Mitral valve surgery; Right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
S.H. Sündermann ◽  
J. Sromicki ◽  
H. Rodriguez Cetina Biefer ◽  
M.Y. Emmert ◽  
B. Seifert ◽  
...  
2020 ◽  
Vol 4 (sup1) ◽  
pp. 121-122
Author(s):  
Amer Harky ◽  
Arish Noshirwani ◽  
Dimitrios Pousios ◽  
Andrew D. Muir

Author(s):  
Amer Harky ◽  
Ter-Er Kusu-Orkar ◽  
Jeffrey Shi Kai Chan ◽  
Arish Noshirwani ◽  
Sugeevan Savarimuthu ◽  
...  

2019 ◽  
Vol 56 (4) ◽  
pp. 643-653 ◽  
Author(s):  
Paul Martin Rival ◽  
Theresa H M Moore ◽  
Alexandra McAleenan ◽  
Hamish Hamilton ◽  
Zachary Du Toit ◽  
...  

Summary This systematic review and meta-analysis aims to determine outcomes following aortic occlusion with the transthoracic clamp (TTC) versus endoaortic balloon occlusion (EABO) in patients undergoing minimally invasive mitral valve surgery. A subgroup analysis compares TTC to EABO with femoral cannulation separately from EABO with aortic cannulation. We searched Medline and Embase up to December 2018. Two people independently and in duplicate screened title and abstracts, full-text reports, extracted data and assessed the risk of bias using the Cochrane risk-of-bias tool for non-randomized studies. We identified 1564 reports from which 11 observational studies with 4181 participants met the inclusion criteria. We found no evidence of difference in the risk of postoperative death or cerebrovascular accident (CVA) between the 2 techniques. Evidence for a reduction in aortic dissection with TTC was found: 4 of 1590 for the TTC group vs 19 of 2492 for the EABO group [risk ratio 0.33, 95% confidence interval (CI) 0.12–0.93; P = 0.04]. There was no difference in aortic cross-clamp (AoX) time between TTC and EABO [mean difference (MD) −5.17 min, 95% CI −12.40 to 2.06; P = 0.16]. TTC was associated with a shorter AoX time compared to EABO with femoral cannulation (MD −9.26 min, 95% CI −17.00 to −1.52; P = 0.02). EABO with aortic cannulation was associated with a shorter AoX time compared to TTC (MD 7.77 min, 95% CI 3.29–12.26; P < 0.001). There was no difference in cardiopulmonary bypass (CPB) time between TTC and EABO with aortic cannulation (MD −4.98 min, 95% CI −14.41 to 4.45; P = 0.3). TTC was associated with a shorter CPB time compared to EABO with femoral cannulation (MD −10.08 min, 95% CI −19.93 to −0.22; P = 0.05). Despite a higher risk of aortic dissection with EABO, the rates of survival and cerebrovascular accident across the 2 techniques are similar in minimally invasive mitral valve surgery.


Author(s):  
Davy C. H. Cheng ◽  
Janet Martin ◽  
Avtar Lal ◽  
Anno Diegeler ◽  
Thierry A. Folliguet ◽  
...  

2020 ◽  
Vol 31 (10) ◽  
pp. 2632-2641 ◽  
Author(s):  
Jacopo Marazzato ◽  
Giangiuseppe Cappabianca ◽  
Fabio Angeli ◽  
Matteo Crippa ◽  
Michele Golino ◽  
...  

Author(s):  
Ali Hage ◽  
Fadi Hage ◽  
Hussein Al-Amodi ◽  
Suruchi Gupta ◽  
Stefania I. Papatheodorou ◽  
...  

Objective The safety of minimally invasive mitral valve surgery (MIMVS) in elderly patients is still debated. Our objective was to perform a systematic review and meta-analysis of studies comparing MIMVS with conventional sternotomy (CS) in elderly patients (≥65 years old). Methods We searched PubMed, EMBASE, Web of Science, clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for trials and observational studies comparing MIMVS with CS in patients ≥65 years old presenting for mitral valve surgery. We performed a random-effects meta-analysis of all outcomes. Results The MIMVS group had lower odds of acute renal failure (odds ratio [OR] 0.27; 95% CI 0.10 to 0.78), prolonged intubation (>48 h; OR 0.47; 95% CI 0.31 to 0.70), less blood product transfusion (weighted mean difference [WMD] −0.82 units; 95% CI −1.29 to −0.34 units), shorter ICU length of stay (LOS; WMD −2.57 days; 95% CI −3.24 to −1.90 days) and hospital LOS (WMD −4.06 days; 95% CI −5.19 to −2.94 days). There were no significant differences in the odds of mortality, stroke, respiratory infection, reoperation for bleeding, and postoperative atrial fibrillation. MIMVS was associated with longer cross-clamp (WMD 11.8 min; 95% CI 3.5 to 20.1 min) and cardiopulmonary bypass times (WMD 23.0 min; 95% CI 10.4 to 35.6 min). Conclusions MIMVS in elderly patients is associated with lower postoperative complications, blood transfusion, shorter ICU, and hospital LOS, and longer cross-clamp and bypass times.


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