Right Minithoracotomy Approach for Replacement of the Ascending Aorta, Hemiarch, and Aortic Valve

2016 ◽  
Vol 11 (4) ◽  
pp. 301-304 ◽  
Author(s):  
Joseph Lamelas ◽  
Angelo LaPietra
Keyword(s):  
Aortic Valve ◽  
Minimally Invasive ◽  
Circulatory Arrest ◽  
Ascending Aorta ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Access Site ◽  
Valve Pathology ◽  
Thoracotomy Incision

A minimally invasive right anterior thoracotomy approach is the preferred technique used at our institution for isolated aortic valve pathology. We have recently introduced more complex concomitant minimally invasive procedures through this access site. Here, we describe how we perform a replacement of the ascending aorta and aortic valve with and without the use of circulatory arrest through a 6-cm right minimally invasive thoracotomy incision.

Outcomes of Aortic Valve and Concomitant Ascending Aorta Replacement Performed via a Minimally Invasive Right Thoracotomy Approach

2014 ◽  
Vol 9 (5) ◽  
pp. 339-342 ◽  
Author(s):  
Angelo LaPietra ◽  
Orlando Santana ◽  
Andrés M. Pineda ◽  
Christos G. Mihos ◽  
Joseph Lamelas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Aortic Valve ◽  
Minimally Invasive ◽  
Circulatory Arrest ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Hypothermic Circulatory Arrest ◽  
Left Ventricular Ejection ◽  
Lengths Of Stay

Objective Replacement of the aortic valve with concomitant replacement of the ascending aorta performed via a minimally invasive right anterior thoracotomy approach has not been reported. We evaluated the feasibility and safety of this procedure. Methods We retrospectively reviewed all minimally invasive aortic valve replacements (AVRs) with concomitant replacement of the ascending aorta performed at our institution between January 1, 2012, and December 30, 2012. The operative times, intensive care unit and hospital lengths of stay, postoperative outcomes, as well as mortality were analyzed. Results A total of 20 consecutive patients who underwent minimally invasive AVR with concomitant replacement of the ascending aorta were identified. There were 16 men (80%), with a mean (SD) age of 61 (13) years. The mean (SD) left ventricular ejection fraction was 58% (8%). The aortic valve was bicuspid in 18 patients (80%), with 14 (70%) being stenotic. The median aortic cross-clamp and cardiopulmonary bypass times were 163 [interquartile range (IQR), 141–170] minutes and 291 (IQR, 177–215) minutes, respectively. Hypothermic circulatory arrest was required in 19 patients (95%), with a median hypothermic circulatory arrest time of 35 (IQR, 33–39.5) minutes. The median intensive care unit and hospital lengths of stay were 24 (IQR, 23–41) hours and 5 (IQR, 4–6) days, respectively. There were no strokes, reoperations for bleeding, or conversions to sternotomy. The 30-day mortality was zero. Conclusions Minimally invasive AVR with concomitant replacement of the ascending aorta, via a right anterior thoracotomy approach, can be performed with low morbidity and mortality.

Minimally Invasive Procedures Will Keep Patients Coming Back

2007 ◽  
Vol 38 (11) ◽  
pp. 26
Author(s):  
HEIDI SPLETE
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures

Treatment of varicocele with reference to age: a retrospective comparison of three minimally invasive procedures

2006 ◽  
Vol 21 (1) ◽  
pp. 61-65 ◽  
Author(s):  
S. Beutner ◽  
M. May ◽  
B. Hoschke ◽  
C. Helke ◽  
M. Lein ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Retrospective Comparison

The Radius Surgical System – A New Device for Complex Minimally Invasive Procedures in Urology?

2007 ◽  
Vol 51 (4) ◽  
pp. 1015-1022 ◽  
Author(s):  
Thomas Frede ◽  
Ahmed Hammady ◽  
Jan Klein ◽  
Dogu Teber ◽  
Noriyuki Inaki ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
New Device ◽  
System A ◽  
Radius Surgical System ◽  
Surgical System

The utility and complications of plasma administration in cirrhotic patients undergoing minimally invasive procedures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kelly E. Diaz ◽  
Douglas Tremblay ◽  
Begum Ozturk ◽  
Ghideon Ezaz ◽  
Suzanne Arinsburg ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Cirrhotic Patients

Surgery for Stress Urinary Incontinence: Minimally Invasive Procedures

Continence ◽  
2009 ◽  
pp. 149-164 ◽  
Author(s):  
Eric A. Hurtado ◽  
Rodney A. Appell
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures

Surgery for Stress Urinary Incontinence: Minimally Invasive Procedures

Continence ◽  
2009 ◽  
pp. 149-164
Author(s):  
Eric A. Hurtado ◽  
Rodney A. Appell
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Minimally Invasive ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures

Urological Disorders in Men

2011 ◽  
Vol 24 (4) ◽  
pp. 374-385 ◽  
Author(s):  
Susan W. Miller ◽  
Mindi S. Miller
Keyword(s):  
Minimally Invasive ◽  
Health Care Providers ◽  
Patient Specific ◽  
Treatment Preferences ◽  
Measurement Tool ◽  
Anticholinergic Drugs ◽  
Minimally Invasive Procedures ◽  
Care Providers ◽  
Invasive Procedures ◽  
Symptom Index

Urinary incontinence (UI) and benign prostatic hyperplasia (BPH) are 2 common urogenital problems in men. UI is associated with involuntary leakage of urine and lower urinary tract symptoms (LUTS) of urgency, frequency, and nocturia. Types of UI include functional, urge, stress, and overflow. Treatment for UI is based on the type of incontinence, patient-specific factors, and treatment preferences of both patients and health care providers. Options for the management of UI include environmental modifications, disposable incontinence products, pelvic floor exercises, pharmacotherapy, surgically implanted devices, and intermittent catheterization. BPH may be also associated with LUTS. Patient symptoms, assessed with a measurement tool such as the American Urological Association Symptom Index (AUASI), serve as the basis for determining treatment. Management approaches for BPH include pharmacotherapy, surgery, and minimally invasive procedures. Anticholinergic drugs as well as α-receptor antagonists and 5-α reductase inhibitors, either alone or in combination, are effective and useful for LUTS unresponsive to traditional pharmacotherapy. Transurethral resection of the prostate (TURP) can eliminate symptoms of BPH but is associated with relatively more complications than other available surgical and minimally invasive procedures.

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