title: Surgical management of minimally invasive aortic valve operations.
abstract: Although there is still a role for conventional sternotomy for aortic valve replacement, minimally invasive techniques are increasing in popularity and may benefit the patient with shorter postoperative course, less morbidity, and decreased overall cost. Additionally, transcatheter procedures have recently shown promising results in high-risk patients. This article provides an overview of the development of minimally invasive aortic valve operations, including a brief history of minimally invasive approaches, surgical considerations during minimally invasive aortic valve replacement, and the technical approach to performing a hemisternotomy with aortic valve replacement. In addition, the authors review transcatheter techniques, including aortic valve replacement via a sheath placed in the apex of the left ventricle or through a sheath placed in the femoral vessels. Finally, the exciting results of the PARTNER trial and the effect of these results on the future of aortic valve surgery are discussed.
authors.affiliation: Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: William F
authors.initials: WF
authors.lastname: Johnston
authors.forename: Gorav
authors.initials: G
authors.lastname: Ailawadi
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000639:trends; D002315:Cardiopulmonary Bypass / Q000379:methods; D002983:Clinical Competence; D002986:Clinical Trials as Topic; D005263:Femoral Artery; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000639:trends; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000639:trends; D056346:Sternotomy / Q000379:methods; D016896:Treatment Outcome