Robotic total endoscopic sutureless aortic valve replacement: proof of concept for a future surgical setting

Int J Med Robot. 2016 Sep;12(3):370-4. doi: 10.1002/rcs.1694. Epub 2015 Aug 18.

Abstract

Background: Sutureless valves have recently enabled closed chest aortic valve replacement. This paper evaluates the feasibility of a robotic telemanipulation during thoracoscopic sutureless aortic valve implantation in cadavers.

Methods: Cadavers were prepared with a five thoracosopic trocar setting, with a transthoracic clamp inserted in the first right intercostal space and the optics inserted in the second. Seven sutureless valve implantations were scheduled using 5 Sorin Perceval and 2 Medtronic 3f Enable valves.

Results: In all cases performance of pericardial suspension, aortotomy and root exposure required less than 20 min. Native valve excision and sutureless bioprosthesis implantation was technically feasible in all cases. A satisfactory prosthesis sealing was ascertained visually and the absence of paravalvular leakages was assessed with a nerve hook test around the prosthetic flange.

Conclusions: Closed chest and robot assisted sutureless valve implantation is feasible in cadavers. Robotic technology can enhance reproducibility of the technique. Copyright © 2015 John Wiley & Sons, Ltd.

Keywords: TAVI; aortic valve; minimally invasive surgery; robotic surgery; sutureless bioprosthesis.

MeSH terms

  • Aortic Valve / surgery*
  • Bioprosthesis*
  • Endoscopy
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Robotic Surgical Procedures / methods*
  • Sutures