Minimally Invasive Aortic Valve Replacement

Abstract

The most common approach for minimally invasive aortic valve replacement is the J-shaped upper mini-sternotomy. Some of the reported results on the technique have demonstrated favorable long-term outcomes in elderly and redo patients when compared with conventional sternotomy, although right anterior mini-thoracotomy is steadily gaining in popularity. The additional exposure achieved from a conventional full sternotomy has little impact on the exposure of the aortic valve and proximal thoracic aorta. A minimally invasive approach with an upper hemi-sternotomy has an equivalent safety profile and has shown a significant difference in terms of reduced transfusion requirement, reduced respiratory complications, reduced postoperative pain and overall short length of hospital stay. The oscillating saw can be used in “J-shaped” mini-sternotomy to achieve more precise and smaller cuts to the sternum that are suitable for a minimally invasive procedure. The oscillating saw can also be used in redo sternotomy patients.