ABSTRACT
Aortic valve replacement (AVR) is the second most common cardiac surgery procedure currently performed in developed countries. Although AVR has been performed for more than 50 years, the first description of a minimally invasive surgery (MIS) approach was not published until 1996 by Cosgrove and Sabik1 and this method is currently employed in only 10% of isolated AVR patients. The slow development and acceptance of MIS AVR surgery is difficult to explain, given the relatively small and focused surgical field required for aortic valve procedures. One reason for its slow adoption is that MIS AVR is more technically challenging than conventional AVR, which is reflected by the increased myocardial ischemic and cardiopulmonary bypass (CPB) times associated with these procedures. However, numerous studies have shown that MIS AVR can be performed with equal safety and efficacy compared to conventional surgery. In addition, several clinical benefits have been demonstrated, including shorter ventilation times, shorter intensive care unit stays, decreased blood loss and transfusions, faster patient recovery, and improved cosmesis. Although MIS AVR is performed by the minority of cardiac surgeons, interest seems to be increasing within the cardiac surgery community. Increasing patient demand and the rapid proliferation of transcutaneous aortic valve procedures are two factors that may be factors driving this trend.
