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Minimally invasive valve surgery

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https://www.readbyqxmd.com/read/29023349/minimally-invasive-redo-mitral-valve-replacement-using-a-robotic-assisted-approach
#1
Hetal Patel, Clifton T P Lewis, Richard L Stephens, Margaret Angelillo, David H Sibley
Minimally invasive, robotic-assisted cardiac surgery has been shown to decrease transfusion rates, decrease wound infection rates, shorten hospital length of stay, and allow for a faster return to full activity compared with traditional sternotomy approaches. However, its application has chiefly been limited to primary, isolated procedures such as primary mitral valve repair or replacement. We describe the first reported use of a robotic surgery platform to perform reoperative mitral valve replacement using a minimally invasive, totally endoscopic, port-access approach...
October 11, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29016551/pectoral-fascial-pecs-i-and-ii-blocks-as-rescue-analgesia-in-a-patient-undergoing-minimally-invasive-cardiac-surgery
#2
Suraj Yalamuri, Rebecca Y Klinger, W Michael Bullock, Donald D Glower, Brandi A Bottiger, Jeffrey C Gadsden
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. CASE REPORT: In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation...
October 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28964415/aortic-valve-replacement-with-perceval-bioprosthesis-single-center-experience-with-617%C3%A2-implants
#3
Giovanni Concistrè, Francesca Chiaramonti, Giacomo Bianchi, Alfredo Cerillo, Michele Murzi, Rafik Margaryan, Pierandrea Farneti, Marco Solinas
BACKGROUND: This study describes the clinical and echocardiographic outcomes in a large single-center cohort of patients who underwent aortic valve replacement (AVR) with a sutureless Perceval (LivaNova, Milan, Italy) aortic bioprosthesis. METHODS: Between March 2011 and December 2015, 617 patients underwent AVR with a Perceval bioprosthesis. The mean age was 76 ± 7 years, 388 patients were female (63%), and the mean European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 6...
September 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28955395/the-mid-term-results-of-thoracoscopic-closure-of-atrial-septal-defects
#4
Heemoon Lee, Ji-Hyuk Yang, Tae-Gook Jun, I-Seok Kang, June Huh, Seung Woo Park, Jinyoung Song, Chung Su Kim
BACKGROUND AND OBJECTIVES: Recently, minimally invasive surgical (MIS) techniques including robot-assisted operations have been widely applied in cardiac surgery. The thoracoscopic technique is a favorable MIS option for patients with atrial septal defects (ASDs). Accordingly, we report the mid-term results of thoracoscopic ASD closure without robotic assistance. SUBJECTS AND METHODS: We included 66 patients who underwent thoracoscopic ASD closure between June 2006 and July 2014...
September 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28912876/effect-of-intercostal-nerve-block-combined-with-general-anesthesia-on-the-stress-response-in-patients-undergoing-minimally-invasive-mitral-valve-surgery
#5
Yanping Zhan, Guo Chen, Jian Huang, Benchao Hou, Weicheng Liu, Shibiao Chen
The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28901936/advances-in-paediatric-urology
#6
REVIEW
David A Diamond, Ivy H Y Chan, Andrew J A Holland, Michael P Kurtz, Caleb Nelson, Carlos R Estrada, Stuart Bauer, Paul K H Tam
Paediatric urological surgery is often required for managing congenital and acquired disorders of the genitourinary system. In this Series paper, we highlight advances in the surgical management of six paediatric urological disorders. The management of vesicoureteral reflux is evolving, with advocacy ranging from a less interventional assessment and antimicrobial prophylaxis to surgery including endoscopic injection of a bulking agent and minimally invasive ureteric reimplantation. Evidence supports early orchidopexy to improve fertility and reduce malignancy in boys with undescended testes...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#7
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28843324/minimally-invasive-heart-valve-surgery
#8
REVIEW
Ismail Bouhout, Marie-Catherine Morgant, Denis Bouchard
Minimally invasive valve surgery represents a recent and significant advance in modern heart surgery. Indeed, many less invasive approaches for both the aortic and mitral valves have been developed in the past 2 decades. These procedures were hypothesized to result in less operative trauma, which might translate into better patient outcomes. However, this clinical benefit remains controversial in the literature. The aim of this review is to discuss the evidence surrounding minimally invasive heart valve surgery in the current era...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28826892/incidence-of-postoperative-delirium-and-its-impact-on-outcomes-after-transcatheter-aortic-valve-implantation
#9
Maciej Bagienski, Pawel Kleczynski, Artur Dziewierz, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Maciej Stapor, Dariusz Dudek
There are limited data on the occurrence of postoperative delirium after transcatheter aortic valve implantation (TAVI). We sought to investigate the incidence of delirium after TAVI and its impact on clinical outcomes. A total of 148 consecutive patients who underwent TAVI were enrolled. Of these patients, 141 patients survived hospital stay. The incidence of delirium was assessed in these patients for the first 4 days after the index procedure. The patients were divided into 2 groups based on the presence of delirium...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28793899/enumeration-of-circulating-endothelial-cell-frequency-as-a-diagnostic-marker-in-aortic-valve-surgery-a-flow-cytometric-approach
#10
Anton Sabashnikov, Klaus Neef, Vera Chesnokova, Leonie Wegener, Kathrin Godthardt, Maximilian Scherner, Elmar W Kuhn, Antje-Christin Deppe, Meike Lauer, Kaveh Eghbalzadeh, Mohamed Zeriouh, Parwis B Rahmanian, Jens Wippermann, Ferdinand Kuhn-Régnier, Navid Madershahian, Thorsten Wahlers, Alexander Weymann, Yeong-Hoon Choi
BACKGROUND: The frequency of circulating endothelial cells (CEC) in patients' peripheral blood can be assessed as a direct marker of endothelial damage. However, conventional enumeration methods are extremely challenging. We developed a novel, automated approach to determine CEC frequencies and tested this method on two groups of patients undergoing conventional (CAVR) versus trans-catheter aortic valve implantation (TAVI). METHODS: CEC frequencies were assessed by a flow cytometric approach, including automated pre-enrichment of CD34 positive blood cell subpopulation and isotype controls...
August 9, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28759544/minimally-invasive-access-aortic-arch-surgery
#11
Nora Goebel, Daniel Bonte, Schahriar Salehi-Gilani, Ragi Nagib, Adrian Ursulescu, Ulrich F W Franke
OBJECTIVE: Median sternotomy is still the standard approach for aortic arch surgery. Minimally invasive techniques promise faster recovery with shorter hospital stay due to thoracic stability, reduced pain, and superior cosmetic results. However, safety is a concern in complex aortic surgery. The aim of our study was to demonstrate that aortic arch surgery via partial upper sternotomy is viable, safe, and equivalent to standard procedure both in terms of its safety and the risk of major adverse cardiac and cerebrovascular events...
July 28, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28750454/minimally-invasive-mitral-valve-surgery-for-mitral-valve-infective-endocarditis
#12
Sandra Folkmann, Joerg Seeburger, Jens Garbade, Uta Schon, Martin Misfeld, Friedrich W Mohr, Bettina Pfannmueller
No abstract text is available yet for this article.
July 27, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28746063/left-atrial-appendage-resection-during-minimally-invasive-aortic-valve-surgery-via-right-minithoracotomy
#13
Nobuo Kondo, Toshinori Totsugawa, Arudo Hiraoka, Kentaro Tamura, Hidenori Yoshitaka, Taichi Sakaguchi
Here, we report concomitant resection of the left atrial appendage through the transverse sinus during minimally invasive aortic valve replacement via right anterolateral thoracotomy. The left atrial appendage was exposed by raising the collapsed ascending aorta and was safely resected using a surgical stapling device. This procedure is a feasible option in elderly patients, for whom a percutaneous procedure would be inappropriate, and could be useful for preventing thromboembolic and hemorrhagic complications...
July 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28740715/minimally-invasive-valve-surgery-in-high-risk-patients
#14
REVIEW
Orlando Santana, Steve Xydas, Roy F Williams, S Howard Wittels, Evin Yucel, Christos G Mihos
The use of minimally, or less invasive, approaches to cardiac valve surgery has increased over the past decade. Because of its less traumatic nature, early studies in lower risk patients demonstrated the approach to be associated with an enhanced recovery, increased patient satisfaction, and good operative outcomes. With time, despite a steep learning curve, surgeons expanded this approach to perform more complex procedures, and include patients with more co-morbidity. The aim of this publication is to review the current literature involving the use of minimally invasive valve surgery (MIVS) in higher-risk patients...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#15
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740713/outcomes-of-minimally-invasive-double-valve-surgery
#16
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Frederick Hasty, Esteban Escolar, Christos G Mihos
BACKGROUND: Double valve surgery is associated with an increased peri-operative morbidity and mortality. A less invasive right thoracotomy approach may be a viable alternative to median sternotomy surgery in these higher-risk patients. METHODS: We retrospectively analyzed the baseline demographics, operative characteristics, and post-operative outcomes of patients who underwent minimally invasive double valve surgery between January 2009 and December 2011 at our institution...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740712/hybrid-approach-of-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-a-5-year-single-center-experience
#17
Orlando Santana, Steve Xydas, Roy F Williams, Maurice Mawad, Todd B Heimowitz, Andrés M Pineda, Howard S Goldman, Christos G Mihos
BACKGROUND: The current study evaluated the safety and feasibility of staged ("hybrid") percutaneous coronary intervention (PCI) followed by isolated minimally invasive mitral valve (MV) surgery [PCI + minimally invasive mitral valve surgery (MIMVS)], for patients with concomitant coronary artery and MV disease. METHODS: A total of 93 patients who underwent PCI + MIMVS for coronary artery and MV disease between February 2009 and April 2014 were retrospectively analyzed...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#18
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740708/staged-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-versus-combined-coronary-artery-bypass-graft-and-mitral-valve-surgery-for-two-vessel-coronary-artery-disease-and-moderate-to-severe-ischemic-mitral-regurgitation
#19
Christos G Mihos, Steve Xydas, Roy F Williams, Andrés M Pineda, Evin Yucel, Hector Davila, Nirat Beohar, Orlando Santana
BACKGROUND: The optimal treatment for concomitant two-vessel coronary artery disease (CAD) and moderate to severe ischemic mitral regurgitation (IMR) remains unclear. We compared the results of a staged percutaneous coronary intervention followed by minimally invasive mitral valve surgery (PCI+MIVS) versus combined coronary artery bypass graft and mitral valve surgery (CABG+MVS) in this population. METHODS: All consecutive patients with two-vessel CAD and moderate to severe IMR, who underwent PCI+MIVS or CABG+MVS at our institution between February 2009 and April 2014, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740685/minimally-invasive-aortic-valve-replacement-in-high-risk-patient-groups
#20
REVIEW
Daniel Fudulu, Harriet Lewis, Umberto Benedetto, Massimo Caputo, Gianni Angelini, Hunaid A Vohra
Minimally invasive aortic valve replacement (AVR) aims to preserve the sternal integrity and improve postoperative outcomes. In low risk patients, this technique can be achieved with comparable mortality to the conventional approach and there is evidence of possible reduction in intensive care and hospital length of stay, transfusion requirement, renal dysfunction, improved respiratory function and increased patient satisfaction. In this review, we aim to asses if these benefits can be transferred to the high risk patient groups...
June 2017: Journal of Thoracic Disease
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