Midterm Results of a Minimally Invasive Approach in David Procedure

2017 ◽  
Vol 66 (04) ◽  
pp. 301-306 ◽  
Author(s):  
Petar Risteski ◽  
Aleksandra Miskovic ◽  
Anton Moritz ◽  
Andreas Zierer ◽  
Nadejda Monsefi
Keyword(s):  
Minimally Invasive ◽  
Heart Surgery ◽  
Group Versus ◽  
Transfusion Rate ◽  
Midterm Results ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Invasive Group ◽  
Packed Red Blood Cells

Background The David procedure is a well-known technique in selected patients with aortic root pathology. A minimally invasive approach in heart surgery increases open interest. Methods From 1991 to 2015, the David technique was performed in 296 patients in our unit. In 90 cases, operations were performed through partial upper sternotomy. The patient mean age was 57 ± 14 years in the minimally invasive group (n = 90) and 58 ± 14 years in the complete sternotomy group (n = 206; p = 0.2). The neosinus modification was performed in 80 patients (89%) in the minimally invasive group and in 79 patients (38%) in the complete sternotomy group (p < 0.01). Mean follow-up was 3 ± 2 years in the minimally invasive group and 8 ± 4 years in the complete sternotomy group. Results Thirty-day mortality was zero in the minimally invasive group and was 3% (n = 6) in the complete sternotomy group (p = 0.1). The need for packed red blood cells was significantly lower in the minimally invasive group (1.6 ± 3 U) than in the complete sternotomy group (3.7 ± 6 U; p < 0.01). Thirty late deaths (2% per patient-year) were observed in the complete sternotomy group versus zero in the minimally invasive group (p < 0.01). One patient (0.5% per patient-year) in the minimally invasive group and 12 patients (0.8% per patient-year) in the complete sternotomy group required reoperation in the follow-up period (p = 0.05). Conclusions Minimally invasive David technique for patients with ascending aortic aneurysm and aortic valve insufficiency offers a good solution with low perioperative blood transfusion rate. Our midterm results show low valve-related complications and reoperation rate. However, long-term follow-up of the minimally invasive group is necessary.

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

2021 ◽  
Vol 37 (5) ◽  
pp. e276-e289
Author(s):  
Kelly Maria Moreira ◽  
Luiz Eduardo Bertassoni ◽  
Robert Phill Davies ◽  
Felipe Joia ◽  
José Francisco Höfling ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Sutureless Aortic Valve Implantation through an Upper V-Type Ministernotomy: An Innovative Approach in High-Risk Patients

2013 ◽  
Vol 8 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Giovanni Concistrè ◽  
Antonio Miceli ◽  
Francesca Chiaramonti ◽  
Pierandrea Farneti ◽  
Stefano Bevilacqua ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Minimally Invasive ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Mean ◽  
Valve Implantation

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.

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

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%.

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

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.

Minimally Invasive Approach to Infected Pancreatic Necrosis

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.

Midterm Results of Minimally Invasive Approach in David Procedure

2016 ◽  
Vol 64 (S 01) ◽  
Author(s):  
N. Monsefi ◽  
P. Risteski ◽  
A. Miskovic ◽  
A. Moritz ◽  
A. Zierer
Keyword(s):  
Minimally Invasive ◽  
Midterm Results ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Right Anterior Mini-Incision Approach to Anomalous Right Coronary Artery Repair

2020 ◽  
Vol 11 (2) ◽  
pp. 215-216 ◽  
Author(s):  
Zoe W. Hinton ◽  
James M. Meza ◽  
Alyssa C. Habermann ◽  
Nicholas D. Andersen ◽  
Mani A. Daneshmand ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Minimally Invasive ◽  
Right Coronary Artery ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
The Right ◽  
Invasive Techniques ◽  
Mini Incision

The right anterior mini-incision has emerged as an effective minimally invasive approach for adult aortic root and valve operations. However, adoption of minimally invasive techniques has been limited in congenital heart surgery. We report a case of anomalous aortic origin of the right coronary artery repair performed through this approach. Following successful right coronary artery unroofing, the patient had an uncomplicated postoperative hospitalization.

Minimally Invasive Surgical Pulmonary Embolectomy

2017 ◽  
Vol 12 (6) ◽  
pp. 406-410 ◽  
Author(s):  
Chetan Pasrija ◽  
Aakash Shah ◽  
Elliot Sultanik ◽  
Michael Rouse ◽  
Mehrdad Ghoreishi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Length Of Stay ◽  
Minimally Invasive ◽  
Hospital Length Of Stay ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Invasive Group ◽  
Pulmonary Embolectomy ◽  
Minimally Invasive Surgical ◽  
Submassive Pulmonary Embolism

Objective Surgical pulmonary embolectomy has gained increasing popularity over the past decade with multiple series reporting excellent outcomes in the treatment of submassive pulmonary embolism. However, a significant barrier to the broader adoption of surgical pulmonary embolectomy remains the large incision and long recovery after a full sternotomy. We report the safety and efficacy of using a minimally invasive approach to surgical pulmonary embolectomy. Methods All consecutive patients undergoing surgical pulmonary embolectomy for a submassive pulmonary embolism (2015–2017) were reviewed. Patients were stratified as conventional or minimally invasive. The minimally invasive approach included a 5- to 7-cm skin incision with upper hemisternotomy to the third intercostal space. The primary outcomes were in-hospital and 90-day survival. Results Thirty patients (conventional = 20, minimally invasive = 10) were identified. Operative time was similar between the two groups, but cardiopulmonary bypass time was significantly longer in the minimally invasive group (58 vs 94 minutes, P = 0.04). While ventilator time and intensive care unit length of stay were similar between groups, hospital length of stay was 4.5 days shorter in the minimally invasive group, and there was a trend toward less blood product use. In-hospital and 90-day survival was 100%. Within the minimally invasive cohort, median right ventricular dysfunction at discharge was none-mild and no patient experienced postoperative renal failure, deep sternal wound infection, sepsis, or stroke. Conclusions Minimally invasive surgical pulmonary embolectomy appears to be a feasible approach in the treatment of patients with a submassive pulmonary embolism. A larger, prospective analysis comparing this modality with conventional surgical pulmonary embolectomy may be warranted.

Minimally Invasive Mitral Valve Surgery for Mitral Valve Infective Endocarditis

2017 ◽  
Vol 66 (07) ◽  
pp. 525-529 ◽  
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.

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

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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