scholarly journals A clinical study of thoracoscopy-assisted mitral valve replacement concomitant with tricuspid valvuloplasty, with domestically manufactured pipeline products for cardiopulmonary bypass

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Hua Cao ◽  
Qiang Chen ◽  
Qian-Zhen Li ◽  
Liang-Wan Chen ◽  
Gui-Can Zhang ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Clinical Study ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement

Acquired submitral aneurysms may be associated with mitral paravalvular leaks

2021 ◽  
pp. 021849232110063
Author(s):  
Palaparti Raghuram ◽  
Kothandam Sivakumar ◽  
Ejaz Ahamed Sheriff
Keyword(s):  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Transcatheter Closure ◽  
Alternative Solution ◽  
Surgical Trauma ◽  
Ideal Solution ◽  
Repeat Surgery

Acquired submitral aneurysm after mitral valve replacement is caused by weakness of the annular tissues induced by inflammation, scarring, and ischemia from surgical trauma. The asynchronous stretch of the annulus caused by the submitral aneurysm may cause recurrent paravalvular leaks. In patients with acquired submitral aneurysms and paravalvular leaks, ideal solution is a repeat surgery to address both the aneurysm and the leak. However, when patients are at high risk for repeat surgeries on cardiopulmonary bypass through sternotomy, transcatheter closure of these paravalvar leaks may offer an alternative solution. Four such procedures in three patients are detailed in this report.

scholarly journals Cardiac surgery in patients with heparin induced thombocytopenia (HIT II)

2009 ◽  
Vol 56 (1) ◽  
pp. 47-52
Author(s):  
M.D. Jovic ◽  
D.G. Nezic ◽  
B.M. Calija ◽  
D.S. Nenadic ◽  
A.M. Knezevic ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Anticoagulant Therapy ◽  
Anticoagulation Therapy ◽  
Thrombin Inhibitors ◽  
Postoperative Treatment ◽  
Per Oral

Heparin-induced thrombocytopenia (HIT) might be lifethreatening in patients undergoing open heart surgery, due to thromboembolic events, thrombocytopenia and bleeding. If cardiac surgery with cardiopulmonary bypass (CPB) is necessary, anticoagulation therapy will be based on usage of danaparoid or direct thrombin inhibitors. Female patient was switched from per oral anticoagulant therapy to low molecular heparin therapy preparing for reredo mitral valve replacement due to endocarditis and artificial valve thrombosis. In next 10 days, thrombocytopenia was obvious (Tr 302 000 mm3 to 11 000 mm3) , and diagnoses of HIT were done. Anticoagulant therapy was continued with danaparoid, 750 IU/12 h sc. During the surgery, reredo mitral valve replacement and aortocoronary bypass on anterior descending coronary artery, blood salvage technique with rhirudin( intravenous bolus 0,4 mg/kg, in CPB prajming solution 0,4mg/kg and continuous infusion during CPB 0,15 mg/kg/h ) during cardiopulmonary bypass was used. Active coagulation time and +++ were monitored, without any sign of micro thrombosis in circuit. Postoperatively, per oral anticoagulation therapy was initiated with prolonged postoperative treatment due to basic disease, endocarditis. Patient was discharged from hospital on 21-st postoperative day without any complication.

scholarly journals Comparison of Totally Thoracoscopic and Traditional Sternotomy Approaches for Mitral Valve Replacement

2019 ◽  
Vol 22 (4) ◽  
pp. E310-E314
Author(s):  
He Fan ◽  
Qian Xi Ming ◽  
Zhang Wei Min ◽  
Chen Huai Dong
Keyword(s):  
Cardiopulmonary Bypass ◽  
Postoperative Complications ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Median Sternotomy ◽  
Traditional Group ◽  
Thoracoscopic Approach ◽  
Postoperative Drainage ◽  
The Right

Background: We aimed to investigate the feasibility and safety of mitral valve replacement using a totally thoracoscopic approach in comparison with traditional median sternotomy. Methods: Between January 2016 and December 2017, 94 consecutive patients who underwent mitral valve replacement were divided into two groups: A thoracoscopic group (43 cases) and a traditional group (51 cases). For the thoracoscopic group, all patients underwent total thoracoscopic procedures with femoral arterial and venous cannulation to cardiopulmonary bypass, transthoracic aortic cross-clamp, and antegrade cardioplegia. Three intercostal ports in the right chest were used for access in the thoracoscopic group. The operation was performed completely under two-dimensional video. For the traditional group, all operations were done with traditional median sternotomy. Results: All the operations were successfully performed. The thoracoscopic group had longer aortic cross-clamping and cardiopulmonary bypass times compared with the traditional group (62.30 ± 8.17 minutes versus 44.90 ± 12.00 minutes, P < .001; 92.33 ± 12.03 minutes versus 74.22 ± 14.72 minutes, P < .001). The two groups did not show statistically significant differences with respect to operative times (184.26 ± 32.49 minutes versus 181.47 ± 23.31 minutes, P = .631). In addition, the postoperative mechanical ventilation, ICU stay, and postoperative hospital stay times and postoperative drainage were 10.14 ± 2.21 hours and 11.35 ± 2.58 hours (P = .016), 21.40 ± 3.15 hours and 29.12 ± 6.59 hours (P < .001), 8.70 ± 2.52 days and 10.04 ± 3.11 days (P = .023), and 325.71 ± 97.11 mL and 396.57 ± 121.50 mL (P < .001), respectively. Major postoperative complications occurred in three (6.98%, P = .873) cases of the thoracoscopic group. Four (7.84%) cases of the traditional group had postoperative complications. Conclusions: Despite the disadvantages such as long cross-clamp and cardiopulmonary bypass times, totally thoracoscopic mitral valve replacement is feasible and safe. More importantly, one of the principal advantages with three intercostal ports over standard sternotomy is avoiding retrosternal adhesion, thus lowering the risk of needing to redo a cardiac procedure in the future.

Cardiopulmonary bypass and mitral valve replacement during pregnancy

Perfusion ◽  
2005 ◽  
Vol 20 (6) ◽  
pp. 359-368 ◽  
Author(s):  
Steven W Sutton ◽  
Michael A Duncan ◽  
Virginia A Chase ◽  
Randy J Marcel ◽  
Thomas P Meyers ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Health Status ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Gestational Age ◽  
Fetal Mortality ◽  
Prior History ◽  
Controlled Clinical Trial ◽  
Pharmaceutical Therapy

Gravid patient cardiopulmonary bypass remains a high- risk procedure with regard to fetal preservation. Maternal mortality is similar to that of the nonpregnant female at 1.5-5%. However, fetal mortality remains high at 16-33%, with an average of 19% over the past 25 years, with no correlation to gestational age. Teratogenesis is a major consideration in the first trimester. Variations in the timing of surgical intervention, gestational age, maternal health status, type of procedure, pre- or post- organogenesis, perfusion protocol, and pharmaceutical therapy are all factors that can influence fetomaternal outcome. In this report, we present a literature review along with our experience of a 26-year-old female who developed complications with her pregnancy at approximately 17 weeks gestation, with adverse neurological sequelae. The patient was 152 cm in height and weighed 48 kg, with a calculated body surface area of 1.40 M2. She had no prior history of cardiac disease and, upon admission to our institution, presented with a declining health status in pulmonary edema and was treated medically, with an ultimate requirement for mitral valve replacement. The total cardiopulmonary bypass time was 99 min with an aortic crossclamp time of 83 min. The literature, as expected, is limited to case reports and reviews since a controlled clinical trial during pregnancy is nonexistent, using extracorporeal circulation. This greatly challenges the medical staff in managing such difficult cases, with an incidence of heart disease during pregnancy of 1.2-3.7%.

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