Evolution of operative techniques and perfusion strategies for minimally invasive mitral valve repair

Abstract

Central aortic cannulation through a right anterior minithoracotomy for mitral valve repair allows excellent outcomes in patients with a broad spectrum of comorbidities and has become our preferred approach for most patients undergoing mitral valve repair. Retrograde arterial perfusion is associated with an increased risk of stroke in patients with severe peripheral vascular disease and should be reserved for select patients without significant atherosclerosis.

The use of the virtual reality as intervention tool in the postoperative of cardiac surgery

“…It is also the number one cause of death among the elderly. Although clinical treatment have made the approach to individuals with cardiovascular diseases less invasive [3], the cardiac surgery is the intervention adopted in some cases of cardiovascular diseases and it aims at increasing patients' life expectancy and life quality [4]. In 2011, around 100 thousand cardiac surgeries were performed in Brazil in more than 170 centers around all the Brazilian states [5].…”

Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study

“…Despite prior reports of stroke being increased [5,24,25] or decreased [4] by a thoracotomy approach to the mitral valve], we found no difference in the stroke incidence in this study. As noted in a prior study [26], avoiding femoral arterial cannulation may have decreased retrograde embolic events from aortic debris. The decreased incidence of postoperative atrial fibrillation with the RT approach could result from less atrial injury with less cardioplegic arrest, lower a All nominal data expressed as presented as n and percentage of total population and compared with Pearson c 2 or Fisher's exact test.…”

Less invasive cardiac surgery via partial sternotomy

“…1,2 There are several different approaches for less invasive cardiac surgery, including parasternal incision, 7,8 lateral thoracotomy, 6,9,10 and partial sternotomy. 11e14 We use upper or lower partial sternotomy, which provide the same exposure of the heart and heart valves as full sternotomy.…”

“…5 The long-term outcome of minimally invasive cardiac surgery has been shown to be excellent. 3,6 There are several different incisions for minimally invasive cardiac surgery, including parasternal incision, 7,8 right mini-thoracotomy, 6,9,10 and partial sternotomy. 11e14 Partial sternotomy provides adequate exposure.…”