT Approach

Braz J Cardiovasc Surg. 2021 Jun 1;36(3):420-423. doi: 10.21470/1678-9741-2020-0393.

Abstract

In the growing era of transcatheter aortic valve implantation, it is crucial to develop minimally invasive surgical techniques. These methods enable easier recovery from surgical trauma, especially in elderly and frail patients. Minimally invasive aortic valve replacement (MIAVR) is frequently performed via upper hemisternotomy. We describe MIAVR via right anterior thoracotomy, which is associated with less trauma, rapid mobilization, lower blood transfusion rates, and lower risk of postoperative wound infections. As minimally invasive procedures tend to take longer operative times, we suggest using rapid-deployment valve prostheses to overcome this limitation. This description focuses on the technical aspects and preoperative assessment.

Keywords: Aortic Valve; Frail Elderly; Heart Valve Prosthesis.; Surgical Wound Infection; Thoracotomy; Transcatheter Aortic Valve Replacement.

MeSH terms

  • Aged
  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Heart Valve Prosthesis Implantation*
  • Heart Valve Prosthesis*
  • Humans
  • Retrospective Studies
  • Thoracotomy
  • Treatment Outcome