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New Clinical Advances in Aortic Valve Surgery
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New Clinical Advances in Aortic Valve Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (26 November 2024) | Viewed by 2231

Special Issue Editors

Dr. Michele Murzi

E-Mail Website
Guest Editor
Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy
Interests: aortic surgery; minimally invasive cardiac surgery; aortic endovascular procedure
Dr. Marco Solinas

E-Mail Website
Guest Editor
Monasterio Foundation Heart Hospital, Massa, Italy
Interests: mitral valve surgery; aortic valve surgery; endoscopic cardiac surgery; sutureless aortic prosthesis

Special Issue Information

Dear Colleagues,

In recent years, aortic valve surgery has undergone numerous and rapid changes. Although aortic valve replacement via median sternotomy remains the standard approach at many centers, new less invasive approaches via partial sternotomies or minithoracotomy are significantly increasing worldwide. These minimally invasive approaches guarantee less surgical trauma which generally translates into quicker recovery, shorter hospitalization times and lower costs. At the same time, the available portfolio of aortic prostheses has also evolved. New models of mechanical valves can now be used with lower INR levels, thus reducing the risks associated with anticoagulant drugs. Sutureless and rapid-deployment prostheses can be implanted with reduced aortic clamping and extracorporeal circulation times, while new chemical treatments are improving the durability of pericardial valves. At the same time, new surgical techniques to enlarge the aortic annulus allowing for the implantation of large-sized prosthesis have been developed. The Special Issue focuses on all aspects of operative and perioperative treatment modalities for minimally invasive aortic valve surgery.

Dr. Michele Murzi
Dr. Marco Solinas
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic valve
  • minimally invasive cardiac surgery
  • aortic stenosis
  • biological aortic prosthesis
  • mechanical aortic prosthesis

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Published Papers (3 papers)

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Research

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11 pages, 873 KiB  
Article
Optimizing Aortic Valve Reoperations: Ministernotomy vs. Full Sternotomy
by Elisa Mikus, Mariafrancesca Fiorentino, Diego Sangiorgi, Simone Calvi, Elena Tenti, Alberto Tripodi and Carlo Savini
J. Clin. Med. 2025, 14(4), 1213; https://doi.org/10.3390/jcm14041213 - 12 Feb 2025
Viewed by 445
Abstract
Background: The minimally invasive approach, performed via ministernotomy, is now often preferred for isolated aortic valve replacement (AVR). However, its benefits in patients with prior cardiac surgery remain unclear. This article compares traditional and minimally invasive surgery for isolated aortic valve replacement [...] Read more.
Background: The minimally invasive approach, performed via ministernotomy, is now often preferred for isolated aortic valve replacement (AVR). However, its benefits in patients with prior cardiac surgery remain unclear. This article compares traditional and minimally invasive surgery for isolated aortic valve replacement in reoperative cases. Methods: A retrospective analysis of 382 patients who underwent reoperative AVR between January 2010 and June 2024 divided them into two groups: 309 patients (80.1%) had a traditional full sternotomy, while 73 patients (19.1%) had minimally invasive AVR via upper ministernotomy. Results: Significant differences were noted between the groups. The full sternotomy group had a higher logistic EuroSCORE (SMD = 0.203), more patients with active endocarditis (SMD = 0.312), and a higher pacemaker rate. To minimize bias, inverse probability of treatment weighting (IPTW) was used. The minimally invasive group had shorter aortic cross-clamp (50 vs. 65 min, p < 0.001) and cardiopulmonary bypass times (62 vs. 85 min, p < 0.001), shorter intensive care unit (ICU) stays (p < 0.001), lower rates of acute renal failure (p = 0.001), and less blood loss (p < 0.001), but similar transfusion needs. Early mortality was higher in the full sternotomy group (4.5% vs. 1.6%, p = 0.025). Conclusions: Minimally invasive aortic valve reoperation via upper “J” sternotomy is as safe as full sternotomy. Patients experienced lower rates of acute renal failure and less postoperative bleeding, contributing to a safer recovery with decreased hospital mortality. Full article
(This article belongs to the Special Issue New Clinical Advances in Aortic Valve Surgery)
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Review

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18 pages, 580 KiB  
Review
Aortic Valve Replacement in the Current Era
by Shannon Parness, Jack T. Womble, Tori E. Hester, Panagiotis Tasoudis and Aurelie E. Merlo
J. Clin. Med. 2025, 14(5), 1447; https://doi.org/10.3390/jcm14051447 - 21 Feb 2025
Viewed by 603
Abstract
Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision-making plays a large [...] Read more.
Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision-making plays a large role in the treatment methodology chosen for each patient. Selection of valve type and surgical intervention requires strong considerations of age and compatibility with vitamin K antagonists (VKAs) to ensure optimal post-operative outcomes. Due to the development of novel surgical techniques, including transcatheter AVR (TAVR) and placement of sutureless valves, patients who previously had limited access to AVD surgical options can now be considered for AVR. Further research into therapeutic development is imperative to improve patient short- and long-term outcomes as well as widen surgical candidacy for those seeking AVR for the management of AVD. Overall, AVR will continue to hold its prominent role in the treatment of AVD. Full article
(This article belongs to the Special Issue New Clinical Advances in Aortic Valve Surgery)
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Graphical abstract

15 pages, 884 KiB  
Review
Contemporary Management of the Aortic Valve—Narrative Review of an Evolving Landscape
by Srihari K. Lella, Brandon E. Ferrell and Tadahisa Sugiura
J. Clin. Med. 2025, 14(1), 134; https://doi.org/10.3390/jcm14010134 - 29 Dec 2024
Viewed by 831
Abstract
Background: Aortic valve replacement has undergone novel changes in recent decades, providing not only a multitude of procedural options but expanding the treatable patient population. Specifically, a number of minimally invasive and interventional treatment options have allowed for the treatment of high and [...] Read more.
Background: Aortic valve replacement has undergone novel changes in recent decades, providing not only a multitude of procedural options but expanding the treatable patient population. Specifically, a number of minimally invasive and interventional treatment options have allowed for the treatment of high and prohibitive risk surgical patients. Further, technology is allowing for the development of innovative surgical and transcatheter valve models, which will advance the treatment of aortic valve disease in the future. Objective: Here, we choose to describe the modern aortic valve replacement techniques and the available valves and designs. Full article
(This article belongs to the Special Issue New Clinical Advances in Aortic Valve Surgery)
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