Towards no-scar cardiac surgery - minimally invasive access through umbilicus for aortic valve replacement

Martins Kalejs, Enrico Ferrari, Ludwig Karl von Segesser

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


There is an ever-growing trend towards less-invasive procedures in all fields of medicine. We designed an animal study to prove the concept that trans-apical aortic valve replacement from an incision within the umbilicus through a single channel for instruments is feasible, which would be a major leap towards no-scar cardiac surgery. In three adult pigs, after creating a single 3-cm incision at a place where the human umbilicus would be, we introduced a 30F sheath through a tunnel created by an endoscopic vein-harvesting device up to the cardiac apex, through it and up to the left ventricle simulating the approach for trans-apical aortic valve replacement. We used a standard Amplatz nitinol occluder to seal the defect in ventricle wall later. The animals were followed up for 1 h. Blood loss was minimal, and no tamponade occurred in any of the animals. In addition, we performed a test with water column static pressure to evaluate the impact of preclotting on the sealing properties of the occluders: 1 min flow-through was 2860 ± 176 ml for the standard occluders and 348 ± 56 ml for preclotted occluders (p < 0.001).

Original languageEnglish
Pages (from-to)773-775
Number of pages3
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number4
Publication statusPublished - Oct 2009
Externally publishedYes


  • Minimally invasive cardiac surgery
  • No-scar surgery
  • Occluder
  • Trans-apical access
  • Trans-catheter valve replacement

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


Dive into the research topics of 'Towards no-scar cardiac surgery - minimally invasive access through umbilicus for aortic valve replacement'. Together they form a unique fingerprint.

Cite this