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International Journal of Molecular Medicine and Advance Sciences
2020, Volume 16, Issue 1 : 1-5
Research Article
Minimally Invasive Aortic Valve Repair Trends in Bangladesh
 ,
 ,
1
Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
2
Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
3
Department of Public Health & Health Systems, South Asian Institute of Medical Sciences, Chattogram, Bangladesh
Received
Jan. 5, 2020
Revised
Feb. 18, 2020
Accepted
March 25, 2020
Published
April 30, 2020
Abstract

Background: Minimally invasive aortic valve repair (MI-AVR) has emerged globally as an alternative to conventional full sternotomy, aiming to reduce surgical trauma, blood loss, intensive care unit (ICU) stay, and recovery time. While developed countries have widely adopted minimally invasive approaches, their diffusion in low- and middle-income countries such as Bangladesh is still evolving. Objective: This narrative review and descriptive analysis aim to describe current trends, institutional experiences, patient profiles, surgical techniques, and perioperative outcomes of minimally invasive aortic valve repair in Bangladesh. Methods: A mixed-method approach was employed, combining (a) a narrative review of international literature on minimally invasive cardiac surgery, and (b) a descriptive synthesis of available institutional reports, conference abstracts, and local cardiac surgery registries from major Bangladeshi centers performing aortic valve surgery. Key outcome indicators included annual case volume, type of minimally invasive access, cardiopulmonary bypass (CPB) time, aortic cross-clamp time, ICU stay, hospital stay, and early postoperative complications. Results: Over the last decade, Bangladeshi tertiary cardiac centers have transitioned from isolated pilot cases to steadily increasing volumes of MI-AVR, though conventional full sternotomy still predominates. Right anterior mini-thoracotomy and upper mini-sternotomy are the most commonly reported approaches. Early institutional series suggest comparable mortality to conventional surgery, with reduced blood loss and shorter hospital stays in selected low- to intermediate-risk patients. However, limitations include restricted access to advanced imaging, limited training opportunities, cost constraints, and absence of a national standardized registry. Conclusion: Minimally invasive aortic valve repair is an emerging but promising technique in Bangladesh. With growing surgical expertise, investments in training and technology, and development of a national cardiac surgery database, MI-AVR is likely to expand further, especially in high-volume centers. Policymakers and professional societies should prioritize structured training and outcome monitoring to optimize patient benefit.

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