title: Minimally invasive valve surgery.
abstract: As alternatives to standard sternotomy, surgeons have developed innovative, minimally invasive approaches to conducting valve surgery. Through very small skin incisions and partial upper sternal division for aortic valve surgery and right minithoracotomy for mitral surgery, surgeons have become adept at performing complex valve procedures. Beyond cosmetic appeal, apparent benefits range from decreased pain and bleeding to improved respiratory function and recovery time. The large retrospective studies and few small prospective randomized studies are herein briefly summarized. The focus is then directed toward describing specific intraoperative technical details in current clinical use, covering anesthetic preparation, incision, mediastinal access, cardiovascular cannulation, valve exposure, and valve reconstruction. Finally, unique situations such as pulmonic valve surgery, reoperations, beating heart surgery, and robotics are discussed.
authors.affiliation: Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. wooy@uphs.upenn.edu
authors.forename: Y Joseph
authors.initials: YJ
authors.lastname: Woo
authors.forename: Joerg
authors.initials: J
authors.lastname: Seeburger
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D006328:Cardiac Catheterization; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D008943:Mitral Valve / Q000601:surgery*; D012371:Robotics