Robotic-Assisted Transcatheter Aortic Valve Explantation and Aortic Valve Replacement

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Robotic Surgery

Background:

• Transcatheter aortic valve replacement (TAVR) is increasingly used in younger patients.
• Premature structural valve degeneration can complicate TAVR in this population.
• Surgical explantation and replacement may be necessary for degenerated TAVR devices.

Purpose of the Study:

• To describe the feasibility of robotic TAVR explantation.
• To detail the robotic aortic valve replacement procedure following TAVR explantation.
• To present a case of a younger patient requiring re-intervention after TAVR.

Main Methods:

• A 67-year-old female patient with a history of TAVR underwent robotic TAVR explantation via a right lateral transaxillary incision.
• The procedure involved explantation of the degenerated TAVR device.
• A new bioprosthetic aortic valve was implanted, along with mitral valve replacement.

Main Results:

• Robotic TAVR explantation and aortic valve replacement were successfully performed.
• The patient underwent concomitant mitral valve replacement.
• The patient experienced an uneventful recovery and was discharged home.

Conclusions:

• Robotic TAVR explantation and aortic valve replacement are technically feasible.
• This approach may be a viable option for select patients, particularly younger individuals with degenerated TAVR.
• It represents a potential advancement in minimally invasive cardiac surgery for complex valve cases.