scholarly journals Minimally Invasive Mitral Valve Surgery: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Fabiana Lucà ◽  
Leen van Garsse ◽  
Carmelo Massimiliano Rao ◽  
Orlando Parise ◽  
Mark La Meir ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Comparable Efficacy ◽  
Surgical Trauma ◽  
Term Survival ◽  
Perioperative Morbidity ◽  
Valve Pathology

In the recent years minimally invasive mitral valve surgery (MIMVS) has become a well-established and increasingly used option for managing patients with a mitral valve pathology. Nonetheless, whether the purported benefits of MIMVS translate into clinically important outcomes remains controversial. Therefore, in this paper we provide an overview of MIMVS and discuss results, morbidity, mortality, and quality of life following mitral minimally invasive procedures. MIMVS has been proven to be a feasible alternative to the conventional full sternotomy approach with low perioperative morbidity and short-term mortality. Reported benefits of MIMVS include also decreased postoperative pain, improved postoperative respiratory function, reduced surgical trauma, and greater patient satisfaction. Finally, compared to standard surgery, MIMVS demonstrated comparable efficacy across a range of long-term efficacy measures such as freedom from reoperation and long-term survival.

scholarly journals Design and training effects of a physical reality simulator for minimally invasive mitral valve surgery

2019 ◽  
Vol 29 (3) ◽  
pp. 409-415 ◽  
Author(s):  
Ahmad-Fawad Jebran ◽  
Shekhar Saha ◽  
Narges Waezi ◽  
Ammar Al-Ahmad ◽  
Heidi Niehaus ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Surgery ◽  
Learning Curves ◽  
Valve Surgery ◽  
Training Effects ◽  
Training Course ◽  
Skill Scores ◽  
Significant Difference

Abstract OBJECTIVES Minimally invasive mitral valve surgery (MIMVS) through an endoscopic right minithoracotomy is a well-established yet complex procedure that has a challenging learning curve. We have developed a simulator for MIMVS and evaluated its short- and long-term training effects. METHODS Trainees without simulator experience or training in MIMVS were divided into 2 groups (10 students and 10 residents) and participated in a 5-day training course after initial instruction. Each trainee performed a ring annuloplasty. Scores were given by a supervisor who assessed 5 skills. The duration of each procedure was also measured. To evaluate the long-term effect of the training course, trainees performed the same procedure 4 weeks after the last session. RESULTS Trainees in the resident group were significantly older compared to those in the student group and had a mean surgical experience of 4.4 ± 0.78 years standard error of the mean. All other demographic data were similar. Significant learning curves could be achieved in both groups over the course of 5 days with regard to total skill scores and total duration. However, when we compared the learning curves of both groups, no significant difference could be seen. Long-term performance in both groups was still significantly better compared to that in the first training session. CONCLUSIONS Training with our simulator provided a significant enhancement of a trainee’s performance. This learning effect was achieved in both groups and was still evident 4 weeks later. We strongly recommend our simulator for simulation-based surgical education of cardiac surgeons interested in MIMVS.

Minimally Invasive Mitral Valve Surgery in Truly High-Risk Patients: Are We Pushing the Boundaries? An Observational Study

2015 ◽  
Vol 10 (5) ◽  
pp. 328-333 ◽  
Author(s):  
Marco Moscarelli ◽  
Rafik Margaryan ◽  
Alfredo Cerillo ◽  
Enkel Kallushi ◽  
Pierandrea Farneti ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Tricuspid Valve Repair ◽  
Discrimination Power ◽  
High Risk Patients ◽  
Risk Patients

Objective This study aimed to assess in a retrospective series of truly high-risk patients who underwent minimally invasive mitral valve surgery: (1) postoperative and long-term results and (2) logistic EuroSCORE and EuroSCORE II discrimination power. Methods Between 2003 and 2013, we reviewed in our institution patients who underwent minimally invasive mitral valve surgery with or without tricuspid valve repair via right minithoracotomy with logistic EuroSCORE of 20 or higher. Results Among a total number of 1604, 88 patients were identified. Median logistic and EuroSCORE II was 27.29 (interquartile range, 15.3) and 12.7% (11.3%), respectively. Mean (SD) age was 71.9 (8.4) years; 42 were female (47.7%); 60 patients (68.1%) underwent previous sternotomy. Mitral valve was replaced in 59 (67%) and repaired in 29 (32.9%) patients; tricuspid valve repair was performed in 23 patients (26.1%). Median cardiopulmonary bypass and cross-clamp times were 157 minutes (interquartile range, 131–187 minutes) and 83 minutes (81–116 minutes), respectively; conversion to sternotomy and reopening for bleeding was necessary in 4 (4.5%) and 3 (3.4%) patients; permanent and transient neurological injuries were reported in 6 (6.8%) and 3 (3.4%) patients; acute kidney injury was reported in 13 patients (14.7%); 15 patients (17%) had pulmonary complications. Ten patients died while in the hospital (11.2%). Survival at 6 years was 78% (95% confidence interval, 69–88). Conclusions In this series of truly high-risk patients, minimally invasive mitral surgery was associated with acceptable early mortality and morbidity as well as long-term outcomes; both logistic and EuroSCORE II showed suboptimal discrimination power.

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