Totally 3D endoscopic aortic valve replacement: initial results and experience from a single center

Area of Science:

• Cardiac Surgery
• Minimally Invasive Procedures
• 3D Endoscopic Technology

Background:

• Traditional sternotomy for aortic valve replacement carries significant morbidity.
• Minimally invasive techniques aim to reduce surgical trauma and improve patient outcomes.
• Endoscopic approaches offer potential for smaller incisions and faster recovery.

Purpose of the Study:

• To evaluate the feasibility and initial outcomes of totally endoscopic aortic valve replacement (TEAVR).
• To assess the efficacy of a single working port technique at the fourth intercostal space (ICS).
• To determine the success rate, in-hospital mortality, and perioperative complications of TEAVR.

Main Methods:

• Retrospective observational study of 35 consecutive patients undergoing TEAVR.
• Single 4cm working port at the 4th ICS with a 3D endoscopic system.
• Peripheral cardiopulmonary bypass (CPB) established for the procedure.

Main Results:

• Successful TEAVR completion in all patients without conversion to sternotomy.
• Median CPB time: 210 min; aortic cross-clamp time: 132 min.
• Early (30-day) mortality rate of 5.7%; 2.9% required reoperation for bleeding.

Conclusions:

• Totally endoscopic aortic valve replacement (TEAVR) is a feasible surgical option.
• This technique demonstrates potential as a viable alternative to conventional sternotomy.
• Further research is warranted to confirm long-term outcomes and broader applicability.