scholarly journals Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0231378
Author(s):  
Jens C. Kubitz ◽  
Leonie Schulte-Uentrop ◽  
Christian Zoellner ◽  
Melanie Lemke ◽  
Aurelie Messner-Schmitt ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Heart Valve ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Valve Surgery ◽  
Heart Valve Surgery

scholarly journals Economic impact of enhanced recovery after surgery protocol in minimally invasive cardiac surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Johannes Petersen ◽  
Benjamin Kloth ◽  
Johanna Konertz ◽  
Jens Kubitz ◽  
Leonie Schulte-Uentrop ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Cost Savings ◽  
Postoperative Recovery ◽  
Valve Surgery ◽  
Control Group ◽  
Heart Valve Surgery ◽  
Eras Protocol

Abstract Background ERAS (Enhanced Recovery After Surgery) is a multidisciplinary and integrative approach with the goal of optimizing the postoperative recovery. We aimed to analyze the economic impact of a newly established ERAS protocol in minimally invasive heart valve surgery at our institution. Methods ERAS protocol was implemented in 61 consecutive patients who were referred for elective minimally-invasive aortic or mitral valve surgery, between February 1, 2018 and March 31, 2019 (ERAS-group). Another 69 patients who underwent elective minimally-invasive heart valve surgery during the same time period were managed according to the hospital standards (Control-group). A detailed cost comparison analysis was carried out from a hospital perspective using a micro-costing approach. Results The total in-hospital stay was significantly shorter in the ERAS-group compared to the Control-group (6.1 ± 2.6 vs 7.7 ± 3.8 days; p = 0.008) resulting in significant cost savings of €1087.2 per patient (p = 0.003). Due to the intensified physiotherapy in the ERAS protocol, the costs for physiotherapy were €94.3 higher compared to the Control-group (p < 0.001). The total costs in the ERAS cohort were €11,200.0 ± 3029.6/patient compared to € 13,109.8 ± 4527.5/patient in the Control-Group resulting in cost savings of €1909.8 patient due to the implementation of the ERAS protocol (p = 0.006). Conclusion Implementation of an ERAS-protocol in minimally-invasive cardiac surgery can be carried out safely with a fast postoperative recovery of the patient. ERAS results in a financial benefit of up to €1909 per patient and therefore will play a key role in modern cardiac surgery in the near future.

scholarly journals Use of Suture tightening automated device COR-KNOT® for minimally invasive heart valve surgery: Our initial experience in Bangladesh

2019 ◽  
Vol 34 (2) ◽  
pp. 127-131
Author(s):  
Md Faizus Sazzad ◽  
Nusrat Ghafoor ◽  
Siba Pada Roy ◽  
Swati Munshi ◽  
Feroza Khanam ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Valve ◽  
Mitral Valve Repair ◽  
Case Series ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Valve Repair

Background: COR-KNOT® (LSI Solutions, New York, NY, USA) is an automated suture securing device has not been well known. We report a case series for first automated knotting device used for minimally invasive heart valve surgery in Bangladesh. Method and Results: To overcome the challenge of knot securing via a Key-Hole surgery we have used CORKNOT ®. The newest device is capable of remotely and automatically secure sutures and simultaneously can cut and remove the excess suture tails. We covered the spectrum of heart valve surgery: There was one case of bioprosthetic aortic valve replacement, one case of mitral valve repair, one case of bioprosthetic mitral valve replacement, one case of failed mitral valve repair with COR-KNOT® explantation followed by mechanical mitral valve replacement and one case of redo-mitral valve replacement. Average length of hospital stays was 5 ± 1days. There was one reopening, one post-operative atrial fibrillation. No wound infection and no 30day mortality. Conclusion: We conclude, COR-KNOT® is a safe and effective tool to reduce the duration of operation. Clinical outcome of heart valve surgery with COR-KNOT® is comparable with other methods of suture tying methods. Bangladesh Heart Journal 2019; 34(2) : 127-131

Combined PCI and minimally invasive heart valve surgery for high-risk patients

2009 ◽  
Vol 11 (6) ◽  
pp. 492-498 ◽  
Author(s):  
Ramanan Umakanthan ◽  
Marzia Leacche ◽  
Michael R. Petracek ◽  
David X. Zhao ◽  
John G. Byrne
Keyword(s):  
High Risk ◽  
Minimally Invasive ◽  
Heart Valve ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
High Risk Patients ◽  
Risk Patients

RF30 INTEGRATED PERCUTANEOUS AND MINIMALLY INVASIVE APPROACH FOR HEART VALVE SURGERY

2018 ◽  
Vol 19 ◽  
pp. e43
Author(s):  
F. Cammertoni ◽  
P. Bruno ◽  
A. Mazza ◽  
N. Pavone ◽  
P. Farina ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Heart Valve ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Minimally Invasive Approach ◽  
Invasive Approach

scholarly journals Minimally invasive heart valve surgery: influence on coagulation and inflammatory response†

2017 ◽  
Vol 25 (2) ◽  
pp. 225-232 ◽  
Author(s):  
Domenico Paparella ◽  
Crescenzia Rotunno ◽  
Pietro Guida ◽  
Mattia Travascia ◽  
Micaela De Palo ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Minimally Invasive ◽  
Heart Valve ◽  
Valve Surgery ◽  
Heart Valve Surgery

Psychological Effects of Skin Incision Size in Minimally Invasive Valve Surgery Patients

2020 ◽  
Vol 15 (6) ◽  
pp. 532-540
Author(s):  
Alessandra Piarulli ◽  
Giovanni Alfonso Chiariello ◽  
Piergiorgio Bruno ◽  
Federico Cammertoni ◽  
Alessia Rabini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Minimally Invasive ◽  
Heart Valve ◽  
Well Being ◽  
Psychological Tests ◽  
Valve Surgery ◽  
Psychological Status ◽  
Heart Valve Surgery

Objective Clinical benefits of minimally invasive cardiac valve surgery (MIVS) have been reported. Improved postoperative mental status was never analyzed with dedicated psychological tests. In the present study we intend to investigate potential benefits of MIVS for patient psychological well-being, with special attention to the relevance of the patient perception of the chest surgical scar, of the self body image and cosmetic aspects. Methods Between 2016 and 2017, 87 eligible patients, age 66.5 ± 14.5 years, operated on for heart valve surgery, underwent either conventional full sternotomy (CS; n = 48) or MIVS by V-shape hemi-sternotomy approach ( n = 39). Before selection of the surgical approach, patients had undergone preoperative evaluation of their psychological status using Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory Form Y (STAI-Y), and EuroQol-5D (EQ-5D) psychological tests. Six months postoperatively, patients filled in dedicated questionnaires to assess their psychological status, quality of life, and subjective perception, thus repeating the above-mentioned tests and adding the Body Image Questionnaire (BIQ) and Patient and Observer Scar Assessment Scale (POSAS) v2.0 tests for scar-healing process evaluation. Results No patient died during the study.The 4 post-test scales of psychological well-being (BDI-II P = 0.04, STAI-Y P = 0.04, 2 indices of EQ-5D P = 0.03, P = 0.01) showed significant differences between the MIVS group and CS group, with MIVS-small incision patients having lower level of depression and anxiety symptoms and better quality of life. Mean score differences of scar perception (BIQ and POSAS v2.0) were significant, with MIVS patients having evaluated the scar quality significantly better than CS patients. Conclusions MIVS appears associated with significant esthetical and related psychological benefits, as documented by technical tests. These findings should be considered when selecting the most appropriate technique for heart valve surgery.

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