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Minimally invasive valve surgery

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https://www.readbyqxmd.com/read/28338550/respiratory-system-function-in-patients-after-minimally-invasive-aortic-valve-replacement-surgery-a-case-control-study
#1
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Janusz Andres
OBJECTIVE: The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. METHODS: Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. RESULTS: Complications of the respiratory system occurred in 16...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28329330/three-port-one-incision-plus-two-port-endoscopic-mitral-valve-surgery-without-robotic-assistance%C3%A2
#2
Toshiaki Ito, Atsuo Maekawa, Satoshi Hoshino, Yasunari Hayashi, Sadanari Sawaki, Junji Yanagisawa, Masayoshi Tokoro
OBJECTIVES: Totally endoscopic minimally invasive mitral valve surgery (MIMVS) is technically demanding and often performed with robotic assistance. We hypothesized that three-port video-assisted thoracic surgery (VATS) would facilitate endoscopic MIMVS and evaluated its feasibility and safety. METHODS: From October 2010 to June 2016, we performed first-time MIMVS in 250 consecutive patients (122 male), with median age of 65 years (54-73 years, 25-75 percentile)...
March 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328570/concomitant-valve-in-valve-transcatheter-aortic-valve-replacement-and-left-ventricular-assist-device-implantation
#3
Takashi Murashita, David L Joyce, Alberto Pochettino, John M Stulak, Lyle D Joyce
Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28314525/intraoperative-electromagnetic-navigational-bronchoscopic-localization-of-small-deep-or-subsolid-pulmonary-nodules
#4
Abbas Abbas, Sagar Kadakia, Vishnu Ambur, Kimberly Muro, Larry Kaiser
BACKGROUND: Localizing small or deep pulmonary nodules or subsolid ground-glass opacities often is difficult during video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS). This can result in larger resections or conversion to thoracotomy. The goal of this study is to evaluate the role of electromagnetic navigational bronchoscopic localization (ENBL) as a safe and accurate intraoperative method to localize small, deep, or subsolid nodules. METHODS: This is a single-institution, single-surgeon retrospective study of all patients (51) who underwent combined ENBL and resection of 54 nodules between May 2013 and August 2015...
February 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28291141/antegrade-cardioplegia-decannulation-using-the-cor-knot-system-in-minimally-invasive-mitral-valve-surgery
#5
Sabet W Hashim, Philip Y K Pang
A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding...
March 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28290005/how-to-treat-tricuspid-valve-disease-what-s-new-on-the-horizon
#6
REVIEW
Karina Brüstle, Christelle Calen, Shingo Kuwata, Fabian Nietlispach, Michel Zuber, Francesco Maisano, Maurizio Taramasso
Tricuspid regurgitation is frequent and is most often caused by annular dilatation and leaflet tethering from adverse right ventricular remodeling in response to several disease processes (functional tricuspid regurgitation), while primary/organic tricuspid valve regurgitation is less common. Surgical intervention for tricuspid regurgitation is usually performed concomitantly to left-sided heart valve surgery. In isolated significant tricuspid regurgitation, however, many patients are left unoperated as they commonly are considered at very high or prohibitive surgical risk...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28222779/magnetic-resonance-imaging-for-cerebral-lesions-during-minimal-invasive-mitral-valve-surgery-study-protocol-for-a-randomized-controlled-trial
#7
Cristina Barbero, Davide Ricci, Erik Cura Stura, Augusto Pellegrini, Giovanni Marchetto, Suad ElQarra, Massimo Boffini, Roberto Passera, Maria Consuelo Valentini, Mauro Rinaldi
BACKGROUND: Recent data have highlighted a higher rate of neurological injuries in minimal invasive mitral valve surgery (MIMVS) compared with the standard sternotomy approach; therefore, the role of specific clamping techniques and perfusion strategies on the occurrence of this complication is a matter of discussion in the medical literature. The purpose of this trial is to prospectively evaluate major, minor and silent neurological events in patients undergoing right mini-thoracotomy mitral valve surgery using retrograde perfusion and an endoaortic clamp or a transthoracic clamp...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28203539/cost-effectiveness-of-robotic-mitral-valve-surgery
#8
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
#9
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
#10
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/28179595/outcomes-of-totally-endoscopic-atrial-septal-defect-closure-using-a-glutaraldehyde-treated-autologous-pericardial-patch
#11
Hidefumi Nishida, Daisuke Nakatsuka, Yuji Kawano, Nobuhiko Hiraiwa, Shuichiro Takanashi, Minoru Tabata
BACKGROUND: We evaluated the outcomes of totally endoscopic minimally invasive surgery for atrial septal defect (ASD) using a glutaraldehyde-treated autologous pericardial patch in the transcatheter interventional era.Methods and Results:We retrospectively reviewed 37 consecutive patients who underwent totally endoscopic ASD closure with a glutaraldehyde-treated autologous pericardial patch between June 2011 and April 2015. All patients had been deferred from catheter-based intervention for clinical or anatomical reasons...
February 8, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28149570/optimizing-the-exposure-in-minimally-invasive-mitral-surgery-a-new-left-atrial-retractor-system
#12
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/28129780/manubrium-limited-ministernotomy-versus-conventional-sternotomy-for-aortic-valve-replacement-mavric-study-protocol-for-a-randomised-controlled-trial
#13
Enoch Akowuah, Andrew T Goodwin, W Andrew Owens, Helen C Hancock, Rebecca Maier, Adetayo Kasim, Adrian Mellor, Khalid Khan, Gavin Murphy, James Mason
BACKGROUND: Aortic valve replacement is one of the most common cardiac surgical procedures performed worldwide. Conventional aortic valve replacement surgery is performed via a median sternotomy; the sternum is divided completely from the sternal notch to the xiphisternum. Minimally invasive aortic valve replacement, using a new technique called manubrium-limited ministernotomy, divides only the manubrium from the sternal notch to 1 cm below the manubrio-sternal junction. More than one third of patients undergoing conventional sternotomy develop clinically significant bleeding requiring post-operative red blood cell transfusion...
January 28, 2017: Trials
https://www.readbyqxmd.com/read/28129319/mini-bentall-an-interesting-approach-for-selected-patients
#14
Elisa Mikus, Antonio Micari, Simone Calvi, Maria Salomone, Marco Panzavolta, Marco Paris, Mauro Del Giglio
OBJECTIVE: Minimally invasive surgery through an upper hemisternotomy for aortic valve replacement has become the routine approach with excellent results. Actually, the same minimally invasive access is used for complex ascending aorta procedures only in few centers. We report our experience with minimally invasive approach for aortic valve and ascending aorta replacement using Bentall technique. METHODS: From January 2010 to November 2015, a total of 238 patients received ascending aorta and aortic valve replacement using Bentall De Bono procedure at our institution...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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
#15
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/28123153/efficacy-of-the-stonehenge-technique-for-minimally-invasive-aortic-valve-replacement-via-right-infraaxillary-thoracotomy
#16
Masataka Yamazaki, Hajime Kin, Shohei Kitamoto, Shota Yamanaka, Hidefumi Nishida, Kosaku Nishigawa, Shuichiro Takanashi
Minimally invasive cardiac surgeries for aortic valve replacement (AVR) are still a technical challenge for surgeons because these procedures are undertaken through small incisions and deep surgical fields. Although AVR via vertical infraaxillary thoracotomy can be a cosmetically superior option, a disadvantage of this approach is the distance between the thoracotomy incision and the ascending aorta. Therefore, we devised a technique to perform all manipulations using the fingertips without the aid of a knot pusher or long-shafted surgical instruments...
February 20, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#17
MULTICENTER STUDY
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28092294/outcomes-of-a-combined-approach-of-percutaneous-coronary-revascularization-and-cardiac-valve-surgery
#18
REVIEW
Orlando Santana, Sandeep Singla, Christos G Mihos, Andrés M Pineda, Gregg W Stone, Paul A Kurlansky, Isaac George, Ajay J Kirtane, Craig R Smith, Nirat Beohar
A subset of patients requiring coronary revascularization and valve surgery may benefit from a combined approach of percutaneous coronary intervention (PCI) and valve surgery, as opposed to the standard median sternotomy approach of combined coronary artery bypass and valve surgery. To evaluate its potential benefits and limitations, a literature search was performed using PubMed, EMBASE, Ovid, and the Cochrane library, through March 2016 to identify all studies involving a combined approach of PCI and valve surgery in patients with coronary artery and valvular disease...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28092288/sutureless-aortic-valves-who-is-the-right-patient
#19
Amine Mazine, Christopher Bonneau, Dimos Karangelis, Bobby Yanagawa, Subodh Verma, Daniel Bonneau
PURPOSE OF REVIEW: Sutureless aortic valve replacement (AVR) has emerged as an alternative to traditional AVR for patients with aortic stenosis who present a higher surgical risk, such as the elderly, or those with small or highly calcified aortic roots. With transcatheter aortic valve implantation - the other major AVR alternative - being used in increasingly lower-risk patients, the place of sutureless valves in the AVR landscape needs to be defined. In this review, we discuss recent data and expert opinion as it pertains to the subject of sutureless AVR...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28076618/aortic-valve-replacement-treatment-by-sternotomy-versus-minimally-invasive-approach
#20
Renata Tosoni Rodrigues Ferreira, Roberto Rocha E Silva, Evaldo Marchi
Objective: To compare the results of aortic valve replacement with access by sternotomy or minimally invasive approach. Methods: Retrospective analysis of medical records of 37 patients undergoing aortic valve replacement by sternotomy or minimally invasive approach, with emphasis on the comparison of time of cardiopulmonary bypass and aortic clamping, volume of surgical bleeding, time of mechanical ventilation, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit, time of hospital discharge, short-term mortality and presence of surgical wound infection...
November 2016: Brazilian Journal of Cardiovascular Surgery
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