Introduction: Aortic valve surgery is no exception to the general rule that history is a cycle
in many fields. This manuscript aims to assist readers in transitioning from past to present and on into
the future within the field of aortic valve surgery.
Methods: The existing literature has been examined, including old and modern articles published on
pubmed, old articles non visible on pubmed, old and recent books on the history of medicine, looking
for similarities and repetitions in techniques and surgical approaches to the aortic valve in the past and
the current times.
Results: Steps of evolution included a blind approach, plasty procedures under direct visualization of
the valve without the aid of cardiopulmonary bypass, prosthetic valve replacements via sternotomies
with cardiopulmonary bypass, minimally-invasive access routes, trans-catheter aortic valve implants
(TAVI), suture-less prostheses, mini-thoracotomies incorporating suture-less prostheses, and finally,
totally-endoscopic aortic valve replacements.
Conclusion: After the advent of CPB and several decades of open-heart surgery with full sternotomies,
the minimally-invasive approach has re-emerged. Supported by a commitment to smaller incisions
and shorter bypass times, the concept is now being aggressively developed. The cycling of science,
including the field of aortic valve surgery, means that ingenious theories and concepts that have
fallen by the wayside can be brought back and explored again with current tools and enhanced knowledge.