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Minimally invasive valve surgery

Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
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
M Muñoz-Corcuera, L Ramírez-Martínez-Acitores, R-M López-Pintor, E Casañas-Gil, G Hernández-Vallejo
Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. _Material and Methods: We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library...
October 1, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
Pallav L Shah, Felix J Herth, Wouter H van Geffen, Gaetan Deslee, Dirk-Jan Slebos
Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction...
September 29, 2016: Lancet Respiratory Medicine
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
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
Trust Saidi, Tania S Douglas
The treatment of rheumatic heart disease presents a medical and surgical challenge, particularly in developing countries, where the disease is prevalent. Most of these countries find it prohibitively expensive to import heart valve prostheses that are required for treatment and are largely manufactured in the United States and Europe. Even if the valves were available, the absence of facilities to conduct open-heart surgery for valve replacement results in many people from developing countries dying needlessly of the disease...
October 2016: Expert Review of Medical Devices
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
Jorge A Belardi, Mariano Albertal
Prior to minimally invasive valve surgery, a strategy of complete revascularization did not impact overall survival. Angiographically guided revascularization may have resulted in unnecessary procedures. A larger sample size and greater atherosclerotic burden may be needed to observe an impact with complete revascularization.
September 2016: Catheterization and Cardiovascular Interventions
Marco Vola, Jean-François Fuzellier
No abstract text is available yet for this article.
September 11, 2016: European Journal of Cardio-thoracic 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
Alen Karic
INTRODUCTION: Degenerative aortic stenosis (AS) is the most frequent cause among aortic valve stenotic changes. Mini Sternotomy Aortic Valve Replacement is a replacement of aortic valve through upper partial sternotomy. AIM: The aim of this approach is to improve postoperative convalescence by leaving pleural spaces closed and do not compromise respiratory function, to decrease bleeding, and reduce post op ventilation time and ICU stay. All these advantages decrease cost during hospital stay by reducing ICU stay, respiration time, bleeding and using blood products, pain killers and shortening hospital stay...
June 2016: Medical Archives
Hang Yu, Lijie Wang, Zhen Wu, Zhen Yang
Bronchoscopic lung volume reduction (BLVR) is a minimally invasive treatment for severe emphysema, providing treatment options for patients who are unable to undergo lung volume reduction surgery (LVRS) or lung transplantation. Current BLVR techniques include bronchoscopic volume reduction with valve implants, use of a lung volume reduction coil (LVRC), bronchoscopic thermal vapor ablation (BTVA), biological lung volume reduction (BioLVR), and use of airway bypass stents (ABS). To date, several randomized controlled trials of these bronchoscopic therapies have been conducted in patients with emphysema, and bronchoscopic volume reduction with valve implants remains the best approach thus far...
September 5, 2016: Bioscience Trends
Sebastiano Castrovinci, Sam Emmanuel, Marco Moscarelli, Giacomo Murana, Giuseppa Caccamo, Emanuela Clara Bertolino, Giuseppe Nasso, Giuseppe Speziale, Khalil Fattouch
Aortic valve disease is a prevalent disorder that affects approximately 2% of the general adult population. Surgical aortic valve replacement is the gold standard treatment for symptomatic patients. This treatment has demonstrably proven to be both safe and effective. Over the last few decades, in an attempt to reduce surgical trauma, different minimally invasive approaches for aortic valve replacement have been developed and are now being increasingly utilized. A narrative review of the literature was carried out to describe the surgical techniques for minimally invasive aortic valve surgery and report the results from different experienced centers...
September 2016: Journal of Geriatric Cardiology: JGC
Diana Reser, Roman Walser, Mathias van Hemelrijk, Tomas Holubec, Alberto Weber, André Plass, Francesco Maisano
Background Minimally invasive aortic valve surgery (MIAV) through a right anterior minithoracotomy evolved to an accepted procedure with favorable short- and mid-term outcomes, whereas long-term results lack. The aim of this study was to evaluate the long-term outcomes. Materials and Methods All our MIAV patients were included (n = 225). Mean age was 68 ± 12 years, 29% were older than 75 years, and median EuroSCORE was 5 (0-11). Baseline characteristics, inhospital outcomes, and follow-up information about survival, major adverse cardiac and cerebrovascular events (MACCE), and need for reoperation were collected and analyzed...
August 30, 2016: Thoracic and Cardiovascular Surgeon
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