Outcomes of minimally invasive versus conventional sternotomy for redo mitral valve surgery according to Mitral Valve Academic Research Consortium: A systematic review and meta-analysis

Hanafy, Dudy Arman; Melisa, Stefanie; Andrianto, Galih Asa; Suwatri, Widya Trianita; Sugisman,

doi:10.1016/j.asjsur.2023.09.001

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…Several studies have shown that right minithoracotomy in a re-intervention is associated with a lower rate of post-operative bleeding, morbidity and in-hospital death [10,18,19].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Strategy to Repair Mitral Valve after Repeated Coronary Revascularization: A Case Report and Literature Review

Asta,

Benedetto,

Tancredi

et al. 2023

JCM

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Redo cardiac surgery after Coronary Artery Bypass Grafting (CABG) is burdened by high morbidity and mortality, either intraoperatively and postoperatively, with the repeated sternotomy playing a crucial role as risk factor. The right minithoracotomy approach guarantees a safer control on conduits integrity and the right ventricular wall and a low impact on the respiratory mechanics. Herein, we report a patient who previously underwent two CABG (coronary artery bypass grafting) procedures and who was admitted to the hospital with a picture of heart failure caused by a severe mitral regurgitation. He was successfully submitted to a mitral valve repair on a beating heart via the right minithoracotomy approach.

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“…Several studies have shown that right minithoracotomy in a re-intervention is associated with a lower rate of post-operative bleeding, morbidity and in-hospital death [10,18,19].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Strategy to Repair Mitral Valve after Repeated Coronary Revascularization: A Case Report and Literature Review

Asta,

Benedetto,

Tancredi

et al. 2023

JCM

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“…Two recent meta-analyses comparing MIMVS vs. conventional resternotomy for redo mitral valve surgery showed an improved mortality rate in patients who had a minimally invasive approach rather than resternotomy [30,31]. A recent analysis of patients having mitral surgery after a previous sternotomy in the national Netherlands heart registry showed no difference in thirty-day mortality or five-year survival, although there was a lower incidence of prolonged intubation and new-onset arrhythmia in the minimally invasive group [32].…”

Section: Redo Surgerymentioning

confidence: 99%

Anaesthesia for Minimally Invasive Cardiac Surgery

Aston,

Zeloof,

Falter

2023

JCDD

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Minimally invasive cardiac surgery (MICS) has been used since the 1990s and encompasses a wide range of techniques that lack full sternotomy, including valve and coronary artery graft surgery as well as transcatheter procedures. Due to the potential benefits offered to patients by MICS, these procedures are becoming more common. Unique anaesthetic knowledge and skills are required to overcome the specific challenges presented by MICS, including mastery of transoesophageal echocardiography (TOE) and the provision of thoracic regional analgesia. This review evaluates the relevance of MICS to the anaesthetist and discusses pre-operative assessment, the relevant adjustments to intra-operative conduct that are necessary for these techniques, as well as post-operative care and what is known about outcomes.

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A technique avoiding cardioplegia delivery complications: a case using systemic hyperkalemia cardiopulmonary bypass combined with circulatory arrest

Takeichi,

Morimoto,

Yamada

et al. 2024

J Extra Corpor Technol

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We conducted a high-risk redo mitral valve replacement through a right mini-thoracotomy without rib spreading (redo-MICS MVR) under systemic hyperkalemia combined with circulatory arrest to circumvent complications associated with cardioplegia delivery. The patient, a 75-year-old man, had a predicted mortality rate of 20%. Initial antegrade cardioplegia successfully induced cardiac arrest, which was administered every 30 minutes. However, upon infusion of the second dose of cardioplegia, the aortic root pressure was approximately 20 mmHg. Despite multiple attempts to re-cross clamp, the aortic root pressure did not improve. Consequently, retrograde cardioplegia was considered, but due to significant adhesion of the inferior vena cava, this approach was abandoned. Thus, the procedure was altered to utilize systemic hyperkalemia without aortic cross-clamping. Given the preoperative transesophageal echocardiography (TEE) diagnosis of mild aortic regurgitation, maintaining a clear surgical field was challenging, necessitating the combination of redo-MVR with circulatory arrest. This case exemplifies the successful management of cardioplegia delivery complications using systemic hyperkalemia and circulatory arrest, resulting in a favorable postoperative recovery for the patient.

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Outcomes of minimally invasive versus conventional sternotomy for redo mitral valve surgery according to Mitral Valve Academic Research Consortium: A systematic review and meta-analysis

Cited by 3 publications

References 36 publications

Minimally Invasive Strategy to Repair Mitral Valve after Repeated Coronary Revascularization: A Case Report and Literature Review

Minimally Invasive Strategy to Repair Mitral Valve after Repeated Coronary Revascularization: A Case Report and Literature Review

Anaesthesia for Minimally Invasive Cardiac Surgery

A technique avoiding cardioplegia delivery complications: a case using systemic hyperkalemia cardiopulmonary bypass combined with circulatory arrest

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