Preoperative planning of left-sided valve surgery with 3D computed tomography reconstruction models: sternotomy or a minimally invasive approach?†

A duplicated middle cerebral artery (DMCA) is a common anomaly. However, aneurysms arising from the origin of a DMCA are extremely rare. A 22-year-old female was admitted to our hospital with a World Federation of Neurosurgical Societies grade 2 subarachnoid haemorrhage. Four-vessel angiography revealed a DMCA and an aneurysm arising from the origin of this artery. The aneurysm was successfully treated by embolization, and the patient was discharged 2 weeks later. Ruptured aneurysms arising from the origin of a DMCA can be successfully treated by embolization. These aneurysms are small and 3D-computed tomography reconstruction is mandatory to detect them. It is important to preserve the DMCA during the treatment procedure.

Download Full-text

Myocardial Protection in Mitral Valve Surgery: Comparison Between Minimally Invasive Approach and Standard Sternotomy

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2017.08.040 ◽

2018 ◽

Vol 32 (2) ◽

pp. 656-663 ◽

Cited By ~ 4

Author(s):

Jean-Sébastien Lebon ◽

Pierre Couture ◽

Annik Fortier ◽

Antoine G. Rochon ◽

Christian Ayoub ◽

...

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Myocardial Protection ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Minimally Invasive Approach ◽

Invasive Approach

Download Full-text

Obesity Should Not Deter a Surgeon from Selecting a Minimally Invasive Approach for Mitral Valve Surgery

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3182a20e5a ◽

2013 ◽

Vol 8 (3) ◽

pp. 225-229 ◽

Cited By ~ 9

Author(s):

Diana Reser ◽

Simon Sündermann ◽

Jürg Grünenfelder ◽

Jacques Scherman ◽

Burkhardt Seifert ◽

...

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Mitral Valve Surgery ◽

Normal Weight ◽

Valve Surgery ◽

Cerebrovascular Event ◽

Minimally Invasive Approach ◽

Term Outcome ◽

Invasive Approach ◽

Postoperative Ventilation

Objective Obesity is highly prevalent in modern patient populations. Several studies have published conflicting outcomes after minimally invasive surgery with regard to morbidity and mortality. Some instances consider obesity as a relative contraindication for this approach because of inadequate exposure of the surgical field. Our aim was to investigate the outcomes of minimally invasive mitral valve surgery through a right lateral minithoracotomy in patients with a body mass index (BMI) of 30 kg/m2 or greater. Methods We conducted a retrospective database review between January 1, 2009, and December 31, 2011. Preoperative, intraoperative, postoperative, and follow-up data of 225 consecutive patients were collected. Results The patients were stratified according to their BMI: 108 had a normal weight with a BMI of lower than 25 kg/m2 (18–24), 90 were overweight with a BMI of 25 to 29 kg/m2, and 27 were obese with a BMI of 30 kg/m2 (30–41) or greater. Statistical analysis showed significantly longer ventilation times in the obese group, whereas all other variables were similar. Survival, major adverse cardiac and cerebrovascular event-free survival, valve competency, and freedom from reoperation were also comparable. Conclusions Our data suggest that obesity should not deter a surgeon from selecting a minimally invasive approach. Despite longer postoperative ventilation times, a BMI of 30 kg/m2 or greater does not influence short- and medium-term outcome. Obese patients may even benefit from this approach because it avoids the need for sternotomy and therefore reduces the risk for sternal wound infection.

Download Full-text

Is a minimally invasive approach for re-operative mitral valve surgery superior to standard resternotomy?

Interactive Cardiovascular and Thoracic Surgery ◽

10.1510/icvts.2009.203448 ◽

2009 ◽

Vol 9 (2) ◽

pp. 327-332 ◽

Cited By ~ 12

Author(s):

M. Murzi ◽

M. Solinas ◽

M. Glauber

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Minimally Invasive Approach ◽

Invasive Approach

Download Full-text

MINIMALLY INVASIVE POSTERIOR OSTEOTOMIES

Neurosurgery ◽

10.1227/01.neu.0000320430.37577.b7 ◽

2008 ◽

Vol 63 (suppl_3) ◽

pp. A204-A210 ◽

Cited By ~ 17

Author(s):

Jean-Marc Voyadzis ◽

Vishal C. Gala ◽

John E. O'Toole ◽

Kurt M. Eichholz ◽

Richard G. Fessler

Keyword(s):

Computed Tomography ◽

Minimally Invasive ◽

Muscle Injury ◽

Pedicle Subtraction Osteotomy ◽

Bone Resection ◽

Minimally Invasive Approach ◽

Tubular Retractor ◽

Invasive Approach ◽

Severe Postoperative Pain ◽

Human Cadavers

ABSTRACT OBJECTIVE Surgery for thoracolumbar deformity can lead to significant muscle injury, excessive blood loss, and severe postoperative pain. The aim of the following studies was to determine the feasibility of minimally invasive posterior thoracic corpectomy and thoracolumbar osteotomy techniques for deformity in human cadavers and select clinical cases. METHODS Human cadaveric specimens were procured for thoracic corpectomy and Smith-Petersen and pedicle subtraction osteotomy using a minimally invasive approach. Post-procedural computed tomography was used to assess the degree of decompression following corpectomy and the extent of bone resection after osteotomy. Pre and post-osteotomy closure Cobb angles were measured to evaluate the degree of correction achieved. RESULTS The minimally invasive lateral extracavitary approach for thoracic corpectomy provided adequate exposure and allowed excellent spinal canal decompression while minimizing tissue disruption. Nearly complete osteotomies of both types could be achieved through a tubular retractor with a modest change in Cobb angle. CONCLUSION These techniques may play a role in deformity surgery for select cases with further technological advancements.

Download Full-text

Minimally invasive approach for aortic and mitral valve surgery

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezw208 ◽

2016 ◽

Vol 50 (6) ◽

pp. 1204-1205 ◽

Cited By ~ 6

Author(s):

Antonio Lio ◽

Antonio Miceli ◽

Matteo Ferrarini ◽

Mattia Glauber

Keyword(s):

Mitral Valve ◽

Minimally Invasive ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Minimally Invasive Approach ◽

Invasive Approach

Download Full-text

Computed tomography as a method of substantiating a minimally invasive approach in the treatment of esophageal injuries and their complications

Medical Visualization ◽

10.24835/1607-0763-997 ◽

2021 ◽

Vol 25 (2) ◽

pp. 63-73

Author(s):

T. G. Barmina ◽

S. N. Danielyan ◽

L. S. Kokov ◽

F. A.-K. Sharifullin ◽

O. A. Zabavskaya ◽

...

Keyword(s):

Computed Tomography ◽

Minimally Invasive ◽

Pleural Empyema ◽

Complete Information ◽

Treatment Method ◽

Thoracic Esophagus ◽

Minimally Invasive Approach ◽

Invasive Treatment ◽

Invasive Approach ◽

Ct Data

The purpose of the study. To analyze possibilities of computed tomography (CT) for esophageal injuries and their complications as part of a differentiated approach to the choice of a minimally invasive treatment method.Materials and methods. The results of CT scans were analyzed in 25 patients with esophageal injuries of various etiologies who were treated at the N.V. Sklifosovsky Research Institute of SP in the period 2019–2020. CT was performed with oral and intravenous bolus contrast, primarily at admission and in dynamics, a total of 77 studies.Results. In all cases, direct and indirect CT signs of esophageal damage were detected, and the degree of involvement of surrounding organs and tissues in the pathological process was assessed. Based on the data obtained, the following variants of esophageal damage and its complications were identified: intramural esophageal hematoma (2); rupture of the thoracic esophagus without the development of purulent complications (2); rupture of the thoracic esophagus complicated by the development of mediastinitis (4); rupture of the thoracic esophagus with the development of mediastinitis and pleural empyema (13); rupture of the cervical calving of the esophagus, complicated by phlegmon of the neck and descending mediastinitis (4). Different patient management tactics were used for each variant. Thus, the selection and sequence of minimally invasive interventions, such as thoracoscopic sanitation mediastinal and pleural cavity, esophageal stenting, percutaneous endoscopic gastrostomy (CEG) and endoscopic vacuum aspiration system (E-VAS), were carried out taking into account CT data, including observations in dynamics.Conclusion. CT scan for esophageal injuries allows you to get complete information about both the nature of esophageal damage and its complications, to determine their type, localization and volume. CT data allow us to justify a minimally invasive approach in the treatment of esophageal injuries, to determine the order of interventions. CT studies performed in dynamics allow us to evaluate the effectiveness of treatment and to carry out timely correction of tactics.

Download Full-text