Port-Access Aortic Valve Replacement First Case Report in Japan

Abstract

A 42-year-old man suffering from massive aortic valve regurgitation with mild stenosis because of a bicuspid valve underwent surgery in May 2007. The surgical procedure was performed through a right anterolateral thoracotomy using the peripheral cannulation method. Cardiac arrest was achieved by direct aortic cross-clamping and selective cardioplegia delivery. The aortic valve was replaced with a bioprosthesis. The operation and aortic cross-clamping periods were 265 and 117 min, respectively. The patient's recovery was uneventful, and he was discharged from hospital 8 days after surgery.

Minimally invasive cardiac surgery for atrial fibrillation complicated by coronary artery disease: combination of video-assisted pulmonary vein isolation and minimally invasive direct coronary artery bypass

“…Our method is slightly complicated owing to the need for sequential bilateral single lung ventilation; nevertheless, this procedure without ster- notomy offers advantages, including a good long-term outcome of CABG; easy transmural ablation on the left atrial cuff and the left atrial roof without hemodynamic instability; avoidance of esophageal perforation and PV stenosis; lower infection rate; less risk of the need for blood transfusion; short hospital stay; and early recovery to physical activity. 5 In addition, the left atrial appendage can be easily excised in this method, although it was not resected in the present case, considering secretion of atrial natriuretic peptide, its contribution to atrial transport, and the risk of bleeding. 9 Furthermore, combination of additional bypass grafting or percutaneous catheter intervention would be applied to our method in the presence of triple-vessel disease.…”

“…The institutional review board of our hospital approved minimally invasive cardiac surgery combining videoassisted bilateral PV isolation and MIDCAB based on our excellent results with port-access surgery. 5 We therefore planned on minimally invasive cardiac surgery after informed consent instead of percutaneous catheter intervention and conventional coronary artery bypass grafting (CABG) with a maze procedure.…”

Left Ventricular Thrombectomy Using Video-Assisted Thoracoscopy

“…In 192 of those cases, a right mini‐thoracotomy approach, using video‐assisted thoracoscopy for mitral valve surgery, had been performed. Furthermore, we reported the first case of port‐access aortic valve replacement and the first case of port‐access double valve replacement in Japan . In our institution, we perform this approach when possible for patients who request it and whose preoperative level of activity of daily living (ADL) is high.…”

Port-access heart surgery for the treatment of cor triatriatum with atrial septal defect: Report of a case

“…Port-access surgery has several advantages, such as low infection rate, shorter length of hospital stay, and less risk of blood transfusion. 12 However, port-access heart surgery is not available for all Lucas-Schmidt types, such as those requiring the reconstruction of pulmonary venous drainage (Lucas-Schmidt IB2, IIB, IIIA2, and IIIB). By contrast, other types (Lucas-Schmidt IA, IB1, IIA, and IIIA1), which usually include cor triatriatum in adults, are thought to be a good indication for port-access surgery.…”