First Human Totally Endoscopic Robotic-Assisted Sutureless Aortic Valve Replacement.

This is the first human case of totally endoscopic robotic-assisted aortic valve replacement using a sutureless valve. The patient is a 76-year-old man with symptomatic severe aortic valve insufficiency. A 12-mm robotic camera port and 25-mm working port were placed in the second intercostal space, and two 8-mm arm ports in the first and the third intercostal space with femoro-femoral cardiopulmonary bypass. Aortotomy, leaflet resection, confirmation of intraannular valve position, and aortic closure were all performed endoscopically with robotic instruments. The tableside assistant deployed the valve. The patient was discharged on postoperative day 2 without complications.