“The patient was running a week after the operation”: a robot succeeded in the unthinkable, replacing a heart valve without opening the chest
The surgical robot used at the Cleveland Clinic allows you to replace an aortic valve via the neck, via four small incisions and without sternotomy. A world first made on four patients in 2025. © Cleveland Clinic / HVI Quinlan, image communicated as part of the study on the transcervical Robotic AVR, 2025
Replacing an aortic valve is a heavy act, traditionally associated with sternotomy, long recovery and significant pain. But this scheme has just shattered. In Cleveland, a team of surgeons made a world first by setting up a valve via an incision in the neck, without touching the thorax – all assisted by robot. The operation promises a new standard: faster, more precise, less invasive.
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Heart surgery controlled by robot, without opening the thorax
The intervention was practiced on four patients aged 60 to 74, with a robot introduced by transcervical route. Dr. Marijan Koprivanac, at the origin of this approach, relied on his experience of transcervical thymectomy, adapted here to the aorta.
The robot allows smaller incisions, better visualization and increased precision compared to conventional methods.
The main entrance is by a natural fold of the neck, minimizing any visible trace. Three other minimal incisions complete access. Inside, the robotic arms allow a complete debride of the native valve, then the installation of the prosthesis (inspiration resilia or pierval l).
Official Cleveland Clinic diagram showing the four chest incisions used during robotic access to the aortic valve by transcenter. Each entry point is positioned between the 2ᵉ and the 4ᵉ coast, completely avoiding the sternal opening. © Cleveland Clinic, 2025
Express recovery and few pain
The clinical results are impressive. Three patients left the hospital within 4 days; Another at 6ᵉ, after setting up a pacemaker. Post-operative pains have been managed with simple analgesics.
These activities are unimaginable so shortly after a classic operation, even mini-invasive.
A patient resumed running a week after the intervention. Another was back on his farm at D+21. Dr. Marc Gillinov, who heads the Cleveland Clinic thoracic and cardiovascular surgery service, welcomes a major advance. “This significant advance allows surgical valve replacement without any thoracic incision.”
A promising method, but still reserved for the elite
The procedure remains for the moment the prerogative of highly specialized centers. It requires fine knowledge of cervical anatomy and excellent coordination between the members of the surgical team. The average clamping time was 140 minutes, but the goal is clear.
“We are very motivated to perfect this technique and make it a maximum of patients”explains Dr. Marijan Koprivanac. With experience, the team hopes to reduce this period to 90, even 60 minutes. Specific instruments and sutures are being designed to make the gesture make. And ultimately, standardization is envisaged.
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