Introduction
Minimally invasive cardiac surgery has become a new trend in modern
medicine because of its reduced trauma, less bleeding and shorter
post-operative recovery time, and there has been a significant increase
in the number of studies related to minimally invasive valve
surgery[1]. With the promotion of minimally
invasive concepts and advances in total thoracoscopic valve surgery,
total thoracoscopic valve surgery is not limited to the mitral valve
procedure anymore, and total thoracoscopic aortic valve surgery has
become a new option for patients with aortic valve lesions. However, due
to its anatomical characteristics, poor surgical field exposure and
limited operating space, total thoracoscopic aortic valve surgery has
not become a routine choice of minimally invasive aortic valve surgery
just like total thoracoscopic mitral valve surgery. Total thoracoscopic
aortic valve replacement (AVR) was first proposed in 2014 by Vola et
al[2], and a single-arm study that included 14
patients who underwent total thoracoscopic AVR in 2016 confirmed the
safety and reliability of this procedure[3].
In this study, patients hospitalized for aortic valve lesions who
underwent AVR were divided into three groups and underwent conventional
AVR, upper mini-sternotomy AVR and total thoracoscopic AVR respectively.
Baseline data, perioperative data, and early outcomes were used for
observation and comparison to assess the safety and reliability of total
thoracoscopic AVR.