scholarly journals Concomitant Tricuspid Annuloplasty in Patients Undergoing Totally Endoscopic Mitral Valve Surgery: A Propensity-Score Matched Analysis

2021 ◽  
Vol 24 (3) ◽  
pp. E553-E559
Author(s):  
Ling-chen Huang ◽  
Dao-zhong Chen ◽  
Liang-wan Chen ◽  
Xiao-fu Dai
Keyword(s):  
Mitral Valve ◽  
Propensity Score ◽  
Median Sternotomy ◽  
Group Versus ◽  
Operation Time ◽  
Nonparametric Tests ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Annuloplasty ◽  
The Mean

Background: We aimed to evaluate the clinical outcomes of concomitant tricuspid annuloplasty (TAP) in patients undergoing totally endoscopic mitral valve surgery. Methods: It is a single-center, retrospective study that enrolled a total of 173 patients who underwent mitral valve surgery combined with tricuspid annuloplasty between January 2019 and June 2020 in our institution. Patients who underwent totally endoscopic mitral valve surgery with concomitant tricuspid annuloplasty were categorized into the MIMVS-TAP group (N = 51), and patients who underwent mitral valve surgery with concomitant tricuspid annuloplasty through a median sternotomy were categorized into the MVS-TAP group (N = 122). The data collected included detailed demographic and perioperative data. Each patient in the MIMVS-TAP group was individually matched to a patient in the MVS-TAP group, using the propensity scores, and we obtained a matched sample of 51 patients in each group. Parametric and nonparametric tests were used to analyze outcomes. Results: There were no differences in death rates or related major adverse events between the two groups after propensity score matched analysis. The total operation time was longer in the MIMVS + TAP group versus the MVS+TAP group, as were the mean duration of cardiopulmonary bypass time and the cross-clamp time. The mean duration of intensive care unit stay was longer in the MVS + TAP group compared with that of the MIMVS + TAP group, as was the duration of post-operative hospital stay. Conclusions: Totally endoscopic mitral valve surgery with concomitant tricuspid annuloplasty can improve a patient’s prognosis, with comparable short-term outcomes to those of the open approaches.

scholarly journals Minimally Invasive versus Conventional Mitral Valve Surgery Comparison of Early Outcomes

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Mohamed ◽  
T M Elsayegh ◽  
H Y Elbawab ◽  
Y M Elnahas ◽  
A H Omar
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Operation Time ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Safe Alternative ◽  
Invasive Group ◽  
Significant Difference ◽  
The Right

Abstract The mitral valve has been traditionally approached through a median sternotomy. However, mitral valve surgery could be performed using smaller incisions including the right minithoracotomy. This study was a case-control non randomized conducted on 60 patients. All patients had isolated mitral valve disease for mitral valve surgery, 30 of them were operated through right anterolateral minithoracotomy and the others through full median sternotomy to study the effects of minimally invasive mitral valve surgery through right anterolateral minithoracotomy on morbidity and mortality compared with conventional mitral surgery. Medico legal concent was taken from all the patients in this study. All the patients completed the study and there was no mortality among the patients. There was no statistically significant difference as regards the demograohic data, NYHA score and the preoperative echocardiographic findings. Regarding intraoperative comparison, there was statistically significant difference in the cross-clamp time, total bypass time & total operation time. This difference may be due to the new experiences in this MIMVS and the lack of instrumentation that narrow the field of MIMVS. The length of the incision was highly significantly lesser in the minimally invasive group than the full sternotomy group. There was significant difference in the intensive care parameters. The blood loss and the blood transfusion required were lesser in the minimally invasive group. But the ventilation hours and ICU stay was nearly the same in both groups. There was highly significantly less postoperative pain in the minimally invasive group than in the stenotomy group. Total hospital stay was nearly the same in both groups. Minimally invasive mitral valve surgery is a safe alternative to a conventional approach and is associated with less morbidity especially with expert surgeon in simple mitral valve surgery.

scholarly journals Totally endoscopic mitral valve surgery: early experience in 188 patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yi Chen ◽  
Ling-chen Huang ◽  
Dao-zhong Chen ◽  
Liang-wan Chen ◽  
Zi-he Zheng ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Disease ◽  
Median Sternotomy ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Disease ◽  
Endoscopic Technique ◽  
Venous Cannula ◽  
Defect Repair

Abstract Introduction Totally endoscopic technique has been widely used in cardiac surgery, and minimally invasive totally endoscopic mitral valve surgery has been developed as an alternative to median sternotomy for many patients with mitral valve disease. In this study, we describe our experience about a modified minimally invasive totally endoscopic mitral valve surgery and reported the preliminary results of totally endoscopic mitral valve surgery. The aim of this retrospective study is to evaluate the results of totally endoscopic technique in mitral valve surgery. Material and methods We retrospectively reviewed the profiles of 188 patients who were treated for mitral valve disease by modified totally endoscopic mitral valve surgery at our institution between January 2019 and December 2020. The procedure was performed under endoscopic right minithoracotomy and with femoro-femoral cannulation using the single two-stage venous cannula. Results A total of 188 patients underwent total endoscopic mitral valve surgery. Fifty-six patients had concomitant tricuspid valvuloplasty, 11 patients underwent concomitant ablation of atrial fibrillation and atrial septal defect repair was performed in three patients. Only one patient postoperatively died of multi-organ failure. Two patients were converted to median sternotomy. Except for one patient underwent operation to stop the bleeding from the incision site, no other serious complications nor reintervention occurred during the follow-up period. Conclusions The modified totally endoscopic mitral valve surgery performed at our institution is technically feasible and safe with the same efficacy as reported studies.

scholarly journals Minimally invasive mitral valve surgery. An anesthesiologist''s viewpoint

2015 ◽  
Vol 17 (2) ◽  
pp. 11 ◽  
Author(s):  
V. A. Shmyrev ◽  
A. V. Bogachev-prokofev ◽  
V. V. Lomivorotov ◽  
D. N. Ponomarev ◽  
P. P. Perovskiy
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Fatal Outcome ◽  
Median Sternotomy ◽  
Group Versus ◽  
Mitral Valve Surgery ◽  
Control Group ◽  
Complication Rates ◽  
Valve Repair ◽  
Invasive Group

We conducted a retrospective comparative analysis of 75 patients undergoing video-assisted mitral valve repair with right minithoracotomy over a period from November 2011 to August 2013. The control group comprised 71 patients operated on mitral valve by using median sternotomy during the same period. Median (25th; 75th) times of cardiopulmonary bypass and aortic cross-clamping were significantly longer in the minimally invasive group (180 [139; 224] and 111 [87; 145] min, respectively) as compared to the controls (84 [69; 117] and 62 [49; 81 ] min, respectively), p<0.01. Fatal outcome occurred in 2 (2.7%) cases in the minimally invasive group versus none in the controls. In both cases death resulted from intraoperative aortic dissection. While ventilation time and intensive care unit stay were comparable across the groups, postoperative respiratory failure occurred in 6 (8%) cases in the minimally invasive group versus none in the controls (p<0.05). No other significant differences in the postoperative course were observed between the groups. The results of the present study are generally consistent with the world's tendencies. On the other hand, complication rates observed in the minimally invasive group present a considerable economic burden and require substantial human resources in the postoperative period.

scholarly journals Additional tricuspid annuloplasty in mitral valve surgery results in better clinical outcome

Heart ◽  
2015 ◽  
Vol 101 (9) ◽  
pp. 720-726 ◽  
Author(s):  
Pieter De Meester ◽  
Dries De Cock ◽  
Alexander Van De Bruaene ◽  
Charlien Gabriels ◽  
Roselien Buys ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Clinical Outcome ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Annuloplasty

scholarly journals Conduction disorders after tricuspid annuloplasty with mitral valve surgery: Implications for earlier tricuspid intervention

2016 ◽  
Vol 151 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Jérôme Jouan ◽  
Alessandro Mele ◽  
Emmanuelle Florens ◽  
Gilles Chatellier ◽  
Alain Carpentier ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Annuloplasty ◽  
Conduction Disorders

scholarly journals Antegrade and retrograde arterial perfusion strategy in minimally invasive mitral-valve surgery: a propensity score analysis on 1280 patients

2013 ◽  
Vol 43 (6) ◽  
pp. e167-e172 ◽  
Author(s):  
M. Murzi ◽  
A. G. Cerillo ◽  
A. Miceli ◽  
S. Bevilacqua ◽  
E. Kallushi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Propensity Score ◽  
Minimally Invasive ◽  
Propensity Score Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Arterial Perfusion ◽  
Score Analysis

scholarly journals Minimally invasive beating heart technique for mitral valve surgery in patients with previous sternotomy and giant left ventricle

2020 ◽  
Author(s):  
hang zhang ◽  
Hua shan Xu ◽  
Bing Wen ◽  
Wen-zeng Zhao ◽  
Chao Liu
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Minimally Invasive ◽  
Operation Time ◽  
Mitral Valve Surgery ◽  
Beating Heart ◽  
Valve Surgery ◽  
Cardiac Patients ◽  
Stay Time ◽  
Transfusion Ratio

Abstract Purpose: To analyze the efficacy of minimally invasive beating heart technique for mitral valve surgery in the cardiac patients with giant left ventricle.Methods: Eighty cardiac patients with giant left ventricle according to the diagnostic criteria that left ventricular end diastolic diameter (LVEDD) was ≥70 mm, who underwent mitral valve surgery at our center from January 2006 to January 2019 were analyzed. We divided all patients into minimally invasive beating heart technique group (n=30) and conventional median arrested heart technique group (n=50) according to the surgical methods. Preoperative, intraoperative, and postoperative variables were compared between two groups.Results: Minimally invasive beating heart technique compared to the conventional median arrested heart technique for mitral valve surgery in the cardiac patients with giant left ventricle had significant differences in operation time(P=0.002), cardiopulmonary bypass (CPB) time(P<0.001), intraoperative blood loss(P<0.001), postoperative transfusion ratio(P=0.01), postoperative transfusion amount(P<0.001), postoperative drainage volume(P=0.001), extubation time(P=0.04), intensive care unit (ICU) stay time(P=0.04) and postoperative hospital stay time(P<0.001), but no significant differences in re-exploration for bleeding, postoperative 30-day mortality, postoperative complications and six months postoperative echocardiographic parameters.Conclusions: Using the method of minimally invasive beating heart technique for mitral valve surgery in the cardiac patients with giant left ventricle is effective reliable meanwhile reduce the operation time and CPB time, decrease the transfusion ratio and transfusion amount, shorten postoperative ICU stay and hospital stay time, promote the early extubation so that accelerate the patients’ early recovery.

scholarly journals Minimally invasive versus sternotomy mitral valve surgery when initiating a minimally invasive programme

2020 ◽  
Vol 58 (6) ◽  
pp. 1168-1174
Author(s):  
Mikael Kastengren ◽  
Peter Svenarud ◽  
Göran Källner ◽  
Anders Franco-Cereceda ◽  
Jan Liska ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Propensity Score ◽  
Minimally Invasive ◽  
Propensity Score Matching ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Short Term ◽  
Invasive Approach

Abstract OBJECTIVES An increasing number of mitral valve operations are performed using minimally invasive procedures. The initiation of a minimally invasive mitral valve surgery programme constitutes a unique opportunity to study outcome differences in patients with similar characteristics operated on through a sternotomy versus a minimally invasive procedure. The goal of this study was to compare short-term outcomes of patients undergoing mitral valve surgery before versus those having surgery after the introduction of a minimally invasive programme. METHODS The single-centre study included mitral valve procedures performed through a sternotomy or with a minimally invasive approach between January 2012 and May 2019. Propensity score matching was performed to reduce selection bias. RESULTS A total of 605 patients (294 sternotomy, 311 minimally invasive) who underwent mitral valve surgery were included in the analysis. Propensity score matching resulted in 251 matched pairs. In the propensity score-matched analysis, minimally invasive procedures had longer extracorporeal circulation duration (149 ± 52 vs 133 ± 57 min; P = 0.001) but shorter aortic occlusion duration (97 ± 36 vs 105 ± 40 min, P = 0.03). Minimally invasive procedures were associated with a lower incidence of reoperation for bleeding (2.4% vs 7.2%; P = 0.012), lower need for transfusion (19.1% vs 30.7%; P = 0.003) and shorter in-hospital stay (5.0 ± 2.7 vs 7.2 ± 4.6 days; P &lt; 0.001). The 30-day mortality was low in both groups (0.4% vs 0.8%; P = 0.56). CONCLUSIONS Minimally invasive mitral valve surgery was associated with short-term outcomes comparable to those with procedures performed through a sternotomy. Initiating a minimally invasive mitral valve programme with a limited number of surgeons and a well-executed institutional selection strategy did not confer an increased risk for adverse events.

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