Minimally Invasive Valve Surgery: When Less Is More

Lamelas, Joseph; Nguyen, Tom C.

doi:10.1053/j.semtcvs.2015.02.011

Cited by 38 publications

(25 citation statements)

References 65 publications

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“…As could be expected, the pulmonary functional status indicated by spirometry examinations continued to improve steadily over the postoperative months [10]. The difference in pulmonary function between the groups disappeared between 1 and 3 months after the operation, and it can be assumed that in the later postoperative period pulmonary rehabilitation would be comparable in both the RT-AVR and AVR groups.…”

Section: Discussionsupporting

confidence: 60%

Respiratory functional status after conventional and minimally invasive aortic valve replacement surgery – a propensity score analysis

Stoliński

Musiał

Plicner

et al. 2017

kitp

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IntroductionReports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent.AimTo compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR).Material and methodsThis was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching. Respiratory function based on spirometry examinations is presented.ResultsHospital mortality was 1.4% in RT-AVR and 1.9% in AVR (p = 0.777). Predicted mortality (EuroSCORE II) was 3.2 ±1.1% in RT-AVR and 3.1 ±1.6% in AVR (p = 0.298). Mechanical ventilation time in intensive care unit (ICU) was 7.3 ±3.9 h for RT-AVR and 9.6 ±5.5 h for AVR patients (p < 0.001). Seven days and 1 month after surgery, the reduction of spirometry functional tests was greater in the AVR group than in the RT-AVR group (p < 0.001). Three months after surgery, all spirometry parameters were still reduced and had not returned to preoperative values in both RT-AVR and AVR groups. However, the difference in spirometry values was no longer statistically significant between RT-AVR and AVR groups. Presence of chronic obstructive pulmonary disease and conventional AVR surgical technique were associated with lower values of spirometry parameters after surgery in linear median regression.ConclusionsRespiratory function based on spirometry examinations was less impaired after minimally invasive RT-AVR surgery in comparison to conventional AVR surgery through median sternotomy.

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Section: Discussionsupporting

confidence: 60%

Respiratory functional status after conventional and minimally invasive aortic valve replacement surgery – a propensity score analysis

Stoliński

Musiał

Plicner

et al. 2017

kitp

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“…Due to the medical development and increasing life expectancy, the number of surgeries and interventions is expected to rise [1, 2]. Currently, surgical aortic valve replacement with biological or mechanical prostheses is the standard of care in most cases of aortic stenosis [3, 4]. In patients with high risk to the surgical procedure, transcatheter aortic valve implantation (TAVI) can be considered [3, 5, 6].…”

Section: Introductionmentioning

confidence: 99%

Effects of heart valve prostheses on phase contrast flow measurements in Cardiovascular Magnetic Resonance – a phantom study

Richau

Dieringer

Traber

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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BackgroundCardiovascular Magnetic Resonance is often used to evaluate patients after heart valve replacement. This study systematically analyses the influence of heart valve prostheses on phase contrast measurements in a phantom trial.MethodsTwo biological and one mechanical aortic valve prostheses were integrated in a flow phantom. B0 maps and phase contrast measurements were acquired at a 1.5 T MR scanner using conventional gradient-echo sequences in predefined distances to the prostheses. Results were compared to measurements with a synthetic metal-free aortic valve.ResultsThe flow results at the level of the prosthesis differed significantly from the reference flow acquired before the level of the prosthesis. The maximum flow miscalculation was 154 ml/s for one of the biological prostheses and 140 ml/s for the mechanical prosthesis. Measurements with the synthetic aortic valve did not show significant deviations. Flow values measured approximately 20 mm distal to the level of the prosthesis agreed with the reference flow for all tested all prostheses.ConclusionsThe tested heart valve prostheses lead to a significant deviation of the measured flow rates compared to a reference. A distance of 20 mm was effective in our setting to avoid this influence.

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“…MICS is becoming safer, easier to perform, and more popular day by day ( 9 ). Choosing the most suitable incision location depending on the patient’s characteristics and the surgeon’s preference is a very challenging issue.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Minimal Invasive Cardiac Surgery Incisions: Periareolar Approach In the Female Patients

Durdu

Baran²,

Gümüş³

et al. 2018

Anatol J Cardiol

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Objective:All innovations in cardiac surgery provide us with new techniques to perform surgery through smaller incisions with less invasive and best cosmetic results. After promising results in minimally invasive cardiac surgery (MICS), pain and cosmetic appearance became important end points, especially for female patients. In the current study, we intended to evaluate the surgical results and cosmetic satisfaction with the periareolar and submammary incision types in cardiac surgery.Methods:Ninety-four female patients underwent MICS between July 2013 and March 2018. MICS was performed in 62 patients via periareolar incision and in 32 patients via submammarian incision. We investigated the incision size, wound infection, pain levels by using a postoperative standard pain-level questionnaire, the postoperative scar size, and patient satisfaction using a postoperative patient questionnaire.Results:Periareolar incision size was smaller than the submammary incision (Group A: 5.6±0.6 vs. Group B: 6.7±0.8, p=0.001). Four patients from Group B had superficial wound infection (p=0.01). Patients who underwent MICS via periareolar incision and submammary incision had similar pain level (p=0.2). The scar tissue was smaller in size and postoperatively healed better in the following days for the patients with periareolar incision due to the elastic structure of breast tissue. (Group A: 4.3±0.4 vs. Group B: 5.3±0.2, p=0.001).Conclusion:Our study suggests that the periareolar approach would be more aesthetic, show better healing, and have a smaller scar size in female patients.

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Minimally Invasive Valve Surgery: When Less Is More

Cited by 38 publications

References 65 publications

Respiratory functional status after conventional and minimally invasive aortic valve replacement surgery – a propensity score analysis

Respiratory functional status after conventional and minimally invasive aortic valve replacement surgery – a propensity score analysis

Effects of heart valve prostheses on phase contrast flow measurements in Cardiovascular Magnetic Resonance – a phantom study

Comparison of Minimal Invasive Cardiac Surgery Incisions: Periareolar Approach In the Female Patients

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