Right Minithoracotomy for Mitral Valve Surgery: Impact of Tailored Strategies on Early Outcome

Comparison of Endoaortic and Transthoracic Aortic Clamping in Less-Invasive Mitral Valve Surgery

“…A study published by Barbero and associates, on 460 consecutive patients who underwent LIMVS through 3 different approaches-RAP with TTC, RAP with EAC, and direct aortic cannulation with EAC and antegrade arterial perfusion-showed that, after a full preoperative vascular screening and allocation to the most appropriate setting, mortality and stroke rates are low and comparable between the different strategies. Overall, no cases of aortic dissection were reported and logistic regression modelling showed no influences of arterial perfusion and aortic clamping techniques on 30day mortality and stroke [19]. This improvement in the rate of neurological and vascular complications can be explained bearing in mind that these last studies have been reported by surgeons with a well-established learning curve and with a consolidated program of patient selection based upon anatomy and clinical history.…”

“…The LIMVS technique has been previously described [17][18][19]. A double lumen endotracheal tube or a bronchus blocker was positioned to allow one-lung ventilation.…”

“…The EAC technique has been widely described in the literature and good results have been reported, particularly in the subgroup of patients with previous cardiac surgical procedures [2,4,19,20]. In the EAC setting perfusion is obtained through femoral vessels, and clamping and cardioplegia delivery are gained through a balloon catheter (Intraclude, Edwards Lifesciences) inserted through the sidearm of the arterial cannula.…”

Transthoracic clamp versus endoaortic balloon occlusion in minimally invasive mitral valve surgery: a systematic review and meta-analysis

“…Included studies with patient characteristics (Table 1) Included studies were performed in Germany 11,12 , Italy 14,15,16,17 , Canada 18 , the USA 19,20,21 and the Netherlands. 13 All studies were observational with 3 being prospective and 8 being retrospective in design ( Table 1).…”

“…11,12,13,16,17,18,19,20 Two studies used the direct aortic cannulation technique for EABO. 15,21 One study, Barbero et al (2016), 14 offered 2 separate EABO cohorts, one with femoral cannulation and one with aortic cannulation ( Table 1).…”