Another reason to become comfortable with the mini – thoracotomy AVR’S is that it prepares you for a direct aortic TAVR. This DIRECT AORTIC access for a TAVR was performed via 3-4 cm mini-thoracotomy without rib dislocation. The 18 Fr. sheath was passed through a separate incision. There is obviously a need for the sheath’s to be made shorter as well as the delivery device.
Becoming comfortable with this access will also prepare you for the sutureless valve implants.