Lateral access fully robotic aortic valve replacement "RAVR": from novel to normal

Area of Science:

• Cardiac Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Right lateral access robotic aortic valve replacement (RAVR) is an emerging technique in minimally invasive cardiac surgery.
• The approach utilizes a small incision for improved visualization and reduced trauma.

Purpose of the Study:

• To review the development, technical aspects, and clinical outcomes of RAVR.
• To evaluate RAVR's potential as a standard therapeutic option in aortic valve surgery.

Main Methods:

• Review of multicenter RAVR experiences and propensity-matched comparisons with transcatheter aortic valve replacement (TAVR).
• Analysis of operative mortality, stroke, pacemaker placement, paravalvular leak, and one-year mortality rates.

Main Results:

• RAVR demonstrated low rates of operative mortality (0.9%), stroke (0.9%), and permanent pacemaker placement (2.9%).
• Compared to TAVR, RAVR showed significantly lower rates of paravalvular leak (0.7% vs. 21.5%) and one-year mortality (1.4% vs. 12.5%).
• The lateral access approach offers advantages in visualization, tissue trauma, and standardization.

Conclusions:

• RAVR is a promising advancement in minimally invasive cardiac surgery with favorable clinical outcomes.
• RAVR has the potential to become a standard treatment for aortic valve disease, offering benefits of minimally invasive approaches and durable valve replacement.