Robotic-Assisted Aortic Valve Replacement in a Hybrid Approach to Concomitant Aortic Valve and Coronary Disease.

BACKGROUND

Robotic-assisted aortic valve replacement (RAVR) has emerged as a novel minimally invasive approach to surgically manage aortic valve disease.

CASE SUMMARY: A 74-year-old man presented with several months of worsening dyspnea and chest pain on exertion. Preoperative work-up identified severe aortic stenosis along with coronary artery disease. Despite being at low operative risk, the patient had a small aortic root, coronary disease not amenable to surgical revascularization, and wanted to avoid sternotomy. The decision was made to perform RAVR with percutaneous coronary intervention in a hybrid approach to manage his concomitant pathologies.

DISCUSSION: We demonstrate the safety and feasibility of performing RAVR using a sutureless aortic valve prosthesis to optimize hemodynamics in a patient with a small aortic root. We also describe the combination of RAVR and percutaneous coronary intervention as part of a hybrid treatment paradigm to manage concomitant aortic stenosis and coronary artery disease.