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Transcervical Robotic Aortic Valve Replacement: A Possible New Frontier in Cardiac Surgery?

Marijan Koprivanac1, Fraser Sutherland2, Lars G Svensson1

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Transcervical robotic aortic valve replacement (TC-AVR) offers a less invasive surgical option. This technique facilitates faster patient recovery without chest restrictions or opioid use.

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Area of Science:

  • Cardiovascular Surgery
  • Robotic Surgery
  • Minimally Invasive Procedures

Background:

  • Surgical approaches for aortic valve replacement (AVR) have evolved to reduce invasiveness and improve recovery.
  • Conventional minimally invasive AVR still involves postoperative opioid use and chest restrictions.
  • Transcervical robotic AVR (TC-AVR) was developed to minimize incisions and expedite recovery.

Purpose of the Study:

  • To evaluate the feasibility and patient outcomes of the novel transcervical robotic aortic valve replacement (TC-AVR) technique.
  • To assess the potential for enhanced recovery compared to traditional AVR methods.

Main Methods:

  • The TC-AVR procedure was performed in seven patients using a cervical incision as a working port.
  • Cardiopulmonary bypass was established via femoral cannulation.
  • Native valves were excised, and prosthetic valves were implanted using a running suture technique.

Main Results:

  • The procedure was feasible in patients (mean age 66±8 years; 71% male) with severe aortic stenosis or bicuspid aortic valves.
  • No post-implantation aortic regurgitation occurred; intraoperative gradients were within normal limits.
  • Uncomplicated cases (n=5) showed no mortality, required no postoperative opioids, and had a mean hospital stay of 3.2 days, with patients resuming activities quickly.

Conclusions:

  • Transcervical robotic AVR is a feasible technique with potential for superior patient recovery.
  • Further development of TC-AVR techniques and instrumentation, alongside safety evaluations, is warranted.