Abstract
Cardiac valve surgery, for either replacement or repair, has seen significant advancements over the last several decades. The majority of operative techniques that have been developed, such as valvular commissurotomy, debridement, prolapse reduction, and native valve replacement, are performed through a full sternotomy or lateral thoracotomy. Although a conventional full median sternotomy offers good exposure to the heart and the origins of the great cardiac vessels, the associated surgical trauma and postoperative bleeding, risk of wound infection, thoracic wall instability and the appearance of the sternal scar from the lengthy incision have driven the current trend toward less invasive cardiothoracic surgical procedures while maintaining or even improving the effectiveness and safety of standard operative procedures. Minimally invasive cardiac surgery has been expanding during the last decade with the use of significantly smaller and shorter incisions, providing patients less painful and better aesthetic outcomes with faster recovery times and lower hospital costs. The use of these new techniques will certainly lessen the increased morbidity and mortality that results from reoperations. Patients have come to expect and request smaller incisions rather than the traditional full median sternotomy access. In this review, we highlight current trends in minimally invasive heart valve therapy, specifically the surgical instruments, devices, and surgical visualization techniques developed for this approach. These modern surgical instruments and devices are essential to help surgeons compensate for limitations in both the field of view and actual surgical field in which to operate by using video assistance and more sophisticated and precise instruments. The many innovative solutions to these challenges that have been designed and manufactured will be addressed.
Keywords: Minimally invasive, surgery devices, instruments, cardiac valve disease, surgical access, cardiopulmonary bypass, repair or replacement, native valve, prosthetic valve
4