Impact of Timing and Surgical Approach on Outcomes After Mitral Valve Regurgitation Operations

Stevens, Louis–Mathieu; Rodríguez, Evelio; Lehr, Eric J.; Kindell, Linda C.; Nifong, L. Wiley; Ferguson, T. Bruce; Chitwood, W. Randolph

doi:10.1016/j.athoracsur.2012.01.016

Cited by 37 publications

(48 citation statements)

References 16 publications

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“…Although cross-clamp and cardiopulmonary bypass time were longer in the minimally invasive group, there were no difference in mortality, stroke, reoperation for bleeding, new onset atrial fibrillation, or duration of ICU stay or hospital stay [44]. In a more recent study, Stevens et al published the results of 2,255 patients who underwent MV operations, including 1,305 with isolated MV regurgitation operations (1,054 repairs and 251 replacements) [45]. The study period was between 1992 and 2009 and surgical approaches were sternotomy in 377, video-assisted right minithoracotomy in 481, or robot-assisted in 447.…”

Section: Mortalitymentioning

confidence: 99%

“…The study period was between 1992 and 2009 and surgical approaches were sternotomy in 377, video-assisted right minithoracotomy in 481, or robot-assisted in 447. Mean followup was 6.4 ± 4.5 years (maximum, 19 years) [45]. The 30-day mortality for isolated MV repair was similar for all approaches ( P = 0.409).…”

Section: Mortalitymentioning

confidence: 99%

“…Fewer neurological events were observed in the videoscopic and robotic groups ( P = 0.013). Adjusted survival was similar for all approaches ( P = 0.357) [45]. Galloway and associates at the New York University have reported the longest outcomes for minimally invasive mitral valve surgery to date [46].…”

Section: Mortalitymentioning

confidence: 99%

“…This group studied 28,143 patients identified from the Society Of Thoracic Surgeons database and found a higher rate of permanent stroke, 1.87%, for the minimally invasive surgery group as opposed to 1.17% for the conventional sternotomy group) [48], and they observed a threefold higher rate of stroke in patients using fibrillatory arrest or beating heart technique without cross clamp. In their recent study, Stevens et al have shown a reverse trend in their stroke rate (3.4%—sternotomy approach, 1.2%—videoscopic approach, and 0.7%—robotic mitral valve procedures) [49]. …”

Section: Neurological Eventsmentioning

confidence: 99%

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Minimally Invasive Mitral Valve Procedures: The Current State

Ritwick

Chaudhuri

Crouch

et al. 2013

Minimally Invasive Surgery

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Since its early days, cardiac surgery has typically involved large incisions with complete access to the heart and the great vessels. After the popularization of the minimally invasive techniques in general surgery, cardiac surgeons began to experiment with minimal access techniques in the early 1990s. Although the goals of minimally invasive cardiac surgery (MICS) are fairly well established as decreased pain, shorter hospital stay, accelerated recuperation, improved cosmesis, and cost effectiveness, a strict definition of minimally invasive cardiac surgery has been more elusive. Minimally invasive cardiac surgery started with mitral valve procedures and then gradually expanded towards other valve procedures, coronary artery bypass grafting, and various types of simple congenital heart procedures. In this paper, the authors attempt to focus on the evolution, techniques, results, and the future perspective of minimally invasive mitral valve surgery (MIMVS).

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Section: Mortalitymentioning

confidence: 99%

Section: Mortalitymentioning

confidence: 99%

Section: Mortalitymentioning

confidence: 99%

Section: Neurological Eventsmentioning

confidence: 99%

See 2 more Smart Citations

Minimally Invasive Mitral Valve Procedures: The Current State

Ritwick

Chaudhuri

Crouch

et al. 2013

Minimally Invasive Surgery

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“…Improved repair rates and outcomes in patients undergoing early surgical intervention for MR have been reported by Gillinov and associates [10] and more recently by Stevens and colleagues [11]. The push to repair asymptomatic MR mandates near 100% success while minimizing morbidity in this relatively healthy patient cohort [10–12].…”

Section: Commentmentioning

confidence: 96%

Nonresectional Single-Suture Leaflet Remodeling for Degenerative Mitral Regurgitation Facilitates Minimally Invasive Mitral Valve Repair

MacArthur¹,

Cohen²,

Goldstone³

et al. 2013

The Annals of Thoracic Surgery

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Background Both leaflet resection and neochordal construction are effective mitral repair techniques, but they may become incrementally time-consuming when using minimally invasive approaches. We have used a single-suture leaflet-remodeling technique of inverting the prolapsed or flail segment tissue into the left ventricle. This repair is straightforward, expeditious, and facilitates a minimally invasive approach. Methods Ninety-nine patients with degenerative mitral regurgitation (MR) underwent a minimally invasive single-suture repair of the mitral valve from May 2007 through December 2012. Preoperative and perioperative echocardiograms as well as patient outcomes were analyzed and compared with those obtained from patients undergoing minimally invasive mitral valve repair using quadrangular resection at the same institution during the same period. Results All 99 patients had a successful mitral repair through a sternal-sparing minimally invasive approach. Ninety-one of the 99 patients had zero MR on postoperative echocardiogram, and 8 of 99 had trace to mild MR. Patients in the nonresectional group had significantly shorter cardiopulmonary bypass and cross-clamp times compared with the quadrangular resection group (115.8 ± 41.7 minutes versus 144.9 ± 38.2 minutes; p < 0.001; 76.2 ± 28.1 minutes versus 112.6 ± 33.5 minutes; p < 0.001, respectively). The mean length of stay was 7.5 ± 3 days. All patients were discharged alive and free from clinical symptoms of MR. There have been no reoperations for recurrent MR on subsequent average follow-up of 1 year. Conclusions An effective, highly efficient, and thus far durable single-suture mitral leaflet-remodeling technique facilitates minimally invasive repair of degenerative MR.

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Anesthetic Management for Minimally Invasive Cardiac Surgery

Hamilton

Caridi-Scheible

2018

Anesthesiology

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Impact of Timing and Surgical Approach on Outcomes After Mitral Valve Regurgitation Operations

Cited by 37 publications

References 16 publications

Minimally Invasive Mitral Valve Procedures: The Current State

Minimally Invasive Mitral Valve Procedures: The Current State

Nonresectional Single-Suture Leaflet Remodeling for Degenerative Mitral Regurgitation Facilitates Minimally Invasive Mitral Valve Repair

Anesthetic Management for Minimally Invasive Cardiac Surgery

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