Objective:

The goal of this video is to illustrate the technical steps related to transaxillary access for aortic valve surgery. This minimally invasive procedure is a great alternative to conventional sternotomy, drastically reducing recovery time and bettering aesthetic results. The short film emphasizes critical procedural components, patient selection criteria, and surgical suggestions to accomplish successful transaxillary aortic valve (AV) access.

 

Methods:

The video provides a step-by-step guidance for performing aortic valve replacement (AVR) via a transaxillary technique. The patient is supine with the right arm elevated, and a 4-6 cm incision is made in the third or fourth intercostal space. The intercostal muscles are made accessible and a soft tissue retractor is applied to access the AV. The valve replacement is conducted using a mixture of conventional and long-shafted minimally invasive equipment, with clear guidance in sight available to maintain optimal exposure and avoid problems.

 

Results:

The transaxillary technique enables an excellent view to the AV whereas causing barely any disruption to the surrounding tissues. This approach produces outstanding aesthetic outcome, reduced recovery times, and less postoperative pain. Our video presents intraoperative capture which demonstrates the successful implantation of a bioprosthetic valve without any need for rib excision or sternotomy.

 

Conclusions:

Transaxillary access for aortic valve surgery is a future potential minimally invasive option. The procedure reduces postoperative complications and produces a cosmetically superior outcome, making it a desirable option for certain patients. We argue that our minimally invasive technique is also suitable for another valve surgeries, like mitral valve repairment or replacement, as well as tricuspid valve procedures.