Cardiac entrapment during minimally invasive aortic valve replacement

Reduced exposure during minimally invasive valve operations poses new difficulties in intraoperative management. Transesophageal echocardiography improves intraoperative management. During a minimally invasive aortic valve replacement, we encountered unexpected hypotension due to mechanical compression of the right ventricle against the sternum. Transesophageal echocardiography facilitated rapid diagnosis of this problem. Surgeons performing these procedures should be aware of this potential problem.