scholarly journals Tricuspid valve annuloplasty and mitral valve replacement are associated with bradyarrhythmia after mitral valve surgery

2021 ◽  
Vol 32 (4) ◽  
pp. 1103-1110
Author(s):  
Florian E. M. Herrmann ◽  
Anne‐Sophie Schleith ◽  
Helen Graf ◽  
Sebastian Sadoni ◽  
Christian Hagl ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Valve Annuloplasty

scholarly journals Video-assisted Minimally Invasive Mitral Valve Surgery versus Conventional Mitral Surgery in Rheumatic Patients

2020 ◽  
Author(s):  
Ayman Badawy ◽  
Mohamed Alaa Nady ◽  
Mohamed Ahmed Khalil Salama Ayyad ◽  
Ahmed Elminshawy
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Invasive Approach ◽  
Video Assisted ◽  
Group A ◽  
Group B

Background: Minimally invasive mitral valve surgery became an attractive option because of its cosmetic advantages over the conventional approach. The superiority of the minimally invasive approach regarding other aspects is still debatable. The aim of our study was to determine the potential benefits of minimally invasive mitral valve replacement with intraoperative video assistance over conventional surgery. Methods: This is a single-center prospective cohort study that included 60 patients with rheumatic heart disease who underwent mitral valve replacement. Patients were divided into two groups: group (A) included patients who had conventional sternotomy (n= 30), and group (B) included patients who had video-assisted minimally invasive mitral valve replacement (n= 30). Intraoperative and postoperative outcomes were compared between both groups. Results: Mortality occurred in one patient in the group (A). Cardiopulmonary bypass time was 118.93 ± 29.84 minutes vs. 64.73 ± 19.16 minutes in group B and A respectively (p< 0.001), and ischemic time was 102.27 ± 30.03 minutes vs. 53.67± 18.46 minutes in group B and A respectively (P < 0.001). Ventilation time was 2.77± 2.27 vs. 6.28 ± 4.48 hours in group B and A respectively (p< 0.001) and blood transfusion was 0.50 ± 0.63 vs. 2.83 ± 1.34 units in group B and A respectively (p< 0.001).  ICU stay was 1.73 ± 0.64 days in the group (B) vs. 4.47 ± 0.94 days in group A (p< 0.001). Postoperative bleeding was 353.33 ± 146.77 ml in the group (B) vs. 841.67 ± 302.03 ml in group A (p <0.001). No conversion to full sternotomy was reported in group B. In group (B), two cases (6.6%) required re-exploration for bleeding vs. four cases (13.2%) in group (A) (p=0.67). The hospital stay was 6.13 ± 1.59 days in the group (B) vs. 13.27 ± 7.62 days in group A (p< 0.001). Four cases (13.3%) developed mediastinitis in group A and in the group (B), there was one case of acute right lower limb embolic ischemia. Conclusion: Video-assisted minimally invasive mitral operations could be a safe alternative to conventional sternotomy with the potential of lesser morbidity and earlier hospital discharge.

scholarly journals Redo mitral valve surgery

2018 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Redoy Ranjan ◽  
Mushfiqur Rahman ◽  
Heemel Saha ◽  
Dipannita Adhikary ◽  
Sanjoy Kumar Saha ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Color Doppler ◽  
Systolic Pressure ◽  
Mechanical Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Pulmonary Artery Systolic Pressure ◽  
Female Ratio

<p class="Abstract">This study is based on the findings of a single surgeon’s practice of mitral valve replacement of 167 patients from April 2005 to June 2017 who developed symptomatic mitral restenosis after closed or open mitral commisurotomy. Both clinical and color doppler echocardiographic data of peri-operative and six months follow-up period were evaluated and compared to assess the early outcome of the redo mitral valve surgery. With male-female ratio of 1: 2.2 and after a duration of 6 to 22 years symptom free interval between the redo procedures, the selected patients with mitral valve restenosis undergone valve replacement with either mechanical valve in 62% cases and also tissue valve in 38% cases. Particular emphasis was given to separate the adhered pericardium from the heart completely to ameliorate base to apex and global contraction of the heart. Besides favorable post-operative clinical outcome, the echocardiographic findings were also encouraging as there was statistically significant increase in the mitral valve area and ejection fraction with significant decrease in the left atrial diameter, pressure gradient across the mitral valve and pulmonary artery systolic pressure. Therefore, in case of inevitable mitral restenosis after closed or open commisurotomy, mitral valve replacement is a promising treatment modality.</p>

scholarly journals Mitral valve surgery for ischemic papillary muscle rupture: outcomes from the Japan cardiovascular surgery database

2020 ◽  
Vol 68 (12) ◽  
pp. 1439-1446
Author(s):  
Tomoyuki Fujita ◽  
Hiroyuki Yamamoto ◽  
Junjiro Kobayashi ◽  
Satsuki Fukushima ◽  
Hiroaki Miyata ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Papillary Muscle ◽  
Cardiovascular Surgery ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Short Term ◽  
Papillary Muscle Rupture ◽  
Muscle Rupture

Abstract Background Ischemic papillary muscle rupture (PMR) is a catastrophic complication following acute myocardial infarction (AMI). We evaluated early outcomes of PMR by using data from the Japan Cardiovascular Surgery Database, a nationwide Japanese registry. Methods We retrospectively analyzed data from 196 patients diagnosed with PMR following AMI in Japan between January 2014 and December 2017. Risk factors for operative mortality and severe complications following mitral valve surgery were analyzed. Results The 30-day and hospital mortality rates were 20% and 26%, respectively. Chronic hemodialysis, abrupt rupture after AMI, resuscitation before surgery, and preoperative venoarterial extracorporeal membrane oxygenation were associated with mortality. Mitral valve replacement was chosen mainly (90%) for surgical correction of mitral regurgitation in these patients. There was no significant difference in short-term outcomes between mitral valve replacement versus mitral valve repair, despite non-matched characteristics in background between the treatment groups. Concomitant coronary artery bypass grafting had no impact on short-term outcomes. Conclusions Information derived from the nationwide database of patients with AMI-associated PMR show that PMR is a rare condition in the modern era. However, PMR is a severe disease with a mortality rate as high as 26%. The severity of the condition is associated with the risk for poor outcomes.

CONCOMITANT TRICUSPID VALVE ANNULOPLASTY AT THE TIME OF MITRAL VALVE SURGERY COMPARED TO ISOLATED MITRAL VALVE SURGERY

2019 ◽  
Vol 73 (9) ◽  
pp. 2033
Author(s):  
Mohanad Hamandi ◽  
Robert Smith ◽  
William Ryan ◽  
Paul Grayburn ◽  
Alexander Crawford ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Valve Annuloplasty

Redo Mitral Valve Surgery Using the Port-Access System

2002 ◽  
Vol 10 (3) ◽  
pp. 215-218 ◽  
Author(s):  
Naresh Trehan ◽  
Yugal K Mishra ◽  
Satish G Mathew ◽  
Krishna K Sharma ◽  
Sameer Shrivastava ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Operating Time ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Paravalvular Leak ◽  
Access System ◽  
Postoperative Blood Transfusion ◽  
Port Access

Redo mitral valve surgery is hazardous, hence we explored an alternative approach using a port-access system that avoids reentry. Between October 1997 and December 2000, 32 patients underwent mitral reoperation using the system. All patients had previous cardiac operations. This procedure consisted of a right anterolateral minithoracotomy and femorofemoral cannulation using special port-access instruments and endoaortic clamping in 24 patients or direct transthoracic sliding-rod aortic clamping in 8. The valve disease was of rheumatic etiology in 28 patients and degenerative in 4. The valve was replaced in 31 cases and a paravalvular leak after mitral valve replacement was closed in 1. In 2 cases, the tricuspid valve was repaired along with mitral valve replacement. Mean total operating time was 4.5 ± 1.2 hours, cardiopulmonary bypass time 162 ± 72 minutes, and aortic crossclamp time 62 ± 21 minutes. There was no mortality, and mean stay in the intensive care unit was 22 ± 7 hours and hospital stay 6.4 ± 1.2 days. Postoperative blood transfusion was required in 12 patients. In view of the favorable results, we recommend using the port-access system as a standard approach for mitral reoperation.

Determinants of recurrent tricuspid regurgitation following tricuspid valve annuloplasty during mitral valve surgery

2017 ◽  
Vol 32 (4) ◽  
pp. 237-244 ◽  
Author(s):  
Hisato Ito ◽  
Toru Mizumoto ◽  
Yasuhiro Sawada ◽  
Kazuya Fujinaga ◽  
Hironori Tempaku ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Valve Annuloplasty

Minimally Invasive Thoracoscopic Mitral Valve Replacement in Rheumatic Disease With Continuous Suture Technique

2019 ◽  
Vol 14 (6) ◽  
pp. 558-563
Author(s):  
Pham Quoc Dat ◽  
Duong Duc Hung ◽  
Duong Thi Hoan ◽  
Nguyen Huu Uoc ◽  
Alexander P. Nissen
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Surgery ◽  
Suture Technique ◽  
Valve Surgery ◽  
Continuous Suture ◽  
Aortic Cross Clamp ◽  
Mitral Disease

Minimally invasive mitral valve surgery has become routine in many institutions. Disadvantages of this approach include prolonged aortic cross-clamp and cardiopulmonary bypass times. Mitral valve replacement with a continuous suture technique may reduce operative times. We present a case of a 51-year-old man suffering from severe rheumatic mitral disease to highlight our continuous suture technique for minimally invasive mitral valve replacement. We also report preliminary results from our series of 15 patients suffering various rheumatic mitral pathology treated with this technique.

scholarly journals Early clinical outcome after right anterolateral thoracotomy as an alternative for median sternotomy for mitral valve replacement

2020 ◽  
Vol 2 (2) ◽  
pp. 47-54
Author(s):  
Ahmed Rady Attallah ◽  
Shady Eid Al-Elwany ◽  
Mohammed A.K. Salama Ayyad ◽  
Ali Mohammed Abdelwahab
Keyword(s):  
Mitral Valve ◽  
Blood Transfusion ◽  
Clinical Outcome ◽  
Blood Loss ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Median Sternotomy ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Anterolateral Thoracotomy

Background: The advantages of the right anterolateral thoracotomy (RALT) approach for mitral valve surgery over standard median sternotomy (MS) are still debatable. The objective of this study was to evaluate and compare the postoperative clinical outcome after RALT and MS for mitral valve replacement. Methods: This prospective observational study included 40 patients who underwent mitral valve replacement between January 2016 and August 2018. Patients were assigned to two groups, the first group included 20 patients who had conventional median sternotomy approach and the second group included 20 patients who had right anterolateral thoracotomy with the complete cannulation and aortic cross-clamping conducted through the same incision. Results: In comparison to MS, RALT had significantly higher cross-clamp time (77.7±16.1 vs 45.8±8.7 minutes, P < 0.01), total bypass time (105.2±12.7 vs 72.2±10.4 minutes, P < 0.01), and total operative time (287±41 vs 231±36 min, P < 0.01), in addition to significantly lower ventilation time (4.2±1.51 vs 6.1±1.84 hours, P < 0.01), blood loss (229±85 vs 335±137 ml), amount of blood transfusion (1.41±0.6 vs 2.19±1.1 units, P < 0.01), ICU stay duration (2.11±0.49 vs 2.78±0.82 days, P < 0.01), pain scores at 1st and 2nd postoperative days (5.67±0.79 vs 7.81±0.53, p < 0.01), and total hospital stay duration (7.2±1.3 vs 8.4±1.6 days, P = 0.01). Patients' satisfaction about their wound was significantly higher in RALT group compared to MS group (95% vs 30%, P < 0.01). Conclusion: The RALT approach for mitral valve surgery could be a safe and effective approach when compared to median sternotomy. RALT could be associated with a reduction of blood loss, blood transfusion, wound infection, in addition to shorter ICU and hospital stay.

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