Redo Mitral Valve Operation via Right Minithoracotomy-"No Touch" Technique

Kitamura, Tadashi; Stuklis, Robert; Edwards, James

doi:10.1536/ihj.52.107

Cited by 18 publications

(20 citation statements)

References 11 publications

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“…Against the situation mentioned above, minimally invasive beating heart technique for redo mitral valve surgery in patients with giant left ventricle has emerged in this environment. More and more reports had confirmed that minimally invasive beating heart technique for redo cardic surgery could be safely performed successfully [3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…At the beginning of experience, the patient's body temperature was cooled to 27 or 28 o C to induce ventricular fibrillation. Subsequently, temperature was maintained between 32 and 33 o C to allow an operation on the empty beating heart [5,7]. An aortic vent was always under continuous suction in the ascending aorta to evacuate air.…”

Section: Minimally Invasive Beating Heart Techniquementioning

confidence: 99%

“…Resternotomy may also be complicated in patients who had chest radiotherapy or previous sternal wound infections or in patients with vascular structures (ascending aorta, brachiocephalic vein,right ventricle and bypass vessels) that lie directly behind the sternum. Recently minimally invasive beating heart technique for redo cardic surgery had been safely performed successfully [1][2][3][4][5][6][7], which combined the availability and the advantage of a right-sided minithoracotomy approach without resternotomy and beating heart technique without aortic cross-clamping and cardiac arrest. The beating heart technique can interfere with the mechanisms of ischemia-reperfusion injury [8,9] that may be advantageous particularly in patients with poor left ventricular functions [10][11][12][13][14].…”

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confidence: 99%

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Minimally invasive beating heart technique for redo mitral valve surgery in patients with giant left ventricle

zhang

Wen

et al. 2020

Preprint

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KEYWORDSMinimally invasive, Beating heart technique, Redo mitral valve surgery, Giant left ventricle 2 Abstract Purpose: To analyze the feasibility and efficacy of minimally invasive beating heart technique for redo 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 redo 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 thoracotomy 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 thoracotomy arrested heart technique for redo mitral valve surgery in the cardiac patients with giantleft 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 redo mitral valve surgery in the cardiac patients with giant left ventricle is feasible, effective, reliable and cosmetic, 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. BackgroundWith the increasing number of cardiac surgery, more and more cases of mitral valve reoperations are made because of various reasons, such as perivalvular leakage, prosthesis dysfunction, rheumatic valve disease, infective endocarditis, perivalvular tissue hyperplasia, bioprosthetic valve decay. These patients tend to have a long course of disease, this could eventually lead to left ventricular Zhengzhou,450052,

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Section: Discussionmentioning

confidence: 99%

Section: Minimally Invasive Beating Heart Techniquementioning

confidence: 99%

mentioning

confidence: 99%

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Minimally invasive beating heart technique for redo mitral valve surgery in patients with giant left ventricle

zhang

Wen

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…During the operation, the vena cava did not need to be snared when the heart was beating; [7][8][9] in other words, there was no need to dissect the adhesion tissue of the vena cava, which would have increased the operative risk. 5,10) The application of a single venous drainage technique should satisfy the following requirements: (1) there are enough pores in the femoral vein cannula; (2) VAVD controller must be applied; and (3) the top of the femoral vein cannula must reach the SCV. When the top of the femoral venous cannula reaches the SVC, the blood in SVC, the right atrium, and IVC drains into the cannula through the pores.…”

Section: Discussionmentioning

confidence: 99%

Single Femoral Venous Drainage Versus Both Vena Cava Drainage in Isolated Repeat Tricuspid Valve Surgery

Peng

Shi

et al. 2018

Int. Heart J.

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SummaryTo assess the potential advantages of minimally invasive surgery using a single femoral venous drainage method versus femoral venous and superior vena cava or jugular venous drainage method during repeat tricuspid valve surgery.From January 2010 to December 2016, 50 repeat tricuspid valve procedures were performed using a minimally invasive approach without aortic cross-clamping at our institution. The arterial cannula was inserted into the femoral artery, and at the same time, the venous cannula was placed in the femoral vein in 28 patients (FV group) during cardiopulmonary bypass (CPB). The venous cannula was inserted into the femoral vein and the superior vena cava or jugular vein in 22 patients (FSV group).Overall, 36 patients underwent tricuspid valve replacement (TVR) and 14 patients underwent tricuspid valvuloplasty (TVP). The CPB time and operation time, respectively, were 72.96 ± 25.90 minutes versus 78.59 ± 31.95 minutes (P = 0.495) and 170.75 ± 73.31 minutes versus 228.87 ± 61.45 minutes (P = 0.004) in the FV group versus the FVS group. There were no significant differences in the ventilator-assisted time, the first-day LVEF, and the intensive care unit (ICU) stay between the FV group and the FSV group.Both types of drainage were effective and could ensure safety during the operative procedure. The vacuumassisted single femoral venous drainage method simplified the minimally invasive isolated repeat tricuspid valve surgical process more significantly and is the more appropriate choice.(Int Heart J Advance Publication)

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“…We believe that several points are important to preclude the possibility of air embolism. Also described elsewhere [11], a combination of vacuum-assisted venous drainage, carbon dioxide gas insufflation and aortic root venting can minimize the chance of air embolism. It is also important to keep the mitral valve incompetent to allow air bubbles to be ejected from the left ventricle.…”

Section: Discussionmentioning

confidence: 99%

Beating heart mitral valve repair for a patient with previous coronary bypass: a case report and review of the literature

Nakamura

Izutani

Sekiya

et al. 2013

J Cardiothorac Surg

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Mitral valve reoperation, through a median sternotomy, for a patient with patent coronary bypass grafts is technically challenging and carries higher postoperative morbidity and mortality than a primary operation. We present a case of mitral valve repair using a beating heart technique under normothermic cardiopulmonary bypass that was performed 3 years after a coronary artery bypass operation. A limited (10 cm) right thoracotomy was made and cardiopulmonary bypass was conducted using the ascending aortic and femoral venous cannulation. The left atrium was opened while beating was maintained. Triangular resection of the prolapsed portion of the posterior leaflet and ring annuloplasty were performed. Completeness of the repair was verified by direct visualization under beating condition and transesophageal echocardiogram. This technique is a safe and feasible option for a mitral valve reoperation that excludes re-sternotomy, extensive pericardial dissection and aortic clamping, thereby minimizes risks of bleeding, graft injury and myocardial damage.

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Redo Mitral Valve Operation via Right Minithoracotomy-"No Touch" Technique

Cited by 18 publications

References 11 publications

Minimally invasive beating heart technique for redo mitral valve surgery in patients with giant left ventricle

Minimally invasive beating heart technique for redo mitral valve surgery in patients with giant left ventricle

Single Femoral Venous Drainage Versus Both Vena Cava Drainage in Isolated Repeat Tricuspid Valve Surgery

Beating heart mitral valve repair for a patient with previous coronary bypass: a case report and review of the literature

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