Minimally invasive aortic valve surgery: Anesthetic considerations

The surgical approach to aortic valve surgery has traditionally involved a median sternotomy with cannulation of the ascending aorta and right atrium for the conduct of cardiopulmonary bypass (CPB) (1). Concerns regarding hospital stay, cost containment, and managed care have prompted less invasive surgical approaches for coronary artery bypass surgery. Recently, a new approach to aortic valve surgery has been used to facilitate early tracheal extubation, ambulation, and hospital discharge. We present two cases that describe the surgical approach as well as perioperative complications and the anesthetic considerations for managing these patients.