Surgical versus transcatheter aortic valve replacement: the future role of robotic aortic valve replacement

Patients desire a minimally invasive option for management of their valve disease. As transcatheter aortic valve replacement (TAVR) remains a straightforward short-term solution, it is incumbent upon surgeons to provide an alternative, and preferably non-sternotomy or anterior chest option with the longitudinal benefits of surgical aortic valve replacement (SAVR). The present review will focus on the novel use of robotic aortic valve replacement (RAVR) via right lateral transaxillary mini-thoracotomy to perform standard SAVR, which permits the additional ability to perform concomitant procedures using the standard lateral approach popularized in mitral and atrial fibrillation surgery. We will define a role for RAVR in the current landscape of TAVR to provide a minimally invasive and durable operation, allowing for performance of concomitant procedures. Furthermore, we will focus on current literature supporting the safe and stepwise expansion of RAVR worldwide to provide patients requiring aortic valve replacement another option.