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Minimally invasive valve surgery

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https://www.readbyqxmd.com/read/29440154/outcomes-comparison-of-different-surgical-strategies-for-the-management-of-severe-aortic-valve-stenosis-study-protocol-of-a-prospective-multicentre-european-registry-e-avr-registry
#1
Francesco Onorati, Riccardo Gherli, Giovanni Mariscalco, Evaldas Girdauskas, Eduardo Quintana, Francesco Santini, Marisa De Feo, Sandro Sponga, Piergiorgio Tozzi, Mohamad Bashir, Andrea Perrotti, Aniello Pappalardo, Vito Ruggieri, Giuseppe Santarpino, Mauro Rinaldi, Silva Ronaldo, Francesco Nicolini
INTRODUCTION: Traditional and transcatheter surgical treatments of severe aortic valve stenosis (SAVS) are increasing in parallel with the improved life expectancy. Recent randomised controlled trials (RCTs) reported comparable or non-inferior mortality with transcatheter treatments compared with traditional surgery. However, RCTs have the limitation of being a mirror of the predefined inclusion/exclusion criteria, without reflecting the 'real clinical world'. Technological improvements have recently allowed the development of minimally invasive surgical accesses and the use of sutureless valves, but their impact on the clinical scenario is difficult to assess because of the monocentric design of published studies and limited sample size...
February 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29435996/type-ii-minimal-invasive-extracorporeal-circuit-for-aortic-valve-replacement-a-randomized-controlled-trial
#2
Erich Gygax, Hans-Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes
Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally-invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end-points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29432360/periareolar-access-for-minimally-invasive-cardiac-surgery-the-brazilian-technique
#3
Robinson Poffo, Paola K Montanhesi, Alisson P Toschi, Renato B Pope, Cláudio A Mokross
The periareolar access has been the preferred technique used at our institution for minimally invasive cardiac surgery since 2006. The surgical approach consists of video-assisted minithoracotomy in the 4th right intercostal space, through a periareolar incision. Initially, the technique was restricted to minimally invasive mitral valve surgeries but, due to its feasibility and safety, was soon incorporated as an ideal access for other cardiac pathologies such as tricuspid valve disease, atrial septal defect, atrial fibrillation, and pacemaker leads endocarditis...
February 9, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29430431/minimally-invasive-mitral-valve-repair-in-a-woman-with-marfan-syndrome-and-type-b-dissection
#4
Mi Hee Lim, Hyung Gon Je, Sang Kwon Lee
We report the case of a patient with mitral regurgitation complicated by type B dissection and Marfan syndrome (MFS) who was managed successfully with minimally invasive mitral valve repair. Without type A aortic dissection or aortic root dilation, MFS patients may develop mitral valve regurgitation, as in this case, and need valve surgery to improve their symptoms and long-term survival. However, it is not clear that a full sternotomy and prophylactic aortic surgery are necessary. Although retrograde perfusion to the dissected aorta is controversial, our approach minimizes the risk of future anticipated aortic surgery in MFS patients...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29415382/one-year-outcomes-after-rapid-deployment-aortic-valve-replacement
#5
Christopher Young, Günther Laufer, Alfred Kocher, Marco Solinas, Francesco Alamanni, Gianluca Polvani, Bruno K Podesser, Jose Ignacio Aramendi, Jose Arribas, Olivier Bouchot, Ugolino Livi, Massimo Massetti, Kim Terp, Christophe Giot, Mattia Glauber
OBJECTIVE: The goals of rapid-deployment aortic valve replacement include facilitation of minimally invasive surgery and reduced aortic crossclamp time. We report the short-term outcomes of a series of 493 patients undergoing rapid-deployment aortic valve replacement with the EDWARDS INTUITY valve system (Edwards Lifesciences, LLC, Irvine, Calif). METHODS: Assessing Standard oF Care and Clinical Outcomes UsiNg the EDWARDS INTUITY VAlve SysTem in a European multI-center, Active, pOst-market surveillaNce Study was a prospective, multicenter (n = 26) European registry designed to evaluate the safety and performance of the valve system...
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29387434/beating-heart-minimally-invasive-mitral-valve-surgery-in-patients-with-previous-sternotomy-the-operative-technique-and-early-outcomes
#6
Robert B Xu, Mohammad Rahnavardi, Mart Nadal, Fabiano Viana, Robert G Stuklis, Michael Worthington, James Edwards
Objective: Reoperative mitral valve surgery is increasingly required and can be associated with significant morbidity and mortality. The beating heart minimally invasive mitral valve surgery has a proposed benefit in avoiding the risks of repeat sternotomy, with reducing the need for adhesiolysis and cardioplegia reperfusion injury. We describe our experience with such a technique in patients with previous sternotomy. Methods: A retrospective study was performed and all patients undergoing surgery of mitral valve through a right limited thoracotomy without application of an aortic cross-clamp (beating heart) as a redo cardiac surgery between January 2006 and January 2015 were included (n=25)...
2018: Open Heart
https://www.readbyqxmd.com/read/29370357/ultra-fast-track-minimally-invasive-aortic-valve-replacement-going-beyond-reduced-incisions
#7
Marco Di Eusanio, Walter Vessella, Roberto Carozza, Filippo Capestro, Alessandro D'Alfonso, Carlo Zingaro, Christopher Munch, Paolo Berretta
Aortic valve replacement (AVR) via a median sternotomy approach has been largely reported to be safe and long-term efficacious, and currently represents the 'gold standard' approach for aortic stenosis treatment. However, aortic valve surgery has undergone continuous development over the last years, involving less invasive techniques and new technologies to reduce the traumatic impact of the intervention and extend the operability toward increasingly high-risk patients. Indeed, minimally invasive AVR and transcatheter aortic valve replacement caseload have steadily increased leading to a paradigm shift in the treatment of aortic valve disease...
January 23, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29336964/continuous-erector-spinae-plane-esp-block-for-postoperative-analgesia-after-minimally-invasive-mitral-valve-surgery
#8
Felipe Muñoz Leyva, Wilman E Mendiola, Antonio J Bonilla, Javier Cubillos, Diego A Moreno, Ki Jinn Chin
No abstract text is available yet for this article.
December 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29325064/comparison-of-right-ventricular-function-after-ministernotomy-and-full-sternotomy-aortic-valve-replacement-a-randomized-study
#9
Magnus Dalén, Cristina Oliveira Da Silva, Ulrik Sartipy, Reidar Winter, Anders Franco-Cereceda, Jasmin Barimani, Magnus Bäck, Peter Svenarud
OBJECTIVES: Right ventricular (RV) function is impaired after cardiac surgery, possibly because of the opening of the pericardium. In minimally invasive aortic valve replacement, the pericardium is only partially incised. METHODS: A randomized trial compared RV function after ministernotomy versus full sternotomy in 40 adults undergoing aortic valve replacement at the Karolinska University Hospital. Primary outcomes were tricuspid annular plane systolic excursion, RV pulsed-wave tissue Doppler velocity, RV fractional area change and basal and mid-RV transversal diameters on postoperative Days 4 and 40...
January 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29304201/short-term-outcomes-of-minimally-invasive-mitral-valve-repair-a-propensity-matched-comparison
#10
Qing Wang, Wang Xi, Yang Gao, Hua Shen, Jie Min, Jie Yang, Shiguan Le, Yufeng Zhang, Zhinong Wang
OBJECTIVES: We aimed to investigate the effect of minimally invasive mitral valve repair on early pulmonary function and haemodynamics, as well as its short-term efficacy. METHODS: From March 2012 to July 2015, 78 cases of minimally invasive mitral valve repair and 89 cases of conventional mitral valve repair were included in this study, with 67 well-matched pairs of patients identified by a propensity score matching, who were divided into the conventional sternotomy group and the right minithoracotomy group (the RT group)...
January 3, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#11
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29283917/anesthetic-management-and-procedural-outcomes-of-patients-undergoing-off-pump-transapical-implantation-of-artificial-chordae-to-correct-mitral-regurgitation-case-series-of-76-patients
#12
Robertas Stasys Samalavicius, Ieva Norkiene, Agne Drasutiene, Arturas Lipnevicius, Vilius Janusauskas, Karolis Urbonas, Diana Zakarkaite, Audrius Aidietis, Kestutis Rucinskas
BACKGROUND: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure. METHODS: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29277548/outcomes-of-video-assisted-minimally-invasive-cardiac-myxoma-resection
#13
Giacomo Bianchi, Rafik Margaryan, Enkel Kallushi, Alfredo Giuseppe Cerillo, Pier Andrea Farneti, Angela Pucci, Marco Solinas
BACKGROUND: Myxomas are the most frequent cardiac tumours. Their diagnosis requires prompt removal. In our centre, for valve surgery we use a minimally invasive approach. Here, we report our experience of cardiac myxoma removal through right lateral mini-thoracotomy (RLMT) with particular focus on its feasibility, efficacy and patient safety. METHODS: Between February 2006 and January 2017, 30 consecutive patients (aged 66±12.6years, range 35-83 years) underwent atrial myxoma resection through video-assisted RLMT...
December 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29237015/perceval-less-invasive-aortic-replacement-register-multicentric-spanish-experience-with-the-perceval-s-bioprosthesis-in-moderate-high-risk-aortic-surgery
#14
Elisabet Berastegui García, Maria Luisa Camara Rosell, Francisco Estevez Cid, Eladio Sanchez Dominguez, Remedios Rios Barrera, Fabrizio Sbraga, Julio Garcia Puente, Elena Rosello Diez, Gregorio Pablo Cuerpo Caballero, Juan Bustamante Munguira, Guillermo Reyes Copa, Marian Tena Pajuelo, Santiago Serrano Fiz, Jose Alfonso Buendía Miñano, Ivan García Martin, Jose Cuenca Castillo, Sergio Cánovas Lopez, Angel Gonzalez Pinto, Xavier Ruyra Baliarda
OBJECTIVES: The development of new percutaneous and surgical techniques has reduced the risk associated with aortic valve replacement procedures. We present the results of a Spanish register after initiating a programme for sutureless prostheses in moderate-high-risk patients. METHODS: This prospective multicentre study was carried out from November 2013 to November 2016. Data were obtained from 448 patients in whom a Perceval S prosthesis was implanted. RESULTS: The mean age was 79...
December 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29232300/three-dimensional-printing-of-life-like-models-for-simulation-and-training-of-minimally-invasive-cardiac-surgery
#15
Toshiyuki Yamada, Motohiko Osako, Tomoya Uchimuro, Ryogen Yoon, Toshiaki Morikawa, Maki Sugimoto, Hisao Suda, Hideyuki Shimizu
OBJECTIVE: As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. METHODS: Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29229038/the-opportunities-and-limitations-of-minimally-invasive-cardiac-surgery
#16
Torsten Doenst, Mahmoud Diab, Christoph Sponholz, Michael Bauer, Gloria Färber
BACKGROUND: Over the past two decades, minimally invasive techniques for classic heart valve surgery and isolated bypass surgery have been developed that enable access to the heart via partial sternotomy for most aortic valve procedures and via sternotomy-free mini-thoracotomy for other procedures. METHODS: We review the current evidence on minimally invasive cardiac surgery on the basis of pertinent randomized studies and database studies retrieved by a selective search in the MEDLINE and PubMed Central databases, as well as by the Google Scholar search engine...
November 17, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29226341/inflammation-and-its-consequences-after-surgical-versus-transcatheter-aortic-valve-replacement
#17
Florian Uhle, Christian Castrup, Anna-Maria Necaev, Philippe Grieshaber, Christoph Lichtenstern, Markus Alexander Weigand, Andreas Böning
Symptomatic aortic stenosis can be treated by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR), the latter of which is regarded as a minimally invasive procedure. Differences between these procedures regarding immune responses or changes in coagulation and neurocognitive function have thus far been evaluated only sparsely. We carried out a prospective, single-center, nonrandomized explorative study with 38 patients. Thirteen patients were subjected to either SAVR or transfemoral (TF-) TAVR, and 12 patients underwent transapical (TA-) TAVR...
December 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29217241/myocardial-protection-in-mitral-valve-surgery-comparison-between-minimally-invasive-approach-and-standard-sternotomy
#18
Jean-Sébastien Lebon, Pierre Couture, Annik Fortier, Antoine G Rochon, Christian Ayoub, Claudia Viens, Éric Laliberté, Denis Bouchard, Michel Pellerin, Alain Deschamps
OBJECTIVE: To compare antegrade and retrograde cardioplegia administration in minimally invasive mitral valve surgery (MIMS) and open mitral valve surgery (OMS) for myocardial protection. DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: The study comprised 118 patients undergoing MIMS and 118 patients undergoing OMS. INTERVENTIONS: The data of patients admitted for MIMS from 2006 to 2010 were reviewed...
August 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29206693/long-term-results-of-suture-annuloplasty-for-degenerative-mitral-valve-disease-a-propensity-matched-analysis
#19
Andrea Garatti, Alberto Canziani, Alessandro Parolari, Serenella Castelvecchio, Marco Guazzi, Andrea Daprati, Ali Abu Farah, Francesco Grimaldi, Sonia Tripepi, Lorenzo Menicanti
AIMS: Ring annuloplasty is the gold standard of surgical repair in degenerative mitral valve disease. However, prosthetic annuloplasty has some drawbacks and potential hazards. Suture annuloplasty theoretically is able to preserve annular leaflet dynamics and left ventricular performance, but experience is limited. The aim of the study was to review the early and long-term outcome of the posterior double-suture annuloplasty (DSA) technique for degenerative mitral valve repair. METHODS: From January 2002 to December 2008, 400 patients underwent primary mitral valve repair for degenerative disease either with posterior DSA [n = 147 (37%)] or with flexible posterior annuloplasty band [n = 253 (63%)]...
January 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29199850/the-evolution-of-minimally-invasive-cardiac-surgery-from-minimal-access-to-transcatheter-approaches
#20
Rachel M Easterwood, Ian C Bostock, Shruthi Nammalwar, Jock N McCullough, Alexander Iribarne
The field of minimally invasive cardiac surgery has undergone rapid transformation over recent years. In this review, we provide a summary of the most current evidence supporting the use of minimally invasive aortic and mitral valve replacement techniques, as well as transcatheter approaches for aortic and mitral valve disease. As an adjunct, the use of robotically assisted coronary bypass surgery and hybrid coronary revascularization procedures is discussed. In order to obtain optimal patient outcomes, a collaborative, heart-team approach between cardiac surgeons and interventional cardiologists is necessary...
December 4, 2017: Future Cardiology
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