Impact of biomineralization on resin/biomineralized dentin bond longevity in a minimally invasive approach: An “in vitro” 18-month follow-up

Objective Aortic valve replacement in minimally invasive approach has shown to improve clinical outcomes even with a prolonged cardiopulmonary bypass and aortic cross-clamp (ACC) time. Sutureless aortic valve implantation may ideally shorten operative time. We describe our initial experience with the sutureless 3f Enable (Medtronic, Inc, ATS Medical, Minneapolis, MN USA) aortic bioprosthesis implanted in minimally invasive approach in high-risk patients. Methods Between May 2010 and May 2011, thirteen patients with severe aortic stenosis underwent aortic valve replacement with the 3f Enable bioprosthesis through an upper V-type ministernotomy interrupted at the second intercostal space. The mean ± SD age was 77 ± 3.9 years (range, 72–83 years), 10 patients were women, and the mean ± SD logistic EuroSCORE was 15% ± 13.5%. Echocardiography was performed preoperatively, at postoperative day 1, at discharge, and at follow-up. Clinical data, adverse events, and patient outcomes were recorded retrospectively. The median follow-up time was 4 months (interquartile range, 2–10 months). Results Most of the implanted valves were 21 mm in diameter (19–25 mm). The CPB and ACC times were 100.2 ± 25.3 and 66.4 ± 18.6 minutes. At short-term follow-up, the mean ± SD pressure gradient was 14 ± 4.9 mm Hg; one patient showed trivial paravalvular leakage. No patients died during hospital stay or at follow-up. Conclusions The 3f Enable sutureless bioprosthesis implanted in minimally invasive approach through an upper V-type ministernotomy is a feasible, safe, and reproducible procedure. Hemodynamic and clinical data are promising. This innovative approach might be considered as an alternative in high-risk patients. Reduction of CPB and ACC time is possible with increasing of experience and sutureless evolution of actual technology.

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A Simplified Technique for Correcting Mitral Valve Regurgitation via Minimally Invasive Approach

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000497 ◽

2018 ◽

Vol 13 (3) ◽

pp. 236-238

Author(s):

Giuseppe Speziale ◽

Marco Moscarelli

Keyword(s):

Cardiopulmonary Bypass ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Mitral Valve Regurgitation ◽

Valve Regurgitation ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Repair Techniques

Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months, freedom from recurrent of mitral regurgitation 2+ or greater and reoperation was 95.2%.

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Fiber reinforced composite supported restoration of congenitally missing tooth by minimally invasive approach: Two years follow-up

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.3.3873 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Muhammad Qasim Javed

Keyword(s):

Minimally Invasive ◽

Anterior Tooth ◽

Fiber Reinforced ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Fiber Reinforced Composite ◽

Reinforced Composite ◽

Congenitally Missing ◽

Missing Tooth

Maxillary lateral incisor is the most frequent congenitally missing anterior tooth of the permanent dentition. The absence of the anterior tooth can adversely affect the production/transmission of speech sounds, mental health, and facial aesthetics of an individual. Considering this, prosthetic rehabilitation of missing front tooth is important. The treatment alternatives include implant supported single crown, conventional fixed partial dentures (FPDs), and resin bonded FPDs that are unilaterally or bilaterally supported by metallic wings. However, with the development in adhesive dentistry fiber reinforced composite (FRC) supported FPDs have provided a workable substitute for traditional techniques because of their improved esthetics, minimal invasiveness, less cost, enhanced bond strength, and revocable nature. The current case, reports the two years follow up of twenty-four years old female patient, for whom the congenitally absent maxillary right lateral incisor was restored with FRC supported FPD. doi: https://doi.org/10.12669/pjms.37.3.3873 How to cite this:Javed MQ. Fiber reinforced composite supported restoration of congenitally missing tooth by minimally invasive approach: Two years follow-up. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3873 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Minimally Invasive Approach to Infected Pancreatic Necrosis

10.1093/med/9780199384075.003.0020 ◽

2017 ◽

Author(s):

Rachel J. Kwon

Keyword(s):

Minimally Invasive ◽

Pancreatic Necrosis ◽

Necrotizing Pancreatitis ◽

Infected Pancreatic Necrosis ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Open Necrosectomy ◽

Study Intervention ◽

Landmark Study

This chapter provides a summary of a landmark study in abdominal surgery. Does a minimally invasive, “step-up” approach to necrotizing pancreatitis reduce mortality and major complications as compared to open necrosectomy? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving a patient with infected pancreatic necrosis.

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Minimally Invasive Mitral Valve Surgery for Mitral Valve Infective Endocarditis

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0037-1604206 ◽

2017 ◽

Vol 66 (07) ◽

pp. 525-529 ◽

Cited By ~ 3

Author(s):

Joerg Seeburger ◽

Jens Garbade ◽

Uta Schon ◽

Martin Misfeld ◽

Friedrich Mohr ◽

...

Keyword(s):

Infective Endocarditis ◽

Mitral Valve ◽

Minimally Invasive ◽

Mitral Annulus ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Mitral Leaflet ◽

Minimally Invasive Approach ◽

Invasive Approach

Background The feasibility of minimally invasive mitral valve (MV) surgery in infective endocarditis (IE) has not been reported in detail. We assessed the safety, efficacy, and durability of the minimally invasive approach through a right anterolateral minithoracotomy for surgical treatment of MV IE. Methods A review of the Leipzig Heart Center database revealed 92 eligible patients operated on between 2002 and 2013. All patients had undergone minimally invasive surgery for IE. The indication for surgery was isolated IE of the MV in all patients. Baseline and intraoperative data, as well as clinical outcomes and short-term follow-up were analyzed retrospectively. Results The patients' mean age was 60.9 ± 15.3 years, the logistic EuroSCORE II was 19.6 ± 19.1%, and 64.1% (59) were male. MV repair was feasible in 23.9% (22/92) of patients. Repair techniques included annuloplasty ring implantation, anterior mitral leaflet resection, posterior mitral leaflet resection, and implantation of neochordae. MV replacement was performed in 69 patients (75%), a mitral annulus patch in 1 patient, and concomitant tricuspid valve surgery for tricuspid regurgitation in 5 patients. Bacteriological analysis showed staphylococcus infection in 45.5%, streptococcus in 36.4%, enterococcus in 13.6%, and others in 4.5%. The 30-day-mortality rate was 9.8% (9 patients). The 1-year follow-up showed a 1-year survival rate of 77.7 ± 4.4% and freedom from reoperation within 1 year due to reendocarditis of 93.3 ± 2.1%. Conclusions The minimally invasive approach is suitable for the treatment of IE of the MV. It is a good technique in IE in selected patients.

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Ovarian Remnant Syndrome: Minimally Invasive Approach and Clinical Follow-Up

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2009.08.358 ◽

2009 ◽

Vol 16 (6) ◽

pp. S143

Author(s):

V. Zanagnolo ◽

P.M. Magtibay ◽

J. Klauschie ◽

M. Akl ◽

J.F. Magrina

Keyword(s):

Minimally Invasive ◽

Minimally Invasive Approach ◽

Invasive Approach

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Minimally invasive removal of thoracic and lumbar spinal tumors using a nonexpandable tubular retractor

Journal of Neurosurgery Spine ◽

10.3171/2013.9.spine121061 ◽

2013 ◽

Vol 19 (6) ◽

pp. 708-715 ◽

Cited By ~ 41

Author(s):

Andre Nzokou ◽

Alexander G. Weil ◽

Daniel Shedid

Keyword(s):

Minimally Invasive ◽

Spinal Tumors ◽

Subtotal Resection ◽

Minimally Invasive Approach ◽

Tubular Retractor ◽

Invasive Approach ◽

Duration Of Surgery ◽

Intradural Extramedullary ◽

Mini Open

Object Resection of spinal tumors traditionally requires bilateral subperiosteal muscle stripping, extensive laminectomy, and, in cases of foraminal extension, partial or radical facetectomy. Fusion is often warranted in cases of facetectomy to prevent deformity, pain, and neurological deterioration. Recent reports have demonstrated safety and efficacy of mini-open removal of these tumors using expandable tubular retractors. The authors report their experience with the minimally invasive removal of extradural foraminal and intradural-extramedullary tumors using the nonexpandable tubular retractor. Methods A retrospective chart review of consecutive patients who underwent minimally invasive resection of spinal tumors at Notre Dame Hospital was performed. Results Between December 2005 and March 2012, 13 patients underwent minimally invasive removal of spinal tumors at Notre Dame Hospital, Montreal. There were 6 men and 7 women with a mean age of 55 years (range 20–80 years). There were 2 lumbar and 2 thoracic intradural-extramedullary tumors and 7 thoracic and 2 lumbar extradural foraminal tumors. Gross-total resection was achieved in 12 patients. Subtotal resection (90%) was attained in 1 patient because the tumor capsule was adherent to the diaphragm. The average duration of surgery was 189 minutes (range 75–540 minutes), and the average blood loss was 219 ml (range 25–500 ml). There were no major procedure-related complications. Pathological analysis revealed benign schwannoma in 8 patients and meningioma, metastasis, plasmacytoma, osteoid osteoma, and hemangiopericytoma in 1 patient each. The average equivalent dose of postoperative narcotics after surgery was 66.3 mg of morphine. The average length of hospitalization was 66 hours (range 24–144 hours). All working patients returned to normal activities within 4 weeks. The average MRI and clinical follow-up were 13 and 21 months, respectively (range 2–68 months). At last follow-up, 92% of patients had improvement or resolution of pain with a visual analog scale score that improved from 7.8 to 1.2. All patients with neurological impairment improved. The American Spinal Injury Association grade improved in all but 1 patient. Conclusions Intradural-extramedullary and extradural tumors can be completely and safely resected through a minimally invasive approach using the nonexpandable tubular retractor. This approach may be associated with even less tissue destruction than mini-open techniques, translating into a quicker functional recovery. In cases of foraminal tumors, by eliminating the need for facetectomy, this minimally invasive approach may decrease the incidence of postoperative deformity and eliminate the need for adjunctive fusion surgery.

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Minimally Invasive Spinal Arthrodesis in Osteoporotic Population Using a Cannulated and Fenestrated Augmented Screw: Technical Description and Clinical Experience

Minimally Invasive Surgery ◽

10.1155/2012/507826 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 7

Author(s):

Alphonse Lubansu ◽

Michal Rynkowski ◽

Laurence Abeloos ◽

Geoffrey Appelboom ◽

Olivier Dewitte

Keyword(s):

Minimally Invasive ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Pmma Bone Cement ◽

Fluoroscopic Control ◽

Clinical Series ◽

Correct Alignment ◽

Spinal Arthrodesis ◽

Vas Scores

We describe a percutaneous or minimally invasive approach to apply an augmentation of pedicle fenestrated screws by injection of the PMMA bone cement through the implant and determine the safety and efficiency of this technique in a clinical series of 15 elderly osteoporotic patients. Clinical outcome and the function were assessed using respectively the Visual Analogue Scale (VAS) score and the Oswestry Disability Index (ODI). Peri- and post-operative complications were monitored during a minimum of 2 years of follow-up. Radiographic follow-up was based on plain fluoroscopic control at 3, 6 and 12 months and every year. In this approach, four steps were considered with care: optimal positioning of the screws, correct alignment of the screw heads, waiting time before the injection of cement, fluoroscopic control of the cement injection. Using these precautions, only 2 minor complications occurred. VAS scores and ODI questionnaires showed a statistically significant improvement up to 13.3 months postoperatively. No radiological complications were observed. Based on this experience, PMMA augmentation technique through the novel fenestrated screws provided an effective and long lasting fixation in osteoporotic patients. Applying this procedure through percutaneous or minimally invasive approach under fluoroscopic control seems to be safe.

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Stereotactic laser ablation for completion corpus callosotomy

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.5.peds19117 ◽

2019 ◽

Vol 24 (4) ◽

pp. 433-441 ◽

Cited By ~ 4

Author(s):

Yuhao Huang ◽

Derek Yecies ◽

Lisa Bruckert ◽

Jonathon J. Parker ◽

Allen L. Ho ◽

...

Keyword(s):

Corpus Callosum ◽

Minimally Invasive ◽

Pediatric Patients ◽

Adult Patients ◽

Multiple Time ◽

Corpus Callosotomy ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Diffusion Weighted

OBJECTIVECompletion corpus callosotomy can offer further remission from disabling seizures when a prior partial corpus callosotomy has failed and residual callosal tissue is identified on imaging. Traditional microsurgical approaches to section residual fibers carry risks associated with multiple craniotomies and the proximity to the medially oriented motor cortices. Laser interstitial thermal therapy (LITT) represents a minimally invasive approach for the ablation of residual fibers following a prior partial corpus callosotomy. Here, the authors report clinical outcomes of 6 patients undergoing LITT for completion corpus callosotomy and characterize the radiological effects of ablation.METHODSA retrospective clinical review was performed on a series of 6 patients who underwent LITT completion corpus callosotomy for medically intractable epilepsy at Stanford University Medical Center and Lucile Packard Children’s Hospital at Stanford between January 2015 and January 2018. Detailed structural and diffusion-weighted MR images were obtained prior to and at multiple time points after LITT. In 4 patients who underwent diffusion tensor imaging (DTI), streamline tractography was used to reconstruct and evaluate tract projections crossing the anterior (genu and rostrum) and posterior (splenium) parts of the corpus callosum. Multiple diffusion parameters were evaluated at baseline and at each follow-up.RESULTSThree pediatric (age 8–18 years) and 3 adult patients (age 30–40 years) who underwent completion corpus callosotomy by LITT were identified. Mean length of follow-up postoperatively was 21.2 (range 12–34) months. Two patients had residual splenium, rostrum, and genu of the corpus callosum, while 4 patients had residual splenium only. Postoperative complications included asymptomatic extension of ablation into the left thalamus and transient disconnection syndrome. Ablation of the targeted area was confirmed on immediate postoperative diffusion-weighted MRI in all patients. Engel class I–II outcomes were achieved in 3 adult patients, whereas all 3 pediatric patients had Engel class III–IV outcomes. Tractography in 2 adult and 2 pediatric patients revealed time-dependent reduction of fractional anisotropy after LITT.CONCLUSIONSLITT is a safe, minimally invasive approach for completion corpus callosotomy. Engel outcomes for completion corpus callosotomy by LITT were similar to reported outcomes of open completion callosotomy, with seizure reduction primarily observed in adult patients. Serial DTI can be used to assess the presence of tract projections over time but does not classify treatment responders or nonresponders.

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Modifying Gummy Smile: A Minimally Invasive Approach

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1625 ◽

2014 ◽

Vol 15 (6) ◽

pp. 821-826 ◽

Cited By ~ 7

Author(s):

Walid Ahmed Abdullah ◽

Hesham S Khalil ◽

Maryam M Alhindi ◽

Hamdy Marzook

Keyword(s):

Patient Satisfaction ◽

Minimally Invasive ◽

Invasive Procedure ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Lower Position ◽

Surgical Methods ◽

Levator Labii Superioris ◽

Gummy Smile

ABSTRACT Aim Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile. Materials and methods Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit. Results At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month. Conclusion This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile. Clinical significance A non-invasive procedure to avoid other complicated surgical procedures. How to cite this article Abdullah WA, Khalil HS, Alhindi MM, Marzook H. Modifying Gummy Smile: A Minimally Invasive Approach. J Contemp Dent Pract 2014;15(6):821-826.

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