What is minimally-invasive aortic valve replacement?

In certain situations, aortic valve replacement surgery can be done through minimally-invasive methods, i.e. keyhole surgery. Aortic valve replacement is performed by a team of cardiac surgeons and cardiologists who use a catheter-based approach, with access either via the femoral artery, or through a small incision in the front of the chest, and then via the apex (tip) of the heart. This procedure is performed in a special operating room that is equipped with state-of-the-art imaging technology (hybrid operating room).

Both techniques are still new, and can currently only be used with tissue valves. As a result, there is still a paucity of data on the long-term durability of these tissue valves. So far, both types of procedures have only been used to treat very elderly patients. This is because reduced long-term durability is considered an acceptable trade-off in these patients. Given that keyhole surgery techniques result in much less trauma to the patient, the benefits associated with these techniques should not be underestimated, particularly with regard to elderly patients whose risk of suffering complications following or during conventional surgery may be too high.

The decision as to which of the two techniques should be used in a particular case should be made following a number of different investigations and, where appropriate, an intervention to widen the aortic valve using a balloon catheter. This means that both procedures require two separate stays in hospital. In short, neither of these two procedures are suitable for use in the event of a clinical emergency.