Minimally Invasive Surgical Aortic Valve Replacement: An Overview of Recent Advances

Aortic valve replacement (AVR) is the only definitive treatment for severe aortic stenosis. Options for valve replacement include surgical AVR (SAVR) and percutaneous transcatheter AVR. Although transcatheter AVR has recently been shown to be the optimal approach for high-risk patients, SAVR is the gold standard for patients with low and intermediate surgical risk. Advances in technique and innovations in rapid-deployment and sutureless valves have facilitated the development of a third alternative. Accumulating evidence suggests that minimally invasive SAVR can be performed as safely as conventional SAVR, and perhaps with less morbidity, allowing patients a quicker return to their productive lives. The following discussion outlines the surgical technique, patient selection and advances in valve design.