Totally Endoscopic Uniportal Surgical Aortic Valve Replacement via Transcervical Approach: How to Do It

The number of aortic valve interventions continues to increase. Although transcatheter aortic valve replacement (TAVR) was a milestone in the field, it is quite uncertain whether this technique will completely supplant surgical aortic valve replacement (SAVR) due to its recognized shortcomings and access limitations.  However, TAVR can be considered in short-term the competitor to SAVR and therefore, there is a pressing clinical need for a less invasive SAVR procedure, capable of delivering superior outcomes when compared with TAVR, without the level of invasiveness of current approaches to SAVR. Different totally endoscopic aortic valve replacement approaches have been described. Nevertheless, we believe that these can be improved and facilitated by cutting-edge technology such as CoreVista® Retractor and CoreVista® Monitor in the surgical field and the feasibility of a single, unique port access centred upon a small transcervical incision to perform the entire procedure. This paper explores the current state of the art and presents detailed how-to-do-it steps for implementing Totally Endoscopic Uniportal SAVR based upon the Transcervical Approach.