Minimally Invasive Transaxillary Approach: Aortic Valve Replacement in a Patient with BMI >50 kg/m²

This video demonstrates the successful application of the transaxillary MICLAT-S (Minimally Invasive Cardiac Lateral Surgery) approach for aortic valve replacement (AVR) in a patient with a BMI >50 kg/m². The procedure showcases the feasibility and safety of the MICLAT-S technique in a high-risk, morbidly obese patient, a group traditionally considered challenging for minimally invasive surgery. By sparing the sternum and utilizing a lateral, transaxillary access route, the MICLAT-S method minimizes surgical trauma, reduces the risk of postoperative wound complications, and preserves thoracic stability, even in patients with extreme obesity. Despite the patient’s elevated BMI, the surgical team was able to maintain excellent access to the aortic valve, ensuring a smooth and efficient valve replacement. This video further supports the findings of our study, which demonstrate that the transaxillary concept of MICLAT-S is a viable alternative to traditional sternotomy, offering significant advantages, particularly in obese patients. This description complements the video by tying it to the findings of the paper and underlining the advantages of the transaxillary concept of MICLAT-S technique in this specific patient population.