A Heart Surgery Simulator With an Integrated Supervision System for Self-Learning the Key Steps and Pitfalls of the Mitral Valve Repair

Mitral valve repair is an accepted method of treating severe mitral valve disease due to rheumatic fever, Valve repair confers fewer complications and better survival as compared to mitral valve replacement. Since commencing open-heart surgery at SGNHC, 49 mitral valve repair operations have been performed here. There were 25 male and 24 female patients. The average age was 28.7 years (5 - 68 years). All were symptomatic with significant dyspnoea and palpitation. Other symptoms were hemoptysis in eight, peripheral embolism in one and CNS embolism in four. Associated lesions included ASD in three, an ASD and constrictive pericarditis in one and a pseudoaneurysm of the left common iliac artery with PDA in the fifth. One patient had undergone CMV nine years before presentation.

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Infective endocarditis and pregnancy

Ukrainian journal of cardiovascular surgery ◽

10.30702/ujcvs/19.3712/067061-066 ◽

2019 ◽

pp. 61-66

Author(s):

S. O. Siromakha ◽

A. O. Rusnak ◽

O. F. Luchinets ◽

A.O. Ogorodnyk ◽

T. A. Malysheva ◽

...

Keyword(s):

Cardiac Surgery ◽

Infective Endocarditis ◽

Mitral Valve ◽

Pregnant Women ◽

Perinatal Mortality ◽

Mitral Valve Repair ◽

Multidisciplinary Team ◽

Heart Surgery ◽

Open Heart Surgery ◽

Valve Repair

Infective endocarditis in pregnant women is a threatening disease that leads to significant maternal and perinatal losses. Methods for caring for such patients have not yet been standardized, and literature sources provide single descriptions of case reports. Objectives. To reduce maternal and perinatal mortality and disability, as well as to provide optimal management and delivery strategy for pregnant women with infective endocarditis. Materials and methods.This paper presents the experience of treating three cases of IE in pregnant women (n-2) and parturient (n-1) by specialists of a national multidisciplinary team. In all three cases, cardiology, cardiac surgery and perinatal tactics were personalized in accordance with the recommendations of the European Society of Cardiologists and the experience of the team members. Parturient with acute IE and septic clot of right ventricle underwent urgent cardiac surgery. Another pregnant was provided with conservative support by a multidisciplinary team due to the absence of indications for immediate surgery (she underwent aortic valve replacement and mitral valve repair in 11 days after in-term labour). The third one underwent cardiac surgery (mitral valve repair) with fetus in utero at 21 weeks of pregnancy after 11 weeks of de-escalation therapy by antibiotics. Results. In all cases, the immediate maternal and perinatal results were good. Follow-up for two cases we could observe (33 and 18 months after surgery) are good. Conclusions. Treatment tactic for pregnant women with acute IE that require heart surgery is always a compromise between the treatment and rehabilitation of a deep-preterm baby and the intra-operative risks to the fetus. Risk of intervention for mother and fetus can be minimized by a highly professional multidisciplinary team with wide experience in open-heart surgery, competent preparation of women for surgical treatment, conducting intraoperative fetal monitoring, as well as using special parameters of artificial circulation and anesthesia. Primary and secondary prevention of infectious complications in pregnant women at risk of IE is a powerful tool to reduce maternal, perinatal mortality and disability.

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A Concept for a Novel Procedure for Mitral Valve Repair by Percutaneous Annuloplasty

ASME 2008 3rd Frontiers in Biomedical Devices Conference ◽

10.1115/biomed2008-38085 ◽

2008 ◽

Cited By ~ 1

Author(s):

Toufic Azar ◽

Sumitra Rajagopalan ◽

Renzo Cecere ◽

Joszef Kovecses ◽

Jorge Angeles

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Valve Repair ◽

Heart Surgery ◽

Open Heart Surgery ◽

Mitral Valve Regurgitation ◽

The United States ◽

Valve Repair ◽

Operative Trauma ◽

Idiopathic Cardiomyopathy

Mitral valve regurgitation [1] (MVR) is a functional heart disease in which the valve does not close completely and causes blood to leak back into the left atrium. This condition increases the workload on the heart, and if left untreated, can lead to irreversible heart damage, cardiac arrhythmia, and congestive heart failure. Annually, in the United States, more than 50 000 patients undergo mitral valve repair. The causes of MR can be either primary, due to an anatomical change of the valve apparatus, or secondary to ischemic heart disease and idiopathic cardiomyopathy. Currently, the intervention requires an open heart surgery with cardiopulmonary bypass. Under such conditions, the patient is subjected to intra and post-operative trauma that can result in a mortality increase and that can prevent high risk individuals from undergoing the repair. A non-invasive percutaneous method would greatly reduce risks associated with a conventional surgery while increasing the potential candidates for repair. Introduced in this paper is a concept for a novel procedure that relies on a robotically-guided compliant catheter, fitted with an anchoring mechanism, intended to reshape the mitral-valve annulus to dimensions suitable for the effective support of the valve leaflets.

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