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Minimally invasive heart valve replacement

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https://www.readbyqxmd.com/read/28201842/minimally-invasive-aortic-root-replacement-with-valved-conduits-through-partial-upper-sternotomy
#1
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/28129316/coronary-artery-disease-complexity-on-the-outcomes-of-a-staged-approach-of-pci-followed-by-minimally-invasive-valve-surgery
#2
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/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#3
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/28018817/transcatheter-valve-unable-to-cure-patient-prosthesis-mismatch-of-mosaic-bioprosthesis
#4
Daniela Serio, Andreas Zierer, Mirko Doss, Anton Moritz
Transcatheter aortic valve implantation (TAVI) has been recently established as a less invasive alternative to conventional aortic valve replacement (CAVR) in patients presenting with expected high procedural risk. The rapid technologic advances and the recent improvement of clinical outcomes with TAVI have made it possible to treat degenerated bioprosthesis using the valve-in-valve implantation concept (Walther T, Simon P, Dewey T, et al. Transapical minimally invasive aortic valve implantation: multicenter experience...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28017338/complications-associated-with-femoral-cannulation-during-minimally-invasive-cardiac-surgery
#5
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/27913175/automated-cta-based-measurements-for-planning-support-of-minimally-invasive-aortic-valve-replacement-surgery
#6
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/27696730/the-future-of-heart-valve-replacement-recent-developments-and-translational-challenges-for-heart-valve-tissue-engineering
#7
Emanuela S Fioretta, Petra E Dijkman, Maximilian Y Emmert, Simon P Hoerstrup
Heart valve replacement is often the only solution for patients suffering from valvular heart disease. However, currently available valve replacements require either life-long anti-coagulation or are associated with valve degeneration and calcification. Moreover, they are suboptimal for young patients, because they do not adapt to the somatic growth. Tissue-engineering has been proposed as a promising approach to fulfill the urgent need for heart valve replacements with regenerative and growth capacity. This review will start with an overview on the currently available valve substitutes and the techniques for heart valve replacement...
September 30, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27677879/preoperative-planning-with-three-dimensional-reconstruction-of-patient-s-anatomy-rapid-prototyping-and-simulation-for-endoscopic-mitral-valve-repair
#8
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
https://www.readbyqxmd.com/read/27626323/minimally-invasive-transcatheter-aortic-valve-implantation-for-the-treatment-of-rheumatic-heart-disease-in-developing-countries
#9
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
https://www.readbyqxmd.com/read/27549435/the-economic-value-of-intuity-in-aortic-valve-replacement
#10
Matthew Moore, Glenn R Barnhart, Walter Randolph Chitwood, John A Rizzo, Candace Gunnarsson, Swetha R Palli, Eugene A Grossi
OBJECTIVE: The recent development of the EDWARDS INTUITY Elite™ (EIE) valve system enables the rapid deployment of a prosthetic surgical heart valve in an aortic valve replacement (AVR) procedure via both the minimally invasive (MISAVR) and conventional (CAVR) approaches. In order to understand its economic value, this study performed a cost evaluation of the EIE valve system used in a MIS rapid-deployment approach (MIS-RDAVR) vs MISAVR and CAVR, respectively, compared to standard prosthetic aortic valves...
October 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27401072/transaortic-transcatheter-aortic-valve-replacement-through-a-right-minithoracotomy-with-the-balloon-expandable-sapien-3-valve
#11
Enrico Ferrari, Olivier Muller, Stefanos Demertzis, Marco Moccetti, Tiziano Moccetti, Giovanni Pedrazzini, Eric Eeckhout
Transaortic transcatheter aortic valve replacement performed through a right anterolateral minithoracotomy at the second intercostal space is a safe and standardized minimally invasive procedure carrying important clinical advantages for the patient, in particular, no damage to the ventricular apex, preservation of the diseased peripheral arteries and no cross of the aortic arch with the delivery system, meaning a lower risk of calcium dislodgement and neurological complications. Using the third-generation, balloon-expandable Edwards Sapien™ 3 transcatheter heart valve and the Certitude™ delivery system, the transaortic procedure is easily performed under fluoroscopic and echocardiographic guidance...
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/27298793/early-outcomes-of-sutureless-aortic-valves
#12
Muhammet Onur Hanedan, İlker Mataracı, Mehmet Ali Yürük, Tanıl Özer, Ufuk Sayar, Ali Kemal Arslan, Uğur Ziyrek, Murat Yücel
BACKGROUND: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation...
June 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27283935/cerebral-microembolization-during-aortic-valve-replacement-using-minimally-invasive-or-conventional-extracorporeal-circulation-a-randomized-trial
#13
RANDOMIZED CONTROLLED TRIAL
Reto Basciani, Felix Kröninger, Erich Gygax, Hansjörg Jenni, David Reineke, Monika Stucki, Niels Hagenbuch, Thierry Carrel, Balthasar Eberle, Gabor Erdoes
To compare intraoperative cerebral microembolic load between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) during isolated surgical aortic valve replacement (SAVR), we conducted a randomized trial in patients undergoing primary elective SAVR at a tertiary referral hospital. The primary outcome was the procedural phase-related rate of high-intensity transient signals (HITS) on transcranial Doppler ultrasound. HITS rate was used as a surrogate of cerebral microembolism in pre-defined procedural phases in SAVR using MiECC or CECC with (+F) or without (-F) an oxygenator with integrated arterial filter...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/27262361/exploring-the-learning-curve-for-minimally-invasive-sutureless-aortic-valve-replacement
#14
Michele Murzi, Alfredo Giuseppe Cerillo, Danyar Gilmanov, Giovanni Concistrè, Pierandrea Farneti, Mattia Glauber, Marco Solinas
OBJECTIVE: The study objective was to assess the learning process and quality of care of right minithoracotomy aortic valve replacement with a sutureless bioprosthesis at a single institution. METHODS: We performed an analysis of the first 300 consecutive patients (aged 76 ± 6 years; logistic European System for Cardiac Operative Risk Evaluation 9 ± 6) who underwent sutureless valve implantation via a right minithoracotomy by 6 surgeons at the G. Pasquinucci Heart Hospital between 2011 and 2015...
December 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27242130/heart-valve-health-disease-replacement-and-repair-a-25-year-cardiovascular-pathology-perspective
#15
REVIEW
Frederick J Schoen, Avrum I Gotlieb
The past several decades have witnessed major advances in the understanding of the structure, function, and biology of native valves and the pathobiology and clinical management of valvular heart disease. These improvements have enabled earlier and more precise diagnosis, assessment of the proper timing of surgical and interventional procedures, improved prosthetic and biologic valve replacements and repairs, recognition of postoperative complications and their management, and the introduction of minimally invasive approaches that have enabled definitive and durable treatment for patients who were previously considered inoperable...
July 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/27149367/cardiothoracic-applications-of-3-dimensional-printing
#16
Andreas A Giannopoulos, Michael L Steigner, Elizabeth George, Maria Barile, Andetta R Hunsaker, Frank J Rybicki, Dimitris Mitsouras
Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as computed tomography, magnetic resonance imaging, echocardiography, and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides...
September 2016: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/27048769/perioperative-transoesophageal-echocardiography-current-status-and-future-directions
#17
REVIEW
Feroze Mahmood, Stanton Keith Shernan
Transoesophageal echocardiography (TOE) is used in the perioperative arena to monitor patients during life-threatening emergencies, cardiac and high-risk non-cardiac surgeries. It provides qualitative and quantitative information on valvular and ventricular functions, and dynamic cardiac anatomy can be displayed with a physiological perspective. This technology has evolved from two-dimensional (2D) to the ready availability of real-time three-dimensional (RT-3D) imaging in the operating rooms. Enhanced spatial and temporal resolutions with 3D imaging have most significantly impacted the quality of intraoperative surgical valve repair and replacement decisions...
August 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27047291/minimally-invasive-repair-of-left-ventricular-pseudoaneurysm-after-transapical-transcatheter-aortic-valve-replacement
#18
Basel Ramlawi, Walid K Abu Saleh, Odeaa Al Jabbari, Colin M Barker, Neal S Kleiman, Michael J Reardon
Transcatheter aortic valve replacement is becoming a routine procedure to treat severe symptomatic aortic stenosis. At most transcatheter aortic valve replacement centers, transapical access is a frequent alternative for use in patients whose ileofemoral access is inadequate. Transapical access is increasingly applied to a variety of other structural heart and aortic procedures as well. There is a caveat, however. When performed in elderly patients with friable myocardium, transapical access is associated with such serious sequelae as bleeding and left ventricular apical pseudoaneurysmal formation...
February 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/26999727/transcatheter-aortic-valve-implantation-today-and-tomorrow
#19
REVIEW
Peter Wenaweser, Fabien Praz, Stefan Stortecky
Aortic stenosis is the most common valvular heart disease in Western industrial countries (including Switzerland) with a prevalence of about 5% in the population aged 75 and over. If left untreated, symptomatic patients have a rate of death of more than 50% within 2 years. As a result of age and elevated surgical risk, an important proportion of elderly patients are not referred to surgery. Thus, the introduction of transcatheter aortic valve implantation (TAVI) in 2002 has initiated a paradigm shift in the treatment of patients with symptomatic, severe aortic stenosis...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/26994122/transcatheter-valve-in-valve-implantation-for-failing-bioprosthetic-triscupid-valves-completing-the-quest
#20
EDITORIAL
Torsten P Vahl, Rebecca T Hahn, Jeffrey W Moses
No abstract text is available yet for this article.
April 19, 2016: Circulation
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