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Minimally invasive valve surgery

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https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#1
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 17, 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
#2
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 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28092288/sutureless-aortic-valves-who-is-the-right-patient
#3
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...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28076618/aortic-valve-replacement-treatment-by-sternotomy-versus-minimally-invasive-approach
#4
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
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#5
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28043442/sutureless-aortic-valves-combining-the-best-or-the-worst
#6
Kareem Bedeir, Michael Reardon, Lawrence H Cohn, Basel Ramlawi
Aortic valve replacement is a life saving intervention. Significant progress has been made toward reducing surgical trauma through minimally invasive surgery and transcatheter techniques. Each of these approaches has its advantages and limitations. Sutureless aortic valves have been proposed to overcome these limitations and have been in use in Europe. It is however less than clear whether these valves will prove advantageous and whether they will have a role in the future. We review the published literature for sutureless aortic valves and their performance against standard and transcatheter aortic valve replacements...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043429/results-of-cryoablation-for-atrial-fibrillation-concomitant-with-video-assisted-minimally-invasive-mitral-valve-surgery
#7
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
#8
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
#9
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
#10
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
#11
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/27989092/ventricular-embolization-of-two-edwards-sapien-xt-prosthetic-valves-during-trans-subclavian-aortic-valve-implantation
#12
Serdal Baştuğ, Abdullah Nabi Aslan, Cenk Sarı, Hacı Ahmet Kasapkara, Hüseyin Ayhan, Engin Bozkurt
Transcatheter aortic valve implantation (TAVI) is an alternative treatment method in high-risk patients with severe aortic stenosis (AS). Although TAVI is a minimally invasive procedure it is not free from complications. Here, the case is presented of a 61-year-old woman who underwent trans-subclavian aortic valve implantation to treat severe symptomatic rheumatic AS. The procedure was complicated by the ventricular embolization of two Edwards SAPIEN XT valves during the procedure, but was successfully managed with emergency open-heart surgery...
January 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27977305/what-is-the-role-of-sutureless-aortic-valves-in-today-s-armamentarium
#13
Dimos Karangelis, Amine Mazine, Apostolos Roubelakis, Christos Alexiou, Socrates Fragoulis, C David Mazer, Bobby Yanagawa, David Latter, Daniel Bonneau
Sutureless and rapid-deployment aortic bioprostheses represent an emerging and promising technology for the treatment of aortic valve stenosis. Unlike traditional aortic bioprostheses, these devices are not hand-sewn, thus allowing a significant reduction in operative times, while facilitating minimally invasive surgery and complex cardiac interventions. Sutureless aortic valve replacement represents a less invasive treatment option and an excellent alternative to conventional aortic valve replacement in elderly and higher risk patients...
December 26, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27942489/is-minimally-invasive-thoracoscopic-surgery-the-new-benchmark-for-treating-mitral-valve-disease
#14
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/27918213/percutaneous-therapies-for-tricuspid-regurgitation
#15
Erin A Fender, Rick A Nishimura, David R Holmes
Chronic tricuspid valve regurgitation is usually associated with left-sided heart disease or pulmonary hypertension. Although severe tricuspid valve regurgitation carries a poor prognosis, isolated surgery is rarely performed due to high in-hospital mortality and an unclear impact on long term survival. The lack of adequate surgical treatment has resulted in a large population of patients with an unmet clinical need. Areas covered: Transcatheter therapies have revolutionized the management of high risk patients with left-sided valvular disease, and have sparked interest in translating minimally invasive therapies to the tricuspid valve...
January 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27913175/automated-cta-based-measurements-for-planning-support-of-minimally-invasive-aortic-valve-replacement-surgery
#16
Mustafa A Elattar, Floortje van Kesteren, Esther M Wiegerinck, Ed Vanbavel, Jan Baan, Riccardo Cocchieri, Bas de Mol, Nils R Planken, Henk A Marquering
Minimally invasive aortic valve replacement (mini-AVR) procedures are a valuable alternative to conventional open heart surgery. Currently, planning of mini-AVR consists of selection of the intercostal space closest to the sinotubular junction on preoperative computer tomography images. We developed an automated algorithm detecting the sinotubular junction (STJ) and intercostal spaces for finding the optimal incision location. The accuracy of the STJ detection was assessed by comparison with manual delineation by measuring the Euclidean distance between the manually and automatically detected points...
January 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/27909512/concomitant-left-atrial-appendage-clipping-during-minimally-invasive-mitral-valve-surgery-technically-feasible-and-safe
#17
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
#18
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/27895342/innovations-in-cardiovascular-care-historical-perspective-contemporary-practice-recent-trends-and-future-directions
#19
Hasanat Sharif, Mayera Tufail
Cardiovascular diseases continue to be a major cause of mortality and morbidity in the world population. First open heart procedure was performed by Gibbon in 1953, since then many advancements have been introduced to the field of cardiac surgery. Minimally invasive techniques were introduced, which include minimally invasive coronary artery bypass grafting (CABG), off-pump technique, minimally invasive valve surgery or transcatheter techniques to implant stentless or sutureless valves. The hybrid strategy to address coronary disease combines catheterisation procedures with standard surgical techniques...
October 2016: JPMA. the Journal of the Pakistan Medical Association
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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