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Minimally invasive valve surgery

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https://www.readbyqxmd.com/read/28203539/cost-effectiveness-of-robotic-mitral-valve-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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