J.Jpn. Surg. Soc.. 117(2): 109-113, 2016

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Feature topic

MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT:CURRENT STATUS AND FUTURE PERSPECTIVES

The first description of aortic valve replacement (AVR) as minimally invasive cardiac surgery (MICS) was given by Rao et al. in 1993. Recently, the number of MICS-AVR has increased and this procedure has been established as the routine standard operative technique in some institutes. MICS-AVR can be performed with two different approaches. One is an upper partial sternotomy and the other is a right small anterior minithoracotomy. MICS-AVR via upper partial sternotomy can be performed without any special instruments and the technical hurdles are relatively few, but the cosmetic benefit is limited. MICS-AVR via right anterior minithoracotomy offers maximal cosmetic benefit, but the technical hurdles are fairly high. For MICS-AVR, longer aortic clamping time and cardiopulmonary bypass time are needed, but this disadvantage can be overcome with sutureless aortic valve repair, and therefore this procedure may become a standard open surgical procedure in the era of transcatheter aortic valve implantation.

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