Redo mitral valve surgery following prior mitral valve repair

Kilic, Arman; Helmers, Mark R.; Han, Jason J.; Kanade, Rahul; Acker, Michael A.; Hargrove, W. Clark; Atluri, Pavan

doi:10.1111/jocs.13944

Cited by 15 publications

(37 citation statements)

References 20 publications

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“…Similarly, from 4 studies [7,9,11,14], 447 patients, no statistical difference in long-term operative mortality was observed between the 2 groups (OR: 0.41, CI: 0.14 to 1.21, p = 0.11) as seen in Fig. 2b.…”

Section: Clinical Outcomesmentioning

confidence: 62%

“…The 8 included retrospective cohort studies [7,9,[11][12][13][14][15][16] was all single centre studies ( Table 1). The quality of these studies was assessed using Newcastle-Ottawa Scale [17], seen in Table 2.…”

Section: Quality Of Evidence and Risk Of Bias Assessmentmentioning

confidence: 99%

“…Procedure related factors mainly encompassed ruptures of previously shortened or transferred chordae, elongations or ruptures of chordae from previously shortened papillary muscles, ring dehiscence, leaflet dehiscence or perforations or incomplete repairs [9]. On the other hand, valve related factors included endocarditis, progression of primary disease, valvular prolapse in an area not involved by the previous repair and valvular retractions [9,14]. A trend was observed where surgeons in Kilic et al [14] and Suri et al [15] studies preferred MVr when the mode of failure was procedure related and MVR when mode of failure was valve related.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…On the other hand, valve related factors included endocarditis, progression of primary disease, valvular prolapse in an area not involved by the previous repair and valvular retractions [9,14]. A trend was observed where surgeons in Kilic et al [14] and Suri et al [15] studies preferred MVr when the mode of failure was procedure related and MVR when mode of failure was valve related. The contrary was true for Nishida et al study [7].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Application of leave-one-out sensitivity analysis (seen in Table 4) revealed that the Kilic et al [14] paper had a substantial influence on the overall significance and heterogeneity of the long-term operative mortality outcome. This heterogeneity could be potentially credited to clinical differences in the Kilic et al [14] paper and its patient population, rather than as a result of statistical heterogeneity across all 4 studies [7,9,11,14]. Therefore, the result of this outcome needs to be interpreted with caution with further exploration of the exact cause of heterogeneity.…”

Section: Clinical Outcomesmentioning

confidence: 99%

See 4 more Smart Citations

Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis

Veerappan

Cheekoty

Sazzad

et al. 2020

J Cardiothorac Surg

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Background The optimal treatment strategy following a failed mitral valve repair remains unclear. This study aims to compare and analyse available studies which report the clinical outcomes post mitral valve re-repair (MVr) or replacement (MVR) after a prior mitral valve repair. Methods Based on PRISMA guidelines, a literature search was performed utilising PubMed, Cochrane and Scopus databases to identify retrospective cohort studies that reported outcomes of MVr and MVR after a prior mitral valve repair. Data regarding operative mortality, clinical outcomes and complications were extracted, synthesized and meta-analysed where appropriate. Results Eight studies with a total cohort of 1632 patients were used. After analysis, no significant differences in the short term and long-term operative mortality, incidence of stroke, congestive heart failure, Grade 1 and Grade 2 mitral regurgitation, requirement of 3rd mitral valve operation and reoperation due bleeding were found between the two groups. However, a slightly higher incidence of postoperative atrial fibrillation (OR: 0.11, CI: 0.02 to 0.17, I2 = 0%, p = 0.02) was observed in the MVR group, as compared to the MVr group. Conclusion MVr appears to be a viable alternative to MVR for mitral valve reoperation, given that they are associated with similar post-operative outcomes.

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Section: Clinical Outcomesmentioning

confidence: 62%

Section: Quality Of Evidence and Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis

Veerappan

Cheekoty

Sazzad

et al. 2020

J Cardiothorac Surg

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Artificial Muscles and Soft Robotic Devices for Treatment of End‐Stage Heart Failure

et al. 2023

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Medical soft robotics constitutes a rapidly developing field in the treatment of cardiovascular diseases, with a promising future for millions of patients suffering from heart failure worldwide. Herein, the present state and future direction of artificial muscle‐based soft robotic biomedical devices in supporting the inotropic function of the heart are reviewed, focusing on the emerging electrothermally artificial heart muscles (AHMs). Artificial muscle powered soft robotic devices can mimic the action of complex biological systems such as heart compression and twisting. These artificial muscles possess the ability to undergo complex deformations, aiding cardiac function while maintaining a limited weight and use of space. Two very promising candidates for artificial muscles are electrothermally actuated AHMs and biohybrid actuators using living cells or tissue embedded with artificial structures. Electrothermally actuated AHMs have demonstrated superior force generation while creating the prospect for fully soft robotic actuated ventricular assist devices. This review will critically analyze the limitations of currently available devices and discuss opportunities and directions for future research. Last, the properties of the cardiac muscle are reviewed and compared with those of different materials suitable for mechanical cardiac compression.

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Robotic Cardiac Compression Device Using Artificial Muscle Filaments for the Treatment of Heart Failure

Phan,

Davies,

Hoang

et al. 2023

Advanced Intelligent Systems

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Heart failure occurs when the heart cannot pump adequate blood to the body, which afflicts over 60 million people worldwide. Its treatment options include physiotherapy, medication, mechanical heart support, heart surgery, or heart transplantation. Ventricular assist devices have direct blood contact while passive ventricular constraint devices have only modest therapeutic efficacy. Current direct cardiac compression devices are either bulky, require noisy driving pneumatic sources, or are unable to mimic the natural heart motion. This study introduces a robotic cardiac compression device made of soft artificial muscle filaments that can simultaneously produce radial, axial, and torsional movements, potentially augmenting the pumping function of a failing heart. An empirical model is developed to describe the device motion and an artificial pericardium is employed to enable uniform force distribution to the heart and real‐time pressure sensing. The proposed device could deliver a stroke volume of 70 mL at 15 beats per minute, or a cardiac output of 1.05 L min−1, and achieve a peak instantaneous flow rate of 2.8 L min−1 and an output pressure of 50 mmHg. The new devices are highly customizable and experimentally validated with fresh porcine heart. They are expected to inspire future development of nonblood‐contacting cardiac assist devices.

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Redo mitral valve surgery following prior mitral valve repair

Cited by 15 publications

References 20 publications

Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis

Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis

Artificial Muscles and Soft Robotic Devices for Treatment of End‐Stage Heart Failure

Robotic Cardiac Compression Device Using Artificial Muscle Filaments for the Treatment of Heart Failure

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