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minimally invasive mitral

P Verbrugghe, H De Praetere, B Meuris, F Rega, B Meyns, G Goodall, P Herijgers
No abstract text is available yet for this article.
2016: Acta Cardiologica
James R McCarthy, T Sloane Guy
Mitral valve dysfunction can seriously impair patients' lives and may require valve repair or replacement. Surgery can be performed using techniques including sternotomy; right thoracotomy with or without robot assistance; and the totally endoscopic robotic technique, which requires percutaneous techniques, femoral cannulation, and endovascular aortic cross-clamping. The totally endoscopic robotic technique has been facilitated by minimally invasive surgical techniques, the evolution of endoscopic techniques, and the development of surgical robots...
October 2016: AORN Journal
Peyman Sardari Nia, Samuel Heuts, Jean Daemen, Peter Luyten, Jindrich Vainer, Jan Hoorntje, Emile Cheriex, Jos Maessen
OBJECTIVES: Mitral valve repair performed by an experienced surgeon is superior to mitral valve replacement for degenerative mitral valve disease; however, many surgeons are still deterred from adapting this procedure because of a steep learning curve. Simulation-based training and planning could improve the surgical performance and reduce the learning curve. The aim of this study was to develop a patient-specific simulation for mitral valve repair and provide a proof of concept of personalized medicine in a patient prospectively planned for mitral valve surgery...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Raif Umut Ayoglu, Mustafa Emmiler, Lutfi Ozyurek, Kerem Inanoglu, Sadik Ozmen
OBJECTIVES: Various minimally invasive surgical approaches have been used in mitral valve (MV) surgery. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive, alternative procedure for the treatment of degenerative mitral regurgitation. There are several special considerations for the anesthesiologist during the TOP-MINI procedure. The main purpose of this study was to present the anesthetic management of the TOP-MINI procedure...
June 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Eric J Lehr, T Sloane Guy, Robert L Smith, Eugene A Grossi, Richard J Shemin, Evelio Rodriguez, Gorav Ailawadi, Arvind K Agnihotri, Trevor M Fayers, W Clark Hargrove, Brian W Hummel, Junaid H Khan, S Chris Malaisrie, John R Mehall, Douglas A Murphy, William H Ryan, Arash Salemi, Romualdo J Segurola, J Michael Smith, J Alan Wolfe, Paul W Weldner, Glenn R Barnhart, Scott M Goldman, Clifton T P Lewis
Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program.
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Thomas Martens, Frank Caes, Michel De Pauw, Lineke Hens, Thierry Bove
Significant mitral valve disease with atrial fibrillation after heart transplantation is unusual. We report the diagnosis and minimally invasive surgical treatment 17 years after transplantation, in which mitral valve repair together with left atrial ablation was performed, resulting in a satisfying clinical and echocardiographic improvement.
October 2016: Annals of Thoracic Surgery
Ali Sait Kavakli, Raif Umut Ayoglu, Nilgun Kavrut Ozturk, Omer Haldun Tekinalp, Zehra Erkal, Kerem Inanoglu, Mustafa Emmiler
Elderly patients with severe hematological malignancies may require cardiac surgery. The combined impact of cardiopulmonary bypass (CPB) and surgical trauma is a potent inflammatory activator and is increased by intraoperative and postoperative complications. To avoid the adverse effects of CPB, minimally invasive off-pump techniques may be used in these patients. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive technique for mitral valve repair, which makes it possible to avoid the risks of CPB in selected patients, such as elderly, cancer or immunosuppressive patients...
September 19, 2016: Journal of Anesthesia
Taichi Sakaguchi
Since its introduction in the mid-1990s, minimally invasive mitral valve surgery (MIMVS) has been shown to be a feasible alternative to a conventional full-sternotomy approach, and several studies have reported excellent clinical outcomes with low perioperative morbidity and mortality. As a result, MIMVS is being increasingly employed as a routine procedure worldwide. On the other hand, several issues have been raised, including complications specific to this technique and its steep learning curve, while there are also concerns regarding the durability of a mitral valve repair through a limited access...
September 16, 2016: General Thoracic and Cardiovascular Surgery
Ralph J Damiano
No abstract text is available yet for this article.
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Rüdiger Lange, Bernhard Voss, Victoria Kehl, Domenico Mazzitelli, Peter Tassani-Prell, Thomas Günther
BACKGROUND: Mitral valve (MV) repair through a right minithoracotomy (RT) is technically more demanding than through a median sternotomy (MS) and has been cited for a higher rate of reoperation, increased postoperative bleeding, thromboembolic events, poor visualization, and longer operative times. Randomized studies are not available, however, and specific characteristics of patients who undergo operation with either technique are usually highly different. Therefore, a propensity matching study was performed to reduce selection bias...
September 9, 2016: Annals of Thoracic Surgery
Marco Vola, Jean-François Fuzellier
No abstract text is available yet for this article.
September 11, 2016: European Journal of Cardio-thoracic Surgery
Christos G Mihos, Andres M Pineda, Sofia A Horvath, Orlando Santana
Ischemic mitral regurgitation (MR) after myocardial infarction is associated with poor long-term survival, and the optimal treatment strategy remains debated. The most common repair technique used is a restrictive annuloplasty. However, up to 15% to 30% of patients experience recurrent MR owing to progressive left ventricular remodeling and geometric distortion of the mitral valve apparatus. Anterior mitral leaflet augmentation using a pericardial patch, in combination with a true-sized mitral annuloplasty, has been proposed as an adjunctive technique to increase the durability of valve repair for ischemic MR...
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Sarah L Breves, Inki Hong, James McCarthy, Mohammed Kashem, G William Moser, Thomas M Kelley, Erin E Mills, Grayson H Wheatley, T Sloane Guy
OBJECTIVE: Aortic occlusion with an endoballoon is a well-established technique to facilitate robotic and minimally invasive mitral valve surgery. Use of the endoballoon has several relative contraindications including ascending aortic dilatation greater than 38 mm in size. We sought to review our experience using the endoballoon in cases of totally endoscopic mitral valve surgery with aortic diameters greater than 38 mm. METHODS: A retrospective review of our single-site database was conducted to identify patients undergoing totally endoscopic mitral valve surgery by a single surgeon using an endoballoon and who had ascending aortic dilation...
September 6, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Dale A Burkett, Cameron Slorach, Sonali S Patel, Andrew N Redington, D Dunbar Ivy, Luc Mertens, Adel K Younoszai, Mark K Friedberg
BACKGROUND: Through ventricular interdependence, pulmonary hypertension (PH) induces left ventricular (LV) dysfunction. We hypothesized that pediatric PH patients have LV diastolic dysfunction, related to adverse pulmonary hemodynamics, leftward septal shift, and prolonged right ventricular systole. METHODS AND RESULTS: Echocardiography was prospectively performed at 2 institutions in 54 pediatric PH patients during cardiac catheterization and in 54 matched controls...
September 2016: Circulation. Cardiovascular Imaging
Johan van der Merwe, Filip Casselman, Bernard Stockman, Yvette Vermeulen, Ivan Degrieck, Frank Van Praet
OBJECTIVES: This study presents the first report on in-hospital and long-term outcomes of endoscopic port access atrioventricular valve surgery (EPAAVVS) in adult patients with uncorrected congenital chest wall deformities (CCWDs). METHODS: Our current surgical team performed EPAAVVS in 7 consecutive adult patients (mean age 51.3 ± 16.4 years, 14.3% female, 50% older than 60 years, mean EuroSCORE II 0.8 ± 0.1%) with uncorrected CCWDs between 1 November 2009 and 30 November 2015...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
Guoying An, Hongyu Zhang, Shanguang Zheng, Weixin Wang, Qin Wu, Quansheng Xing
OBJECTIVES: To investigate the feasibility and cosmetic results of a right subaxillary thoracotomy for closure of doubly committed subarterial ventricular septal defects. METHODS: From October 2009 to September 2015, 78 patients [50 boys, 28 girls, mean age 4.7 ± 2.9 years (range, 0.5-15 years) and mean body weight 16.3 ± 9.6 kg (range, 7-42 kg)] with doubly committed subarterial ventricular septal defects were treated with minimally invasive surgical closure through a right subaxillary thoracotomy...
August 11, 2016: Interactive Cardiovascular and Thoracic Surgery
X Z Xu, W Yi, H Li, G Y Shi, Y W Chen, N Qiao, M Chen, Z X Jin, R Zhao, Y Jin, S Q Yu
OBJECTIVE: To summarize the experience of totally thoracoscopic cardiac surgical (TTCS) at congenital heart diseases (CHD) treatment. METHODS: From April 2000 to March 2016, 2 543 patients with CHD underwent TTCS in Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, including 957 male and 1 586 female patients. The age ranged from 0.5 to 66.0 years with a mean age of (21±18) years. The body weight ranged from 6 to 118 kg with a mean of (49±30) kg...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
S Yücel, H Ince, S Kische, M A Sherif, H Bushnaq, A Bärisch, A Öner
The demographic changes in society lead to an increasing number of patients with aortic valve stenosis and mitral regurgitation. Simultaneously the higher age of patients is associated with an increase in multimorbidity with a high surgical risk so that they cannot be referred to surgery. Besides the current gold standard of surgery, minimally invasive therapeutic options are increasingly becoming established for these patients. For the differentiated indications and therapeutic success, a multidisciplinary heart team assumes an important role...
August 2016: Herz
Toshiaki Ito
We perform minimally invasive mitral valve plasty under totally endoscopic view. Skin incisions are composed of a 3 to 5 cm of main wound along the right 4th intercostal space, 1 trocar port in the 3rd intercostal space, and a camera port in the 5th intercostal space. Matal rib spreader is not used. A 3-dimensional endoscope was recently introduced. Forceps controlled by the left hand are inserted through the independent trocar port in the 3rd intercostal space. Left atrial retractor, aortic clamp, and all the cannulae are inserted through the main incision...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kazuma Okamoto
Mitral valve surgery via minithoracotomy under direct vision is a safe and feasible surgery with excellent short-term and long-term result. Because of patients' satisfaction regarding early recover and cosmetic aspects, further growth and spread of this minimally invasive approach is expected. Although incision is longer in a few cm compared with totally endoscopic cardiac surgery, minithoracotomy approach under direct vision for mitral valve surgery is worth while to adapt. For good operative result, careful patient selection, secure establishment of cardiopulmonary bypass, and strict myocardial protection are important...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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