Abstract
Temporary stent-post cinching to facilitate minimally invasive implantation of the Avalus aortic bioprosthesis
NH Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
Kardiochirurgia i Torakochirurgia Polska 2026; 23 (3): 220-222
Bioprosthetic valves are often supplied with a cinching mechanism in the box. This is to prevent leaflet damage during valve implantation. The incidence of valve damage during implantation is further higher in minimally invasive cardiac surgery. The implantation of a valve in both aortic and mitral positions in minimally invasive surgeries is often challenging due to both the anatomy and the poor visualisation of both the valve and the surrounding structures during implantation which can lead to potential complications of structural damage to the valve leaflets. Various commercially available valves have a work around this issue by positioning the holder with respect to the valve to prevent the dreaded complications that occur during implantation. The Avalus valve is not supplied in the box with a cinching mechanism. This poses a challenge to safe implantation of the valve. During implantation of the valve, due to the relative orientation of the holder to the valve leaflets, there is potential for leaflet damage and tear due to suture entanglement. This complication occurring during implantation can be prevented by using the surgical technique described in this report. Our experience with this technique has been satisfactory. We feel that this should be at the disposal of every surgeon, and we suggest that it may facilitate safe implantation of the Avalus valve in minimally invasive cardiac surgery.
Keywords
minimally invasive cardiac surgery, minimally invasive valve surgery, Avalus™ valve, novel surgical technique
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