scholarly journals MINIMALLY INVASIVE MITRAL VALVE REPLACEMENT (MIMVR) THROUGH RIGHT MINITHORACOTOMY: A SINGLE-CENTER EXPERIENCE FROM CENTRAL INDIA

2022 ◽  
Vol 6 (1) ◽  
Author(s):  
Piyush Gupta ◽  
Manish Porwal
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Operating Time ◽  
Median Sternotomy ◽  
Central India ◽  
Good Alternative ◽  
Mitral Valve Surgery ◽  
Mortality And Morbidity

Background: Minimally invasive mitral valve replacement surgery (MIMVR) is gaining popularity for its multifold advantages. Here we report our single-institution experience with MIMVR through the right minithoracotomy over two years. Materials and Methods: This study was a retrospective analytical study. Forty-two patients undergoing MIMVR between August 2019 and July 2021 were included. Recorded perioperative data were collected and evaluated retrospectively. Results: A total of 42 patients were included in the study, of which 29 were females (69%). The mean age was 43.2+/- 8.2 years. Overall 30-day mortality was 2.38% (n = 1). Mean operating time, cardiopulmonary bypass, and aortic cross-clamp times were 264.9 ± 48.7, 151.5 ± 39.8, and 89.8 ± 25.6 minutes, respectively. Tricuspid valve annuloplasty was performed in 8 patients (19%). One patient (2.38%) required conversion to median sternotomy, and three patients (7.1%) underwent re-explorations due to bleeding. The median postoperative hospital stay was 5 days. Conclusions: MIMVR through right minithoracotomy is feasible, safe, and reproducible with low mortality and morbidity. Mitral valve surgery through a small anterior thoracotomy is a good alternative to conventional thoracotomy. Keywords: minimally invasive, minithoracotomy, mitral valve replacement

scholarly journals Video-assisted Minimally Invasive Mitral Valve Surgery versus Conventional Mitral Surgery in Rheumatic Patients

2020 ◽  
Author(s):  
Ayman Badawy ◽  
Mohamed Alaa Nady ◽  
Mohamed Ahmed Khalil Salama Ayyad ◽  
Ahmed Elminshawy
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Invasive Approach ◽  
Video Assisted ◽  
Group A ◽  
Group B

Background: Minimally invasive mitral valve surgery became an attractive option because of its cosmetic advantages over the conventional approach. The superiority of the minimally invasive approach regarding other aspects is still debatable. The aim of our study was to determine the potential benefits of minimally invasive mitral valve replacement with intraoperative video assistance over conventional surgery. Methods: This is a single-center prospective cohort study that included 60 patients with rheumatic heart disease who underwent mitral valve replacement. Patients were divided into two groups: group (A) included patients who had conventional sternotomy (n= 30), and group (B) included patients who had video-assisted minimally invasive mitral valve replacement (n= 30). Intraoperative and postoperative outcomes were compared between both groups. Results: Mortality occurred in one patient in the group (A). Cardiopulmonary bypass time was 118.93 ± 29.84 minutes vs. 64.73 ± 19.16 minutes in group B and A respectively (p< 0.001), and ischemic time was 102.27 ± 30.03 minutes vs. 53.67± 18.46 minutes in group B and A respectively (P < 0.001). Ventilation time was 2.77± 2.27 vs. 6.28 ± 4.48 hours in group B and A respectively (p< 0.001) and blood transfusion was 0.50 ± 0.63 vs. 2.83 ± 1.34 units in group B and A respectively (p< 0.001).  ICU stay was 1.73 ± 0.64 days in the group (B) vs. 4.47 ± 0.94 days in group A (p< 0.001). Postoperative bleeding was 353.33 ± 146.77 ml in the group (B) vs. 841.67 ± 302.03 ml in group A (p <0.001). No conversion to full sternotomy was reported in group B. In group (B), two cases (6.6%) required re-exploration for bleeding vs. four cases (13.2%) in group (A) (p=0.67). The hospital stay was 6.13 ± 1.59 days in the group (B) vs. 13.27 ± 7.62 days in group A (p< 0.001). Four cases (13.3%) developed mediastinitis in group A and in the group (B), there was one case of acute right lower limb embolic ischemia. Conclusion: Video-assisted minimally invasive mitral operations could be a safe alternative to conventional sternotomy with the potential of lesser morbidity and earlier hospital discharge.

Redo Mitral Valve Surgery Using the Port-Access System

2002 ◽  
Vol 10 (3) ◽  
pp. 215-218 ◽  
Author(s):  
Naresh Trehan ◽  
Yugal K Mishra ◽  
Satish G Mathew ◽  
Krishna K Sharma ◽  
Sameer Shrivastava ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Operating Time ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Paravalvular Leak ◽  
Access System ◽  
Postoperative Blood Transfusion ◽  
Port Access

Redo mitral valve surgery is hazardous, hence we explored an alternative approach using a port-access system that avoids reentry. Between October 1997 and December 2000, 32 patients underwent mitral reoperation using the system. All patients had previous cardiac operations. This procedure consisted of a right anterolateral minithoracotomy and femorofemoral cannulation using special port-access instruments and endoaortic clamping in 24 patients or direct transthoracic sliding-rod aortic clamping in 8. The valve disease was of rheumatic etiology in 28 patients and degenerative in 4. The valve was replaced in 31 cases and a paravalvular leak after mitral valve replacement was closed in 1. In 2 cases, the tricuspid valve was repaired along with mitral valve replacement. Mean total operating time was 4.5 ± 1.2 hours, cardiopulmonary bypass time 162 ± 72 minutes, and aortic crossclamp time 62 ± 21 minutes. There was no mortality, and mean stay in the intensive care unit was 22 ± 7 hours and hospital stay 6.4 ± 1.2 days. Postoperative blood transfusion was required in 12 patients. In view of the favorable results, we recommend using the port-access system as a standard approach for mitral reoperation.

Minimally Invasive Thoracoscopic Mitral Valve Replacement in Rheumatic Disease With Continuous Suture Technique

2019 ◽  
Vol 14 (6) ◽  
pp. 558-563
Author(s):  
Pham Quoc Dat ◽  
Duong Duc Hung ◽  
Duong Thi Hoan ◽  
Nguyen Huu Uoc ◽  
Alexander P. Nissen
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Surgery ◽  
Suture Technique ◽  
Valve Surgery ◽  
Continuous Suture ◽  
Aortic Cross Clamp ◽  
Mitral Disease

Minimally invasive mitral valve surgery has become routine in many institutions. Disadvantages of this approach include prolonged aortic cross-clamp and cardiopulmonary bypass times. Mitral valve replacement with a continuous suture technique may reduce operative times. We present a case of a 51-year-old man suffering from severe rheumatic mitral disease to highlight our continuous suture technique for minimally invasive mitral valve replacement. We also report preliminary results from our series of 15 patients suffering various rheumatic mitral pathology treated with this technique.

scholarly journals Early clinical outcome after right anterolateral thoracotomy as an alternative for median sternotomy for mitral valve replacement

2020 ◽  
Vol 2 (2) ◽  
pp. 47-54
Author(s):  
Ahmed Rady Attallah ◽  
Shady Eid Al-Elwany ◽  
Mohammed A.K. Salama Ayyad ◽  
Ali Mohammed Abdelwahab
Keyword(s):  
Mitral Valve ◽  
Blood Transfusion ◽  
Clinical Outcome ◽  
Blood Loss ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Median Sternotomy ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Anterolateral Thoracotomy

Background: The advantages of the right anterolateral thoracotomy (RALT) approach for mitral valve surgery over standard median sternotomy (MS) are still debatable. The objective of this study was to evaluate and compare the postoperative clinical outcome after RALT and MS for mitral valve replacement. Methods: This prospective observational study included 40 patients who underwent mitral valve replacement between January 2016 and August 2018. Patients were assigned to two groups, the first group included 20 patients who had conventional median sternotomy approach and the second group included 20 patients who had right anterolateral thoracotomy with the complete cannulation and aortic cross-clamping conducted through the same incision. Results: In comparison to MS, RALT had significantly higher cross-clamp time (77.7±16.1 vs 45.8±8.7 minutes, P < 0.01), total bypass time (105.2±12.7 vs 72.2±10.4 minutes, P < 0.01), and total operative time (287±41 vs 231±36 min, P < 0.01), in addition to significantly lower ventilation time (4.2±1.51 vs 6.1±1.84 hours, P < 0.01), blood loss (229±85 vs 335±137 ml), amount of blood transfusion (1.41±0.6 vs 2.19±1.1 units, P < 0.01), ICU stay duration (2.11±0.49 vs 2.78±0.82 days, P < 0.01), pain scores at 1st and 2nd postoperative days (5.67±0.79 vs 7.81±0.53, p < 0.01), and total hospital stay duration (7.2±1.3 vs 8.4±1.6 days, P = 0.01). Patients' satisfaction about their wound was significantly higher in RALT group compared to MS group (95% vs 30%, P < 0.01). Conclusion: The RALT approach for mitral valve surgery could be a safe and effective approach when compared to median sternotomy. RALT could be associated with a reduction of blood loss, blood transfusion, wound infection, in addition to shorter ICU and hospital stay.

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 Tricuspid valve annuloplasty and mitral valve replacement are associated with bradyarrhythmia after mitral valve surgery

2021 ◽  
Vol 32 (4) ◽  
pp. 1103-1110
Author(s):  
Florian E. M. Herrmann ◽  
Anne‐Sophie Schleith ◽  
Helen Graf ◽  
Sebastian Sadoni ◽  
Christian Hagl ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Valve Annuloplasty

scholarly journals Minimally invasive transatrial mitral valve replacement in mitral annular calcification

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 891-891
Author(s):  
Alexander P. Nissen ◽  
Joseph Lamelas ◽  
Isaac George ◽  
Juan Umana-Pizano ◽  
Tom C. Nguyen
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Annular Calcification ◽  
Annular Calcification

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 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

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