scholarly journals Minimally Invasive Mitral Valve Surgery I: Patient Selection, Evaluation, and Planning

2016 ◽  
Vol 11 (4) ◽  
pp. 243-250 ◽  
Author(s):  
Gorav Ailawadi ◽  
Arvind K. Agnihotri ◽  
John R. Mehall ◽  
J. Alan Wolfe ◽  
Brian W. Hummel ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Best Practices ◽  
Minimally Invasive ◽  
Myocardial Protection ◽  
Preoperative Planning ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Patient Evaluation ◽  
Valve Repair ◽  
Selection For

Widespread adoption of minimally invasive mitral valve repair and replacement may be fostered by practice consensus and standardization. This expert opinion, first of a 3-part series, outlines current best practices in patient evaluation and selection for minimally invasive mitral valve procedures, and discusses preoperative planning for cannulation and myocardial protection.

scholarly journals Minimally Invasive Mitral Valve Surgery II Surgical Technique and Postoperative Management

2016 ◽  
Vol 11 (4) ◽  
pp. 251-259 ◽  
Author(s):  
J. Alan Wolfe ◽  
S. Chris Malaisrie ◽  
R. Saeid Farivar ◽  
Junaid H. Khan ◽  
W. Clark Hargrove ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Surgical Technique ◽  
Best Practices ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Postoperative Care ◽  
Postoperative Management ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Repair

Techniques for minimally invasive mitral valve repair and replacement continue to evolve. This expert opinion, the second of a 3-part series, outlines current best practices for nonrobotic, minimally invasive mitral valve procedures, and for postoperative care after minimally invasive mitral valve surgery.

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

2018 ◽  
Vol 32 (2) ◽  
pp. 656-663 ◽  
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

Safety of Single-Dose Histidine-Tryptophan-Ketoglutarate Cardioplegia during Minimally Invasive Mitral Valve Surgery

2014 ◽  
Vol 9 (6) ◽  
pp. 416-420 ◽  
Author(s):  
Carlo Savini ◽  
Giacomo Murana ◽  
Marco Di Eusanio ◽  
Sofia Martin Suarez ◽  
Giuliano Jafrancesco ◽  
...  
Keyword(s):  
Single Dose ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Myocardial Protection ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Aortic Cross Clamp Time ◽  
Htk Solution ◽  
Cardioplegic Solutions ◽  
Creatine Kinase Isoenzyme Mb

Objective Minimally invasive mitral valve surgery may require a prolonged period of myocardial ischemia. Cardioplegic solutions that necessitate a single dose for adequate myocardial protection are evoked to simplify surgery and result to be appealing in this setting. The aim of this study was to assess early outcomes after minimally invasive mitral valve surgery using one single dose of histidine-tryptophanketoglutarate solution (HTK; Custodiol) for myocardial protection. Methods Between February 2003 and October 2012, a total of 49 consecutive patients underwent minimally invasive mitral valve surgery using a single dose of HTK solution for myocardial protection. The patients’ mean (SD) age was 57 (14) years; the preoperative ejection fraction was normal in all cases. The mean (SD) CPB time and aortic cross-clamp time were 148 (45) minutes and 97 (45) minutes, respectively. Results The heart spontaneously restarted after cross-clamp removal in 37 patients (75.5%). Five patients (10.2%) required prolonged inotropic drug support. Postoperatively, no significant increase in myocardial cytonecrosis enzymes was found [mean (SD) creatine kinase isoenzyme MB, 77.14 (53.67) μg/L at 3 hours, 71.2 (55.67) μg/L at 12 hours, and 42.53 (38.38) μg/L at 24 hours)], and no ischemic electrocardiogram modifications were observed before discharge. Conclusions During minimally invasive mitral valve surgery, HTK solution provided excellent myocardial protection even after prolonged periods of cardioplegic arrest. The avoidance of repetitive infusions may reduce the risk for coronary malperfusion due to dislodgement of the endoaortic clamp (if used) and increase the surgeon's comfort during the procedure.

The age-adjusted Charlson comorbidity index in minimally invasive mitral valve surgery

2019 ◽  
Vol 56 (6) ◽  
pp. 1124-1130 ◽  
Author(s):  
Jan-Philipp Minol ◽  
Vanessa Dimitrova ◽  
Georgi Petrov ◽  
Robert Langner ◽  
Udo Boeken ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Adverse Events ◽  
Minimally Invasive ◽  
Predictive Value ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Repair ◽  
Comorbidity Index ◽  
Sts Score ◽  
Perioperative Course

Abstract OBJECTIVES Mitral valve repair is the preferred method used to address mitral valve regurgitation, whereas transcatheter mitral valve repair is recommended for high-risk patients. We evaluated the risk-predictive value of the age-adjusted Charlson comorbidity index (aa-CCI) in the setting of minimally invasive mitral valve surgery. METHODS The perioperative course and 1-year follow-up of 537 patients who underwent isolated or combined minimally invasive mitral valve surgery were evaluated for 1-year mortality as the primary end point and other adverse events. The predictive values of the EuroSCORE II and STS score were compared to that of the aa-CCI by a comparative analysis of receiver operating characteristic curves. Restricted cubic splines were applied to find optimal aa-CCI cut-off values for the increased likelihood of experiencing the predefined adverse end points. Consequently, the perioperative course and postoperative outcome of the aa-CCI ≥8 patients and the remainder of the sample were analysed. RESULTS The predictive value of the aa-CCI does not significantly differ from those of the EuroSCORE II or STS score. Patients with an aa-CCI ≥8 were identified as a subgroup with a significant increase of mortality and other adverse events. CONCLUSIONS The aa-CCI displays a suitable predictive ability for patients undergoing minimally invasive mitral valve surgery. In particular, multimorbid or frail patients may benefit from the extension of the objectively assessed parameters, in addition to the STS score or EuroSCORE II. Patients with an aa-CCI ≥8 have a very high surgical risk and should receive very careful attention.

scholarly journals Right Minithoraсotomy as a Standard Approach for Mitral Valve Surgery

2020 ◽  
pp. 23-28
Author(s):  
O. D. Babliak ◽  
V. M. Demianenko ◽  
D. Y. Babliak ◽  
A. I. Marchenko ◽  
K. A. Revenko ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Tricuspid Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Standard Approach ◽  
Wound Complications ◽  
Tricuspid Valve Repair ◽  
Valve Repair

  Background. Minimally invasive mitral valve surgery provides many advantages for patients. The aim. To investigate and represent our own experience in minimally invasive mitral valve surgery, and to describe the operative technique. Materials and methods. The study was included 100 consecutive patients who underwent a minimally invasive mitral valve repair or replacement through the right lateral minithoracotomy from June 2017 to December 2019. Results. Mitral valve repair was performed in 87 patients (87%), and 13 patients (13%) were required mitral valve replacement. In 24 patients (24%), concomitant procedures were performed: tricuspid valve repair, atrial septal defect repair and left atrial myxomectomy. Ring anuloplasty was performed in all patients who underwent mitral valve repair. Additional methods of correction were used in accordance to the lesion anatomy: neochords implantation, cleft and leaflet perforation closure, leaflet resection, Alfieri (edge-to-edge) stitch, posterior leaflet plication. There was no in-hospital and 30-day mortality. Post-operative strokes were not reported. No wound complications were observed in the femoral cannulation area. The total length of stay in a hospital was 6 ± 1.46 (3–9) days. There were no cases of mitral valve insufficiency greater more than mild degree after mitral valve repair at the time of discharge. Conclusions. Minimally invasive mitral valve surgery can be performed as a routine standard approach, provides safe and effective correction of the mitral valve defects, allows excellent results of mitral valve repair and replacement in various abnormalities. Minimally invasive approach enables to perform a large number of reconstructive valve techniques and perform simultaneous correction of atrial septal defects, tricuspid valve repair and atrial neoplasm removal.

scholarly journals Minimally Invasive Mitral Valve Surgery III: Training and Robotic-Assisted Approaches

2016 ◽  
Vol 11 (4) ◽  
pp. 260-267 ◽  
Author(s):  
Eric J. Lehr ◽  
T. Sloane Guy ◽  
Robert L. Smith ◽  
Eugene A. Grossi ◽  
Richard J. Shemin ◽  
...  
Keyword(s):  
United States ◽  
Mitral Valve ◽  
Best Practices ◽  
Minimally Invasive ◽  
Expert Opinion ◽  
State Of The Art ◽  
The United States ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Robotic Assisted

Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program.

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