"MIAVR: How We Do It" Video 

 

Objective: Despite offering the benefits of enhanced recovery compared to sternotomy approaches, minimally invasive aortic valve replacement (AVR) has not achieved widespread adoption across the United States based on Society of Thoracic Surgeons (STS) Database data. Our center has a 20 year history performing minimally invasive cardiac surgery. For isolated aortic valve disease the mini-thoracotomy approach represents a reproducible standard at our center and a viable alternative to transcatheter aortic valve replacement. We present a case video that illustrates step by step how we perform a minimally invasive AVR.

 

Case Video Summary: A 66 year old male with recent shortness of breath with exertion and a new systolic heart murmur on physical exam was found on echocardiogram to have severe aortic stenosis. He was referred for consideration of aortic valve replacement. The case video shows step by step performance of the procedure.

 

Conclusions: Minimally invasive AVR can be safely and reproducibly performed  for essentially all patients with isolated aortic valve disease by adhering to basic principles that simplify the procedure. We believe the lessons learned through our 20 year experience can be adopted by other centers.