Key result
Robotic-assisted AVR demonstrates low 30-day mortality of ~0.7% with favorable safety outcomes.
Cohort (n=300)
Yes
Robotic-assisted aortic valve replacement demonstrates excellent safety and 1-year hemodynamic outcomes, offering a reproducible, less invasive alternative to traditional surgery.
Does not yet support routine clinical use of robotic AVR; leaves open the need for randomized trials in low- and intermediate-risk patients.
OBJECTIVES: In an effort to maintain the technical aspects of traditional prosthetic surgical aortic valve replacement (AVR) while reducing invasiveness and facilitate options for concomitant operations, transaxillary lateral mini-thoracotomy endoscopic robotic-assisted aortic valve replacement (RAVR) has been introduced. The present data highlight the contemporary international collaborative experience. METHODS: All consecutive patients undergoing standardized RAVR across 10 international sites (1/2020-7/2024) were evaluated using a central database with 1 year follow-up. RESULTS: A total of 300 patients were analysed with a median predicted risk of 1.6% with aortic stenosis in 85.7%, nearly half with bicuspid valves. Biological prostheses were implanted in 220 (73.3%) with a median valve size 23 mm, 10% receiving aortic root enlargement, with 17% of all patients undergoing concomitant procedures. Median cross-clamp 120 min with no conversions to sternotomy. Median length of stay was 5 days, 4.3% with prolonged ventilation, 1.7% renal failure, 1.0% stroke and 8.3% required re-thoracotomy for evacuation of haemothorax. There were two 30-day operative mortalities (0.7%). The new permanent pacemaker rate for the full cohort was 2.6%. Of 163 patients with complete 1-year clinical and echocardiographic follow-up, mean aortic valve gradient was 10 mmHg and all but 2 patients (1.2%) had trace to no prosthetic or paravalvular insufficiency. CONCLUSIONS: RAVR is safe and effective, providing the reproducible benefits of surgical AVR while affording a less invasive approach that permits the opportunity for concomitant procedures. For low and intermediate risk patients with aortic valve disease, RAVR is a potential reproducible alternative for patients and heart teams.
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Wei et al. (2025) conducted a cohort in Aortic valve disease (n=300). Robotic-assisted aortic valve replacement (RAVR) was evaluated on 30-day operative mortality. Robotic-assisted aortic valve replacement was safe and effective, with a 30-day operative mortality of 0.7% and a 2.6% new permanent pacemaker rate.
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