"Robotic Assisted Suture-less Aortic Valve Replacement" by Nicholas Ray, BS, Danny Ramzy, MD, Blaz Podgorsek. UTHealth at Houston McGovern, Houston, TX, USA.

We report a case of severe bicuspid aortic valve stenosis replaced robotically using a suture-less aortic valve.

We present a 59-year-old male with severe bicuspid aortic valve stenosis. Pre-op echocardiogram revealed an aortic valve gradient of 61 mmHg. This patient’s STS predicted a risk of mortality of 0.71%. After discussing the surgical decision-making with the patient, we decided to proceed with the minimally invasive surgical approach.

Surgeons must use their clinical decision-making skills to determine if patients should receive surgical or transcatheter aortic valve replacement. The transcatheter approach may pose a higher risk for patients with bicuspid aortic disease. Young patients with low-risk aortic stenosis who undergo the minimally invasive surgical approach may achieve improvements in their longitudinal outcomes.

Robotic aortic valve replacement with suture-less valves can be performed safely using similar approaches to robotic mitral valve replacements. This case study shows that robotic AVR can close the gap between minimally invasive surgeries for young, low-risk individuals with bicuspid aortic valve stenosis.