scholarly journals Transapical septal myectomy in the beating heart via a minimally invasive approach: a feasibility study in swine

2019 ◽  
Author(s):  
Jing Fang ◽  
Rui Wang ◽  
Hongyun Liu ◽  
Yunshu Su ◽  
Jun Chen ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Beating Heart ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Aortic Cusp ◽  
Septal Myectomy ◽  
Custom Made ◽  
The Right

Abstract OBJECTIVES The aim of this study was to establish an original transapical septal myectomy procedure that can be performed in the beating heart via a minimally invasive approach for the treatment of hypertrophic obstructive cardiomyopathy. METHODS We designed an original intracardiac septum resection device to conduct off-pump septal myectomy in swine. A subxiphoid minithoracotomy was performed to access the apex of the heart. This resection device was inserted into the left ventricular outflow tract of the heart via the apex. The basal anteroseptal myocardium beneath the right aortic cusp was identified using a combination of transoesophageal and transthoracic echocardiography and then resected and collected by the device. RESULTS Six consecutive operations were successfully and accurately performed using the custom-made device under echocardiographic guidance. All pigs survived and appeared to be normal until planned euthanasia 1 week after operation. A 300–700 mg portion of the septal myocardium was resected from the normal swine heart. Echocardiography and electrocardiogram revealed no abnormalities after resection. One exception was the fifth pig, in which mild annular regurgitation of the aortic valve occurred after repetitive resection. Postmortem necropsy demonstrated that all resections were correctly located at the basal anteroseptal septum beneath the right aortic cusp. CONCLUSIONS Our study provides the first proof-of-concept evidence for a novel beating heart transapical septal myectomy procedure, which showed promising translational potential for the treatment of hypertrophic obstructive cardiomyopathy. This procedure would probably reduce operative risks and improve outcomes and reduce the demanding expertise required to perform conventional surgical myectomy.

scholarly journals Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy

2017 ◽  
Vol 12 (6) ◽  
pp. 489-492 ◽  
Author(s):  
Farah N. Musharbash ◽  
Matthew R. Schill ◽  
Matthew C. Henn ◽  
Ralph J. Damiano
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Septal Myectomy ◽  
Patient Preparation ◽  
Clinical Considerations

Surgical septal myectomy is the treatment of choice for patients with symptomatic hypertrophic obstructive cardiomyopathy refractory to medications. This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience.

Minimally Invasive Septal Myectomy for the Treatment of Hypertrophic Obstructive Cardiomyopathy and Intrinsic Mitral Valve Disease

2015 ◽  
Vol 10 (2) ◽  
pp. 106-113 ◽  
Author(s):  
Daniyar Sh. Gilmanov ◽  
Stefano Bevilacqua ◽  
Marco Solinas ◽  
Matteo Ferrarini ◽  
Enkel Kallushi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Disease ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Valve Disease ◽  
Invasive Approach ◽  
Septal Myectomy ◽  
Left Ventricular Outflow

Objective Transaortic left ventricular septal myectomy described by Morrow is a classical procedure for the treatment of systolic anterior motion of the mitral apparatus associated with hypertrophic obstructive cardiomyopathy (HOCM). We aimed to review our results of transmitral septal myectomy and mitral valve repair/replacement in patients with intrinsic mitral valve disease associated with HOCM, operated on through a minimally invasive approach. Methods Between 2005 and 2014, 19 patients [7 men (37%); mean (SD) age, 69.4 (14.5) years] were treated with minimally invasive approach for degenerative mitral regurgitation and HOCM. Preoperative peak left ventricular outflow tract (LVOT) gradient was 66 (24) mm Hg. Severe mitral regurgitation was diagnosed in 16 cases (84%). New York Heart Association functional class III to IV heart failure was present in 13 patients (68%). Results Fifteen patients (79%) underwent mitral valve replacement, and four patients (21%) underwent mitral valve repair. Left ventricular outflow tract obstruction was corrected directly in all patients via the mitral valve with septal myectomy/myotomy, avoiding aortotomy in majority of the patients. No significant prolongation of extracorporeal circulation/aortic cross-clamping times was observed ( P = 0.41 and P = 0.67, respectively) when compared with a similar population without HOCM. No iatrogenic ventricular septal defect developed in treated patients. No hospital mortality occurred. Resting LVOT gradient reduced at discharge to 13 (22) mm Hg ( P = 0.025). Conclusions Transmitral left ventricular septal myectomy in patients with degenerative mitral valve disease is quite a simple, feasible, and effective technique and does not require aortotomy in most cases. It can be performed with low early mortality and satisfactory resolution of LVOT obstruction in a minimally invasive setting.

scholarly journals Minimally Invasive Plate Osteosynthesis for a Distal Radius Fracture with Forearm Skin Problem

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Mayuko Kinoshita ◽  
Ahmed Zemirline ◽  
Chihab Taleb ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Distal Radius ◽  
Skin Disorder ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Volar Locking Plate ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Locking Plate Osteosynthesis ◽  
The Right

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Minimally invasive locking plate osteosynthesis was performed, and there was no skin lesion at this incision site. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. We reported volar locking plate osteosynthesis using the minimally invasive approach in a patient with skin disorder of the forearm. Such patients are rarely encountered. However, this minimally invasive approach is extremely useful for utilizing the advantages of volar locking plate fixation without being affected by the soft tissue environment.

scholarly journals A NOVEL MINIMALLY INVASIVE APPROACH FOR SURGICAL SEPTAL MYECTOMY

2014 ◽  
Vol 30 (10) ◽  
pp. S234
Author(s):  
A. Mazine ◽  
A. Ghoneim ◽  
W. Fortin ◽  
J. Lebon ◽  
D. Bouchard
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Septal Myectomy

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.

scholarly journals Use of a Minimally Invasive Approach to Correct Diffuse External Compression of the Left Ventricular Assist Device Outflow Graft

ASAIO Journal ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ismael A. Salas De Armas ◽  
Manish Patel ◽  
Mehmet Hakan Akay ◽  
Jayeshkumar Patel ◽  
Mustafa Singapurwala ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Left Ventricular Assist Device ◽  
Left Ventricular ◽  
Minimally Invasive Approach ◽  
Assist Device ◽  
External Compression ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Left Ventricular Assist ◽  
Outflow Graft

scholarly journals Long-term outcomes of pericardial strip versus prosthetic ring annuloplasty for secondary tricuspid regurgitation by a minimally invasive approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Giuseppe Nasso ◽  
Nicola Di Bari ◽  
Giuseppe Santarpino ◽  
Marco Moscarelli ◽  
Mario Siro Brigiani ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Tricuspid Regurgitation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Minimally Invasive Approach ◽  
Ventricular Ejection Fraction ◽  
Invasive Approach ◽  
Functional Tricuspid Regurgitation ◽  
Prosthetic Ring

Abstract Background This study was conducted to compare the outcomes of prosthetic ring versus autologous pericardial strip for the treatment of functional tricuspid regurgitation during left-sided valve surgery by minimally invasive approach. Methods From January 2008 and July 2016, autologous pericardial strip (group P-TAP) was used in 109 patients, and prosthetic ring (group R-TAP) in 115 patients. The primary outcomes were long-term overall survival, development of patch degeneration, and significant tricuspid regurgitation recurrence. The second outcome was the assessment of right ventricular functional parameters. Results Operative mortality was 1 case (0.9%) in the R-TAP group. At the time of hospital discharge only one patient (0.9%) in the R-TAP group had grade III+ tricuspid regurgitation, and none had grade IV+. Mean follow-up was 94.1 ± 24.5 months. Mild and moderate tricuspid regurgitation recurrence was 3.7% and 4.5% (P-TAP vs. R-TAP groups, p = 0.99). Severe regurgitation was observed in 1.8% of cases only in the R-TAP group (p = 0.49). There were no reoperations. Late mortality was 3.7% and 5.4% (P-TAP vs. R-TAP groups, p = 0.75). Freedom from death, all causes, were comparable among groups (log-rank p = 0.45). There were no statistically significant differences between two groups in TAPSE, left ventricular end-diastolic diameter, left ventricular ejection fraction, and left atrial diameter. Conclusions Tricuspid annuloplasty using an autologous pericardial strip in patients undergoing minimally invasive surgery is associated to similar long results (survival, late tricuspid regurgitation, and functional echocardiographic parameters) than annuloplasty with a prosthetic ring. In particular, the pericardial strip over time does not develop any degeneration or retraction.

A Novel Minimally Invasive Approach for Surgical Septal Myectomy

2016 ◽  
Vol 32 (11) ◽  
pp. 1340-1347 ◽  
Author(s):  
Amine Mazine ◽  
Aly Ghoneim ◽  
Ismail Bouhout ◽  
William Fortin ◽  
Ilyes Berania ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Septal Myectomy
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