Transaxillary access for valve prosthesis – advantages and features

Minimally invasive surgical techniques in cardiac surgery are increasingly applied, particularly in elderly and high-risk patients. One of the most universal and promising approaches is the transaxillary access, which allows surgical interventions on all cardiac valves and their combinations. This access does not require bone transection and leaves practically an invisible scar, making it exceptionally sparing. In combination with sutureless valve prostheses (e.g., Perceval S), this approach shortens aortic cross-clamp and cardiopulmonary bypass times, improves hemodynamic outcomes, and facilitates work in a limited surgical fi eld. In the Department of Cardiac Surgery at Tokuda Hospital, 19 operations have been performed using this method over the past year and a half: 8 aortic valves, 10 mitral valves, and 1 tricuspid valve. The present article reviews the advantages and specifi c features of the transaxillary approach in valve replacement.