Video-assisted mitral valve operations

Lin, Pyng Jing; Chen, Chang; Chu, Jaw‐Ji; Liu, Huiping; Tsai, Feng‐Chun; Chu, Po-Hsien; Chiang, Cheng-Wen; Yang, Min-Wen; Shyr, Ming-Hwang; Tan, Peter

doi:10.1016/0003-4975(96)00193-2

Cited by 58 publications

(21 citation statements)

References 15 publications

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“…No complications were observed in 25 patients. Lin et al [8] reported two patients undergoing a small right anterior thoracotomy with femoral vein to femoral artery bypass and ventricular fibrillation for mitral valve operation. Chitwood et al [2] described a right anterolateral thoracotomy in two patients with cannulation of the femoral artery and vein, direct clamping of the aorta, and use of video assistance.…”

Section: Discussionmentioning

confidence: 99%

“…With the introduction of minimally invasive coronary bypass procedures, interest has been rekindled in minimally invasive mitral operations. Several minimally invasive approaches to the mitral valve have been described, including parasternal incision [9] and right anterolateral thoracotomy [2,6,8]. Originally intended as a purely thoracoscopic procedure, Port Access cardiac operations were developed by Stevens et al [11,12] to combine thoracoscopy and a limited thoracotomy with specialized catheters to arrest the heart and provide cardiac decompression.…”

Section: Introductionmentioning

confidence: 99%

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Mitral valve operation via Port Access versus median sternotomy

Glower

Landolfo

Clements

et al. 1998

European Journal of Cardio-Thoracic Surgery

118

100

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Objective: The advantages and disadvantages of minimally invasive Port Access mitral valve operation have not been defined relative to standard median sternotomy. A study was therefore designed to delineate differences in outcome from mitral operation via Port Access versus sternotomy in comparable patients. Methods: The records of 41 consecutive patients undergoing isolated mitral valve replacement (n = 14) or repair (n = 27) were examined. All operations were performed using cardioplegic arrest through either median sternotomy (n = 20) or a small right anterolateral thoracotomy using an endoaortic clamp and catheter system (Heartport, Redwood City, CA) to arrest and decompress the heart (Port Access, n = 21). Results: Both groups were well matched for age, mitral pathology, ejection fraction, and comorbidity, except that Port Access patients were less likely to be female. Three patients had undergone previous cardiac operations. Surgical procedure time was longer for Port Access patients (384 ± 80 vs. 263 ± 41 min, P Ͻ 0.05). Port Access provided significantly smaller incision length (8 ± 2 vs. 26 ± 2 cm, P Ͻ 0.01) and similar or shorter hospital stay (6 ± 4 vs. 7 ± 3 days). Port Access provided excellent visualization of the mitral valve and subvalvular apparatus, generally better than sternotomy, to allow complex mitral valve repairs. The greatest advantage of Port Access mitral operation was that Port Access patients returned to normal activity more rapidly (4 ± 2 vs. 9 ± 1 weeks, P = 0.01) than did patients undergoing standard median sternotomy. Conclusions: By avoiding a sternotomy, Port Access mitral valve operation provided a smaller incision and a dramatically more rapid return to normal activity than did median sternotomy. Port Access cardioplegic arrest with the Heartport system allowed visualization of the mitral valve superior to median sternotomy and has become the standard approach at this institution.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mitral valve operation via Port Access versus median sternotomy

Glower

Landolfo

Clements

et al. 1998

European Journal of Cardio-Thoracic Surgery

118

100

View full text Add to dashboard Cite

show abstract

“…Lança-se mão de procedimentos cardiológicos invasivos com cateteres ou balões (4) e, ultimamente, de abordagens cirúrgicas através de reduzidas incisões torácicas com ou sem o auxílio de videotoracoscopia (5)(6)(7)(8)(9)(10)(11) , com excelentes resultados.…”

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Mediastinite em cirurgia cardíaca: tratamento com epíploon

Sampaio¹,

Alves²,

Silva³

et al. 2000

Rev Bras Cir Cardiovasc

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A cirurgia cardíaca não foge à regra. Apesar de ser sofisticado método de tratamento invasivo, observamos a ocorrência de quadros infecciosos gravíssimos que desafiam a competência da equipe cirúrgica e dos centros de tratamento cardiológico.A abertura do esterno para possibilitar o acesso ao coração, introduzida por MILTON (1,2) , em 1897, e popularizada por JULIAN (3) et al., tem sido evitada sempre que possível. Lança-se mão de procedimentos cardiológicos invasivos com cateteres ou balões (4) e, ultimamente, de abordagens cirúrgicas através de reduzidas incisões torácicas com ou sem o auxílio de videotoracoscopia (5)(6)(7)(8)(9)(10)(11) , com excelentes resultados.A incidência de mediastinite nos procedimentos operatórios cardíacos em que se pratica esternotomia é pequena, variando de 0,4 a 5% (12,13) . A mortalidade desta temível complicação, no entanto, é alta, variando de 14 a 47% (14) . Além desta alta mortalidade, verifica-se considerável aumento dos custos do tratamento após esta complicação, quase triplicando estes valores (15,16) .Os fatores de risco parecem ser muitos, podendo ser citados: associação de diabete melito e

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“…Recently, minimally invasive cardiac surgery (MICS) has been applied to correct intracardiac lesions [9,10,18,20,29]. In patients with ASD, the heart is approached by a video-assisted endoscope inserted through a thoracostomy incision, and the intracardiac lesions are repaired through a small manipulation incision over a right anterolateral fourth intercostal space minithoracotomy incision (4 to 6 cm in length) [10].…”

mentioning

confidence: 99%