Innovative techniques of left atrial exposure in minimally invasive mitral valve repair

2021 ◽  
pp. 021849232110466
Author(s):  
Dat T Pham ◽  
Thanh N Le ◽  
Hung Q Doan
Keyword(s):  
Minimally Invasive Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Left Atrium ◽  
Invasive Surgery ◽  
Left Atrial ◽  
Traumatic Injury ◽  
Valve Repair ◽  
Good Exposure ◽  
Innovative Techniques

Various atrial retractors have been developed to achieve optimal exposure of mitral valve in minimally invasive surgery. We introduce our technique of only using retraction sutures to expose mitral valve. This method is simple, efficient, and provides good exposure of the left atrium without causing traumatic injury.

Contemporary trends in mitral valve surgery in East China: a 10-year experience

2020 ◽  
Vol 28 (7) ◽  
pp. 404-412
Author(s):  
Liang Ma ◽  
Renyuan Li ◽  
Lijun Jiang ◽  
Weidong Li ◽  
Haige Zhao ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Invasive Surgery ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
East China ◽  
Valve Repair ◽  
Valve Lesions

Background Contemporary nationwide data from mainland China on trends in mitral valve surgery are scarce. The purpose of the present study was to review a single-center experience with mitral valve surgery over a 10-year period in East China. Methods Between July 2009 and June 2019, 3238 consecutive patients who underwent mitral valve surgery in our center were retrospectively reviewed. The patients were evenly divided into three periods: July 2009 to October 2012 (period I), November 2012 to February 2016 (period II), March 2016 to June 2019 (period III). Results The 3238 patients included 536 (16.6%) who had mitral valve repair and 2702 (83.4%) who had mitral valve replacement. Early mortalities for mitral valve repair and mitral valve replacement were 0.2% and 0.9%, respectively. There were trends towards a higher proportion of degenerative valve lesions (24.6%, 35.8%, 54.7% in periods I, II, and III, respectively) and a lower proportion of rheumatic valve lesions (71.0%, 62.6%, 38.0%) in more recent years. The proportions of minimally invasive surgery (0.7%, 2.1%, 30.2%), mitral valve repair (8.3%, 15.4%, 27.5%), use of a bioprosthesis (10.1%, 17.0%, 23.1%), and concomitant tricuspid valve procedures (13.2%, 28.5%, 46.0%) increased dramatically, while early mortality remained constant during the 10-year period (1.0%, 0.3%, 0.9%). Conclusions In the past 10 years, the spectrum of mitral valve disease experienced a trend towards more degenerative valve lesions and less rheumatic valve lesions in East China. Mitral valve repair, bioprostheses, tricuspid valve repair, and minimally invasive surgery have been more often applied in recent years.

scholarly journals Left Atrial Function after Atrial Fibrillation Cryoablation Concomitant to Minimally Invasive Mitral Valve Repair: A Pilot Study on Long-Term Results and Clinical Implications

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 709
Author(s):  
Anselmino ◽  
Rovera ◽  
Marchetto ◽  
Castagno ◽  
Morello ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Surface Area ◽  
Mitral Valve Repair ◽  
Body Surface ◽  
Left Atrial ◽  
Valve Repair

Background and Objectives: Surgical atrial fibrillation (AF) ablation concomitant to minimally invasive mitral valve repair has been proven to offer improved short- and long-term sinus rhythm (SR) maintenance compared to mitral valve surgery only. The objective of the present study was to explore, by thorough echocardiographic assessment, long-term morphological and functional left atrial (LA) outcomes after this combined surgical procedure. Materials and Methods: From October 2006 to November 2015, 48 patients underwent minimally invasive mitral valve repair and concomitant surgical AF cryoablation. Results: After 3.8 ± 2.2 years, 30 (71.4%) of those completing the follow-up (n = 42, 87.5%) presented SR. During follow-up, four (9.5%) patients suffered from cerebrovascular accidents and two of these subjects had a long-standing persistent AF relapse and were in AF at the time of the event, while the other two were in SR. An echocardiographic study focused on LA characteristics was performed in 29 patients (69.0%). Atrial morphology and function (e.g., maximal LA volume indexed to body surface area and total LA emptying fraction derived from volumes) in patients with stable SR (60.6 ± 13.1 mL/mq and 25.1 ± 7.3%) were significantly better than in those with AF relapses (76.8 ± 16.2 mL/mq and 17.5 ± 7.4%; respectively, p = 0.008 and p = 0.015). At follow-up, patients who suffered from ischemic cerebral events had maximal LA volume indexed to body surface area 61 ± 17.8 mL/mq, with total LA emptying fraction derived from volumes 23.6 ± 13.7%; patients with strokes in SR showed very enlarged LA volume (>70 mL/mq). Conclusions: AF cryoablation concomitant with minimally invasive mitral valve repair provides a high rate of SR maintenance and this relates to improved long-term morphological and functional LA outcomes. Further prospective studies are needed to define the cut-off values determining an increase in the risk for thromboembolic complications in patients with restored stable SR.

Minimally invasive surgery in patients with mitral valve disease

2018 ◽  
Vol 60 (1) ◽  
pp. 19-27
Author(s):  
O.Yu. Pidanov ◽  
K.V. Shcherbatyuk ◽  
N.A. Kolomeychenko ◽  
V.A. Tsepenshchikov
Keyword(s):  
Minimally Invasive Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Mitral Valve Disease ◽  
Valve Disease

Minimally invasive mitral valve repair

2018 ◽  
pp. 145-156
Author(s):  
Evelio Rodriguez ◽  
W. Randolph Chitwood
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Surgical Techniques ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Direct Visualization ◽  
Technical Aspects

The practice of minimally invasive surgery is becoming increasingly widespread in the current era of cardiac surgery. Minimally invasive mitral valve surgery (MIMVS) describes many different surgical techniques used in the management of mitral valve (MV) disease. Variations in surgical techniques include a combination of the type of incision, direct visualization (videoscopic or robotic visualization), cardiopulmonary perfusion techniques, and aortic occlusion (external clamping, endo-clamping, or fibrillatory arrest). In this chapter, the history and current literature related to MIMVS are reviewed in detail. In addition, we discuss both important technical aspects associated with MIMVS, as well as our approach at the Saint Thomas Heart Institute.

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