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Updated: May 24, 2026
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Indication for percutaneous aortic valve implantation
Ibrahim Akin1, Stephan Kische, Tim C Rehders
1Department of Medicine I, Divisions of Cardiology, Pulmonology and Intensive Care Unit at the University Hospital Rostock, Rostock School of Medicine, Rostock, Germany.
Insights
Transcatheter aortic valve replacement offers a new treatment for severe aortic stenosis in patients ineligible for surgery. This minimally invasive approach provides a life-saving alternative, improving survival rates for high-risk individuals.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Valvular aortic stenosis incidence is rising due to increased life expectancy.
- Surgical aortic valve replacement improves survival but is contraindicated in up to one-third of patients with severe symptomatic disease due to high comorbidities.
- Traditional alternatives like medical therapy or balloon valvuloplasty do not improve mortality.
Purpose of the Study:
- To introduce transcatheter aortic valve replacement (TAVR) as a therapeutic option for patients with severe aortic stenosis who are unfit for traditional surgery.
- To highlight the development of minimally invasive, catheter-based solutions for this high-risk patient population.
Main Methods:
- Review of current interventional cardiology advancements in aortic valve replacement.
- Description of two primary transcatheter systems: the balloon-expandable Edwards SAPIEN valve and the self-expanding CoreValve ReValving System.
Main Results:
- Transcatheter methods provide a viable therapeutic solution for patients unsuitable for surgical aortic valve replacement.
- These systems offer a less invasive alternative to open-heart surgery for severe aortic stenosis treatment.
Conclusions:
- Transcatheter aortic valve replacement represents a significant advancement in managing severe aortic stenosis in high-risk patients.
- This technology expands treatment options, offering improved survival prospects for individuals previously denied surgical intervention.
Abstract:
The incidence of valvular aortic stenosis has increased over the past decades due to improved life expectancy. Surgical aortic valve replacement is currently the only treatment option for severe symptomatic aortic stenosis that has been shown to improve survival. However, up to one third of patients who require lifesaving surgical aortic valve replacement are denied surgery due to high comorbidities resulting in a higher operative mortality rate. In the past such patients could only be treated with medical therapy or percutaneous aortic valvuloplasty, neither of which has been shown to improve mortality. With advances in interventional cardiology, transcatheter methods have been developed for aortic valve replacement with the goal of offering a therapeutic solution for patients who are unfit for surgical therapy. Currently there are two catheter-based treatment systems in clinical application (the Edwards SAPIEN aortic valve and the CoreValve ReValving System), utilizing either a balloon-expandable or a self-expanding stent platform, respectively.
