A Case of Coronary Artery Fistula Ligation in Minimally Invasive Mitral Valve Plasty via Right Anterolateral Minithoracotomy

2019 ◽  
Vol 14 (2) ◽  
pp. 174-176
Author(s):  
Nobuo Kondo ◽  
Toshinori Totsugawa ◽  
Hidenori Yoshitaka ◽  
Taichi Sakaguchi
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Present Method ◽  
Coronary Artery Fistula ◽  
Minimally Invasive Cardiac Surgery ◽  
Mitral Valve Plasty ◽  
Safe Option ◽  
Heart Beating

We report a case of coronary artery fistula treated by ligation with concomitant minimally invasive mitral valve plasty via right anterolateral minithoracotomy. The coronary artery fistula was isolated well under heart beating, and clip-ligation was easily and safely performed. The present method is an effective and safe option for use with minimally invasive cardiac surgery.

Percutaneous femoral cannulation and decannulation using a plug-based vascular closure device in minimally invasive cardiac surgery

2020 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Extracorporeal Circulation ◽  
Minimally Invasive Cardiac Surgery ◽  
Closure Device ◽  
Arterial Cannulation ◽  
Vascular Closure Device ◽  
Video Tutorial ◽  
Percutaneous Cannulation

Minimally invasive cardiac surgery such as a mitral valve procedure requires femoral arterial cannulation for extracorporeal circulation. To avoid complications associated with surgical groin incisions, such as seromas and infections, percutaneous cannulation techniques can be used. This video tutorial illustrates percutaneous femoral cannulation and decannulation using a plug-based vascular closure device.

Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine

2019 ◽  
Vol 14 (6) ◽  
pp. 512-518
Author(s):  
Mario Castillo-Sang ◽  
Cheryl Bartone ◽  
Cassady Palmer ◽  
Vien T. Truong ◽  
Brian Kelly ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Mitral Valve ◽  
Length Of Stay ◽  
Minimally Invasive ◽  
Hospital Length ◽  
Minimally Invasive Cardiac Surgery ◽  
Hospital Length Of Stay ◽  
Liposomal Bupivacaine ◽  
Asd Closure

Objective Minimally invasive cardiac surgery via a right minithoracotomy (RMT) is a common approach to different valve pathologies, tumor resection, and atrial septal defect (ASD) closure. We studied intraoperative field block using liposomal bupivacaine (LB) in these operations. Methods Consecutive 171 minimally invasive RMTs (fourth intercostal space) were studied, and patients in cardiogenic or septic shock, intravenous drug abuse, and those re-explored were excluded ( n = 12). An early cohort was treated with standard postoperative analgesia while another underwent intraoperative field block with LB immediately after incision. We compared postoperative pain level, narcotic utilization (morphine milligram equivalent), and intensive care unit (ICU) and hospital length of stay. Results The procedures included 48 isolated mitral valve replacements (MVR); 2 MVR with other procedures; 93 mitral valve repairs (MVRr); 9 MVRr with other procedures; 4 isolated tricuspid valve repairs; 2 myxoma resections; 1 ASD closure. There were 13 patients in the non-LB group and 146 patients in the LB group. Use of LB decreased mean postoperative narcotic utilization by 50% ( P = 0.003). The LB group had lower pain levels on postoperative day 1 ( P = 0.039), which continued through postoperative day 5 ( P = 0.030). We found no difference in ICU or hospital length of stay between groups. There were no complications from LB field block. Conclusions LB field block decreases postoperative pain and narcotic utilization after cardiac surgery via a RMT, but it does not reduce length of stay. The technique is safe and should be considered in all patients undergoing RMT cardiac surgery.

scholarly journals Three-Dimensional Printing of Life-Like Models for Simulation and Training of Minimally Invasive Cardiac Surgery

2017 ◽  
Vol 12 (6) ◽  
pp. 459-465 ◽  
Author(s):  
Toshiyuki Yamada ◽  
Motohiko Osaka ◽  
Tomoya Uchimuro ◽  
Ryogen Yoon ◽  
Toshiaki Morikawa ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Three Dimensional ◽  
Minimally Invasive Cardiac Surgery ◽  
Valve Repair ◽  
Three Dimensional Printing ◽  
Simulation And Training ◽  
Dimensional Printing ◽  
And Training

Objective As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. Methods Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity. A polyvinyl alcohol model material with a texture and physical properties similar to those of heart tissue was initially used in mitral valve replicas to simulate surgical procedures. To develop this material, we mechanically investigated the composition of each part of the porcine heart. Results We investigated the elastic modulus and breaking strength of the porcine heart. Based on investigation results, the cardiac model was set at rupture strength 20 MPa, elastic modulus 0.17 MPa, and moisture content 85%. This provided a biotexture and feeling exactly like a patient heart. Computed tomography scans confirmed that the model shape was nearly the same as that of a human heart. We simulated minimally invasive mitral valve repair, including ring annuloplasty, chordal reconstruction, resection and suture, and edge-to-edge repair. Full surgery simulations using this model used minimally invasive cardiac surgery tools including a robot. Conclusions This life-like model can be used as a standard simulator to train younger, less experienced surgeons to practice minimally invasive cardiac surgery procedures and may help develop new operative tools.

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