Totally endoscopic aortic valve replacement: Techniques and early results.

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Aortic Valve Replacement

Background:

• Traditional aortic valve replacement (AVR) involves a full sternotomy, a major surgical incision.
• Minimally invasive techniques aim to reduce surgical trauma and improve patient recovery.
• Total endoscopic AVR (TE-AVR) utilizes small ports for valve replacement, avoiding a large chest incision.

Purpose of the Study:

• To detail the technical aspects of total endoscopic aortic valve replacement (TE-AVR) using standard prostheses.
• To compare the clinical outcomes and safety of TE-AVR versus traditional full-sternotomy AVR.

Main Methods:

• A comparative study involving 60 patients undergoing elective isolated AVR from 2020-2021.
• Patients were divided into two groups: TE-AVR (29 patients) and traditional AVR (31 patients).
• The TE-AVR procedure was performed using three working ports.

Main Results:

• No mortality occurred in either group.
• TE-AVR group had longer cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) times (p < 0.001 for both).
• TE-AVR patients experienced shorter mechanical ventilation duration (p=0.015) and hospital stays (p=0.025).

Conclusions:

• Total endoscopic aortic valve replacement is a safe and feasible procedure.
• TE-AVR is associated with reduced trauma and a faster patient recovery.
• Further research may explore optimizing CPB and ACC times in TE-AVR.