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Robotic Aortic Valve Replacement: First 50 Cases.

Lawrence M Wei1, Chris C Cook1, J W Awori Hayanga1

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|September 24, 2021
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Summary
This summary is machine-generated.

Robotic-assisted aortic valve replacement (RAVR) shows promising safety and short-term results comparable to traditional methods. Further experience may allow for more complex concomitant procedures during RAVR.

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Cardiac Surgery
  • Robotic Surgery

Background:

  • Challenges exist in selecting between transcatheter and surgical aortic valve replacement (SAVR).
  • These challenges include bicuspid stenosis, low clinical risk, and the need for concomitant procedures.
  • Robotic-assisted aortic valve replacement (RAVR) is explored to address these limitations.

Purpose of the Study:

  • To present the initial experience and outcomes of fully robotic-assisted aortic valve replacement (RAVR).
  • To evaluate the safety and feasibility of RAVR in a diverse patient cohort.
  • To assess the potential of RAVR for complex aortic valve procedures.

Main Methods:

  • Fifty consecutive RAVR operations were performed between January 2020 and February 2021.
  • A 3- to 4-cm lateral mini-thoracotomy with a 3-port technique and transthoracic aortic clamping was utilized.
  • Conventional SAVR prostheses were implanted using interrupted braided sutures.

Main Results:

  • The study included 50 patients with a median age of 67.5 years; 56% had calcified bicuspid disease.
  • Operative times plateaued after the first 5 cases, with 84% of patients extubated in the operating room.
  • No 30-day operative mortality or stroke was observed, and all patients had normal 30-day echocardiograms.

Conclusions:

  • RAVR demonstrates procedural safety and short-term outcomes comparable to existing alternatives.
  • The technique appears suitable for patients with complex aortic valve disease, including bicuspid stenosis.
  • Increased experience with RAVR may enable the safe incorporation of concomitant procedures.