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https://www.readbyqxmd.com/read/28203542/robotic-trans-atrial-and-trans-mitral-ventricular-septal-resection
#1
REVIEW
W Randolph Chitwood
Localized ventricular septal hypertrophy, also known as idiopathic hypertrophic subaortic stenosis or idiopathic hypertrophic subaortic septal obstruction (IHSS), can create severe ventricular outflow obstruction. This often results in a high sub-aortic pressure gradient with potentially lethal symptoms. In 1960, Braunwald described the hemodynamic characteristics of IHSS, and thereafter, Morrow developed a trans-aortic approach to resect a large part of the ventricular septum, enlarging the outflow tract. The Morrow operation has remained the gold standard for surgically treating this pathology...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203539/cost-effectiveness-of-robotic-mitral-valve-surgery
#2
Emmanuel Moss, Michael E Halkos
Significant technological advances have led to an impressive evolution in mitral valve surgery over the last two decades, allowing surgeons to safely perform less invasive operations through the right chest. Most new technology comes with an increased upfront cost that must be measured against postoperative savings and other advantages such as decreased perioperative complications, faster recovery, and earlier return to preoperative level of functioning. The Da Vinci robot is an example of such a technology, combining the significant benefits of minimally invasive surgery with a "gold standard" valve repair...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203535/the-state-of-robotic-cardiac-surgery-in-europe
#3
Matteo Pettinari, Emiliano Navarra, Philippe Noirhomme, Herbert Gutermann
BACKGROUND: In the past two decades, the introduction of robotic technology has facilitated minimally invasive cardiac surgery, allowing surgeons to operate endoscopically rather than through a median sternotomy. This approach has facilitated procedures for several structural heart conditions, including mitral valve repair, atrial septal defect closure and multivessel minimally invasive coronary artery bypass grafting. In this rapidly evolving field, we review the status of robotic cardiac surgery in Europe with a focus on mitral valve surgery and coronary revascularization...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28201842/minimally-invasive-aortic-root-replacement-with-valved-conduits-through-partial-upper-sternotomy
#4
Julia Hillebrand, Mosab Alshakaki, Sven Martens, Mirela Scherer
Background Minimally invasive surgical access through limited sternotomy reduces trauma and morbidity in cardiosurgical patients. However, until now, it is not the standard access for aortic root replacement. This study details our clinic's experience with minimally invasive implantation of valved conduits through partial upper sternotomy and the comparison to conventional full median sternotomy. Methods Between January 2012 and March 2016, a total of 187 patients underwent aortic root replacement with valved conduits in our department...
February 15, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28149570/optimizing-the-exposure-in-minimally-invasive-mitral-surgery-a-new-left-atrial-retractor-system
#5
Ernesto Greco, David Rose, Francesco Irace, Giacomo Frati
Optimal exposure of the mitral valve is paramount in minimally invasive surgery (MIS) and a prerequisite for successful mitral valve repair or replacement. We report the concept of a new left atrial retractor (Karl Storz GmbH, Tuttlingen, Germany) dedicated to MIS. The effectiveness of the device was evaluated in a prospective series of 40 patients successfully operated at our institution.
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28129316/coronary-artery-disease-complexity-on-the-outcomes-of-a-staged-approach-of-pci-followed-by-minimally-invasive-valve-surgery
#6
Andrés M Pineda, Saqib A Gowani, Christos G Mihos, Ramesh Chandra, Orlando Santana, Joseph Lamelas, Nirat Beohar
OBJECTIVE: A staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) is an alternative to the combined coronary artery bypass graft and valve surgery for patients with concomitant coronary artery (CAD) and valvular heart disease. We sought to evaluate the impact of the complexity of CAD, as assessed by the Syntax score, on the outcomes of the staged approach. METHODS: We retrospectively evaluated 138 patients who underwent PCI and MIVS at our institution between January 2009 and June 2013...
January 27, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28108573/transcatheter-mitral-valve-implantation-a-percutaneous-transapical-system
#7
Huangdong Dai, Katharina Huenges, Saskia Pokorny, Gunther Fischer, Jochen Cremer, Anja Metzner, Derk Frank, Georg Lutter
OBJECTIVES: Despite recent achievements, implantation of a transcatheter mitral valved stent remains challenging. In this study, we present a different approach for implantation of a percutaneous mitral valved stent. METHODS: Percutaneous transapical access is combined with, respectively, a left-transatrial, right-transatrial/transseptal or transfemoral/transseptal approach for mitral valve stent implantation and secure fixation. The apical fixation and occlusion are ensured with an Amplatzer occluder...
January 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28106967/mitral-valve-repair-and-aortic-valve-replacement-with-sutureless-prosthesis-implantation-through-a-right-minithoracotomy
#8
Antonio Lio, Antonio Miceli, Matteo Ferrarini, Mattia Glauber
Little experience exists in minimally invasive treatment of double-valve disease. In this report, we present a minimally invasive approach for mitral and aortic valve disease through a minithoracotomy in the 3rd intercostal space with a sutureless aortic prosthesis implantation.
December 14, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28077510/mitral-implant-of-the-inovare-transcatheter-heart-valve-in-failed-surgical-bioprostheses-a-novel-alternative-for-valve-in-valve-procedures
#9
Diego Felipe Gaia, Ademir Massarico Braz, Matheus Simonato, Danny Dvir, João Roberto Breda, Gustavo Calado Ribeiro, Carolina Baeta Ferreira, José Augusto Marcondes Souza, Enio Buffolo, José Honório Palma
OBJECTIVES: Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-invasive approach, reducing morbidity and mortality. The objective of this paper was to evaluate the mitral ViV approach using the Braile Inovare prosthesis. METHODS: The transcatheter balloon-expandable Braile Inovare prosthesis was used in 12 cases...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28052663/acute-single-leaflet-dysfunction-and-spontaneous-recovery-of-a-previously-implanted-bi-leaflet-mechanical-mitral-prosthesis-during-unrelated-isolated-minimally-invasive-aortic-valve-replacement-a-surgical-decision-making-dilemma-in-a-high-risk-patient
#10
LETTER
https://www.readbyqxmd.com/read/28043429/results-of-cryoablation-for-atrial-fibrillation-concomitant-with-video-assisted-minimally-invasive-mitral-valve-surgery
#11
Giovanni Marchetto, Matteo Anselmino, Chiara Rovera, Samuel Mancuso, Davide Ricci, Marina Antolini, Mara Morello, Fiorenzo Gaita, Mauro Rinaldi
Interest in minimally invasive video-assisted mitral valve surgery (MIMVS) is rapidly growing. Data on concomitant atrial fibrillation (AF) ablation to MIMVS are still lacking. The present study investigates the long-term results of AF cryoablation concomitant to MIMVS. From October 2006-September 2014, 68 patients with mitral valve disease (age 65.9 ± 11.1 years, 34 men out of 68 patients, Euroscore log 5.4 ± 4.5) and drug-resistant AF underwent MIMVS via right minithoracotomy and concomitant left-sided AF endocardial cryoablation (Cryoflex Medtronic, Minneapolis, MN)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040754/antegrade-and-retrograde-perfusion-in-minimally-invasive-mitral-valve-surgery-with-transthoracic-aortic-clamping-a-single-institution-experience-with-1632-patients-over-12-years
#12
Michele Murzi, Alfredo G Cerillo, Tommaso Gasbarri, Rafik Margaryan, Enkel Kallushi, Pierandrea Farneti, Marco Solinas
OBJECTIVES: The aim of the present study was to evaluate the impact of a retrograde arterial perfusion (RAP) strategy versus an antegrade arterial perfusion (AAP) strategy in a consecutive, large cohort of patients who underwent minimally invasive mitral valve surgery with transthoracic aortic clamping through a right minithoracotomy. METHODS: Between 2003 and 2015, 1632 consecutive patients underwent first-time minimally invasive mitral valve surgery with transthoracic aortic clamping at our institution; 141 (8...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28017338/complications-associated-with-femoral-cannulation-during-minimally-invasive-cardiac-surgery
#13
Joseph Lamelas, Roy F Williams, Maurice Mawad, Angelo LaPietra
BACKGROUND: Different types of cannulation techniques are available for minimally invasive cardiac surgery. At our institution, we favor a femoral platform for most minimally invasive cardiac procedures. Here, we review our results utilizing this cannulation approach. METHODS: We retrospectively reviewed all minimally invasive valve surgeries that were performed at our institution between January 2009 and January 2015. Operative times, lengths of stay, postoperative complications, and mortality were analyzed...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28009954/outcomes-of-minimally-invasive-valve-surgery-in-patients-with-multiple-previous-cardiac-operations
#14
Orlando Santana, Rama Krishna, Nisharahmed Kherada, Christos G Mihos
BACKGROUND: The study aim was to evaluate the outcomes of minimally invasive valve surgery, performed via a right anterior thoracotomy approach, in patients with a history of multiple (more than two) prior cardiac surgeries. METHODS: A retrospective review was conducted of all minimally invasive valve operations performed in patients with a prior history of two or more cardiac surgeries, including coronary artery bypass grafting (CABG) and/or valve surgery, at the authors' institution between January 2008 and November 2014...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28007259/a-standardized-loop-technique-for-mitral-valve-repair
#15
Ilir Hysi, Olivier Rebet, Laurence Gautier, Olivier Fabre
The loop technique is widely used for mitral valve repair. However, estimation of the correct loops' length remains challenging. We describe a standardized technique with implantation of standardized 15- and 25-mm loops for posterior and anterior mitral prolapses. The number of loops and the site of their implantation are decided after a careful surgical valve analysis. This has shown reliable results in our initial experience in eight patients both, in sternotomy and minimally invasive surgery repairs, but needs further long-term evaluation...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27942491/technical-aspects-of-robotic-posterior-mitral-valve-leaflet-repair
#16
REVIEW
Hoda Javadikasgari, Rakesh M Suri, Tomislav Mihaljevic, Stephanie Mick, A Marc Gillinov
Posterior mitral valve leaflet repair is safe, effective and durable and can be performed through conventional sternotomy or by using minimally invasive thoracoscopic or robotic-assisted approaches. Triangular resection with ventricularization, quadrangular resection with sliding or folding leaflet reconstruction, neochordae implantation and edge-to-edge leaflet repair are different techniques for eliminating the prolapsing mitral leaflet segment and restoring normal leaflet coaptation. Recent studies have demonstrated that minimally invasive approaches are associated with a reduced risk of postoperative complications, shorter hospital stay and improved cosmetic outcomes when compared to conventional sternotomy...
November 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27942489/is-minimally-invasive-thoracoscopic-surgery-the-new-benchmark-for-treating-mitral-valve-disease
#17
Andrew B Goldstone, Y Joseph Woo
The treatment of mitral valve disease remains dynamic; surgeons and patients must now choose between many different surgical options when addressing mitral regurgitation and mitral stenosis. Notably, advances in imaging and surgical instrumentation allow surgeons to perform less invasive mitral valve surgery that spares the sternum. With favorable long-term data now emerging, we compare the benefits and risks of thoracoscopic mitral valve surgery with that through conventional sternotomy or surgery that is robot-assisted...
November 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27909512/concomitant-left-atrial-appendage-clipping-during-minimally-invasive-mitral-valve-surgery-technically-feasible-and-safe
#18
Ashraf Alqaqa Md, Shabiah Martin Md, Aiman Hamdan Md Facc, Fayez Shamoon Md Facc, Kourosh T Asgarian DO
BACKGROUND: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach. METHOD: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27905211/minimally-invasive-mitral-repair-surgery-why-does-controversy-still-persist
#19
REVIEW
Jeevan Nagendran, Jorge Catrip, Katie L Losenno, Corey Adams, Bob Kiaii, Michael W A Chu
Surgical treatment for mitral valve disease has evolved and remains a rapidly expanding field. Minimally invasive mitral valve repair (MI-MVR) is a well-known alternative to conventional sternotomy mitral valve repair (cMVR). However, controversy as to the efficacy of MI-MVR persists, hindering the adoption and potential benefits of this less invasive approach. Areas covered: In this review, we provide an updated summary evaluation of the latest evidence, including observational studies, clinical trials and meta-analyses, regarding MI-MVR in comparison to cMVR...
January 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27879532/myocardial-protection-and-financial-considerations-of-custodiol-cardioplegia-in-minimally-invasive-and-open-valve-surgery
#20
Brian W Hummel, Randall W Buss, Paul L DiGiorgi, Brittany N Laviano, Nalani A Yaeger, M Lee Lucas, George M Comas
OBJECTIVE: Single-dose antegrade crystalloid cardioplegia with Custodiol-HTK (histidine-tryptophan-ketoglutarate) has been used for many years. Its safety and efficacy were established in experimental and clinical studies. It is beneficial in complex valve surgery because it provides a long period of myocardial protection with a single dose. Thus, valve procedures (minimally invasive or open) can be performed with limited interruption. The aim of this study is to compare the use of Custodiol-HTK cardioplegia with traditional blood cardioplegia in patients undergoing minimally invasive and open valve surgery...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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