Minimally Invasive Treatment of Mitral Valve Disease

Abstract Introduction Totally endoscopic technique has been widely used in cardiac surgery, and minimally invasive totally endoscopic mitral valve surgery has been developed as an alternative to median sternotomy for many patients with mitral valve disease. In this study, we describe our experience about a modified minimally invasive totally endoscopic mitral valve surgery and reported the preliminary results of totally endoscopic mitral valve surgery. The aim of this retrospective study is to evaluate the results of totally endoscopic technique in mitral valve surgery. Material and methods We retrospectively reviewed the profiles of 188 patients who were treated for mitral valve disease by modified totally endoscopic mitral valve surgery at our institution between January 2019 and December 2020. The procedure was performed under endoscopic right minithoracotomy and with femoro-femoral cannulation using the single two-stage venous cannula. Results A total of 188 patients underwent total endoscopic mitral valve surgery. Fifty-six patients had concomitant tricuspid valvuloplasty, 11 patients underwent concomitant ablation of atrial fibrillation and atrial septal defect repair was performed in three patients. Only one patient postoperatively died of multi-organ failure. Two patients were converted to median sternotomy. Except for one patient underwent operation to stop the bleeding from the incision site, no other serious complications nor reintervention occurred during the follow-up period. Conclusions The modified totally endoscopic mitral valve surgery performed at our institution is technically feasible and safe with the same efficacy as reported studies.

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THE ROLE OF ROBOTIC TECHNOLOGY IN MINIMALLY INVASIVE SURGERY FOR MITRAL VALVE DISEASE

Expert Review of Medical Devices ◽

10.1080/17434440.2021.1960506 ◽

2021 ◽

Author(s):

Johannes Bonatti ◽

Bob Kiaii ◽

Cem Alhan ◽

Stepan Cerny ◽

Gianluca Torregrossa ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Mitral Valve ◽

Minimally Invasive ◽

Invasive Surgery ◽

Mitral Valve Disease ◽

Valve Disease ◽

Robotic Technology

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Letter to Editor regarding: Equivalent outcomes with minimally invasive and sternotomy mitral valve repair for degenerative mitral valve disease. J Card Surg. 2021;36:2636‐43

Journal of Cardiac Surgery ◽

10.1111/jocs.16172 ◽

2021 ◽

Author(s):

Chao Song ◽

Yunlong Fan ◽

Shixiong Wei ◽

Shengli Jiang

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Mitral Valve Repair ◽

Mitral Valve Disease ◽

Valve Disease ◽

Valve Repair

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Percutaneous Mitral Valve Procedures

Cardiac Anesthesia: A Problem-Based Learning Approach ◽

10.1093/med/9780190884512.003.0020 ◽

2019 ◽

pp. 186-194

Author(s):

Sheela Pai Cole

Keyword(s):

Cardiac Surgery ◽

Mitral Valve ◽

Minimally Invasive ◽

Patient Selection ◽

Mitral Valve Disease ◽

Fast Track ◽

Valve Disease ◽

Percutaneous Approach ◽

Detailed Understanding ◽

Complex Patient

As the population ages, more patients are presenting with symptomatic mitral valve disease that requires risk-prohibitive cardiac surgery. In the last decade, advances in valve technology have generated valves that can be inserted via a minimally invasive percutaneous approach. Nonetheless, patients must fulfill specific criteria in order to be considered for a percutaneous mitral intervention. From an anesthesiologist’s perspective, these cases are unique as they require both a detailed understanding of complex patient physiology and the need to be planned as fast-track procedures. Echocardiography is the cornerstone to success for these procedures, and typically a separate team of echocardiographers may be involved in the conduct of the case. This review discusses patient selection, complications of the procedure, and perioperative considerations for this technique.

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