Left Ventricular Thrombectomy Using Video-Assisted Thoracoscopy

Tanaka, Koyu; Sakaguchi, Taichi; Chikazawa, Genta; Totsugawa, Toshinori; Yoshitaka, Hidenori

doi:10.1111/jocs.12062

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…We have already reported that a minimally invasive approach through right minithoracotomy has several advantages, including less risk of fatal ventricular arrhythmia, surgical site bleeding, and mediastinitis by means of avoiding ventriculotomy and sternotomy [6]. In the present case, anticoagulation therapy was introduced within 3 hours after surgery, and early administration of an anticoagulant agent resulted in effective prevention of recurrent thrombus formation.…”

Section: Commentmentioning

confidence: 67%

A Left Ventricular Thrombus in a Patient With Primary Antiphospholipid Syndrome Removed Under Thoracoscopic Support

Suzuki

Totsugawa

Hiraoka

et al. 2016

The Annals of Thoracic Surgery

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The antiphospholipid syndrome is an autoimmune disorder characterized by vascular thrombosis. Left ventricular thrombus with antiphospholipid syndrome is rare, and there are few reports regarding surgical resection of such cases. We report the case of a 45-year-old woman who had been diagnosed as having primary antiphospholipid syndrome and was admitted to our hospital for treatment of left ventricular thrombus detected by an echocardiography. The thrombus was completely removed using video-assisted thoracoscopy through a right minithoracotomy. Left ventricular thrombectomy through a right minithoracotomy in a patient with antiphospholipid syndrome has not been previously reported. This approach is less invasive and more effective in such coagulation system disorders.

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Section: Commentmentioning

confidence: 67%

A Left Ventricular Thrombus in a Patient With Primary Antiphospholipid Syndrome Removed Under Thoracoscopic Support

Suzuki

Totsugawa

Hiraoka

et al. 2016

The Annals of Thoracic Surgery

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“…This was followed by semi-rigid endoscopes in four [7, 9, 21, 29], flexible endoscopes in three [2, 3, 30] and mixture of rigid and flexible endoscopes in one study [11]. In 13 studies, the type of endoscope used was not specified [4, 6, 10, 15, 20, 24–28, 31, 34, 35]. Other adjunct endoscopic instruments such as forceps, graspers, scissors, suckers or retractors were used in 13 studies [2, 3, 12, 13, 15, 19, 21, 25, 30, 32, 34, 35, 37].…”

Section: Resultsmentioning

confidence: 99%

“…In one case ventriculography was used [19] and in the remaining 22 cases the imaging method was not specified [1, 11]. In addition to pre-operative imaging with echocardiogram, in 10 cases intra-operative echocardiography was also used to ensure complete removal of the intracardiac lesions [9, 10, 12, 15, 21, 24, 26–28, 31]. …”

Section: Resultsmentioning

confidence: 99%

“…In this pooled series of data a right mini thoracotomy and thoracoscopic approach were used in 5 cases. Such minimally invasive procedures are well recognized to not only improve cosmesis but also facilitate lower post-operative infection rates, shorter hospital stay and earlier return to work when compared to sternotomy [3, 6, 24, 46]. As such, the employment of cardio-endoscopic visualization with minimal access incisions for treatment of LV lesions, would be expected to produce similar benefits [6].…”

Section: Discussionmentioning

confidence: 99%

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A systematic review of left ventricular cardio-endoscopic surgery

Soylu

Kidher

Ashrafian

et al. 2017

J Cardiothorac Surg

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Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes. A systematic review of the literature identified 34 studies, incorporating 54 subjects undergoing treatment of left ventricular tumours, thrombus or hypertrophic myocardium using a cardio-endoscopic technique. There were no mortalities (0%; 0/47). In 12 studies, the follow-up period was longer than 30 days. There were no post-operative complications apart from one case of atrial fibrillation (2.2%; 1/46). Complete resection of left ventricular lesion was achieved in all cases (100%; 50/50). These successful results demonstrate that the cardio-endoscopic technique is a useful adjunct in resection of left ventricular tumours, thrombus and hypertrophic myocardium. This approach facilitates accurate resection of pathological tissue from left ventricle whilst avoiding exposure related valvular damage and adverse effects associated with ventriculotomy. Future research should focus on designing adequately powered comparative randomised trials focusing on major cardiac and cerebrovascular morbidity outcomes in both the short and long-term. In this way, we may have a more comprehensive picture of both the safety and efficacy of this technique and determine whether such devices could be safely adopted for routine use in minimal access or robotic intra-cardiac surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-017-0599-z) contains supplementary material, which is available to authorized users.

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“…Compared to conventional median sternotomy, it has the advantages of reduced bleeding, fewer blood transfusions, lower incidence of mediastinitis, shorter ICU stay, and faster recovery. Moreover, videoassisted right minithoracotomy allows determination of the AMLC shape and identification of intra-annular structures by direct view [5]. The safety and efficacy of MICS via minithoracotomy has been described in young patients with congenital heart defects and in patients with previous sternotomy [6,7].…”

Section: Discussionmentioning

confidence: 99%