scholarly journals Percutaneous drainage of delayed post-cardiac surgery pericardial effusion

2020 ◽  
Vol 2 (3) ◽  
pp. 105-113
Author(s):  
Mohammed Sanad ◽  
Sherif Arafa ◽  
Shady Elhusseiny ◽  
Mohammed Adel ◽  
Mohammed Elshabrawy Saleh
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Pericardial Effusion ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Percutaneous Drainage ◽  
Artery Bypass ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Large Pericardial Effusion

Background: Pericardial effusion and tamponade are common following valve surgery. The optimal treatment of symptomatic pericardial effusions remains controversial. The objective of this study was to present our experience in non-surgical management of delayed postoperative pericardial effusion. Methods: This retrospective study was conducted on 64 patients who had delayed pericardial effusion after cardiac surgery from 2016 to 2020. Eight patients were excluded due to the presence of inaccessible posterior or clotted pericardial effusion and were managed surgically, and 56 patients had percutaneous drainage of the pericardial fluid and were included in the analysis. Results: The mean age was 46.84±11.67 years (range: 22- 68 years), and 46.43% were females. The patients had coronary artery bypass grafting (n= 9), Aortic valve replacements  (n= 13), Mitral valve surgery (n= 21), double valve replacements (n= 8) and  combined procedures (n= 5).  All patients complained of varying degrees of exertional dyspnea. There were statistically significant differences between INR in different cardiac surgeries. Mean INR following mitral valve replacement (4.72±0.63) was significantly higher than in aortic valve replacement patients (3.32±0.34; p<0.001) and aortic valve patients (1.76±0.24; p<0.001). Fifteen patients (26.78%) had a large pericardial effusion. Successful drainage was achieved in all cases. Complications were pneumothorax (n= 2, 3.57%), recurrent effusions (n= 4, 7.14%), arrhythmias (n= 7, 12.5%), myocardial punctures (n= 2, 3.57%) and no mortality was reported. Conclusions: percutaneous drainage of postoperative pericardial effusion under radiological guidance is generally safe. Pericardial effusion is common after mitral valve surgery, which could be related to higher INR in these patients.

scholarly journals Totally endoscopic aortic valve replacement via an anterolateral approach using a standard prosthesis

2019 ◽  
Vol 30 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Masayoshi Tokoro ◽  
Sadanari Sawaki ◽  
Takahiro Ozeki ◽  
Mamoru Orii ◽  
Akihiko Usui ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Operating Time ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Intercostal Space ◽  
Anterolateral Approach ◽  
The Right

Abstract OBJECTIVES Totally endoscopic aortic valve replacement (AVR) is still a challenging operation, and only a few series reports exist in the literature. The purposes of this study were to establish a method for endoscopic AVR and evaluate its initial results. METHODS A total of 47 patients (median age 76 years, 17 men) underwent endoscopic AVR. The main wound was created in the right anterolateral 4th intercostal space through a 4-cm skin incision. No rib spreader was used. A 3-dimensional endoscope was inserted at the midaxillary line. A 5.5-mm trocar was inserted in the 3rd intercostal space, thus creating a 3-port setting similar to that used for endoscopic mitral valve surgery. A standard prosthesis was used, and the sutures were tied using a knot pusher. Results were compared with those of 157 patients who underwent right transaxillary AVR with direct vision plus endoscopic assist. RESULTS Patient backgrounds did not differ significantly between the 2 groups. No deaths occurred in the entire series. There was no conversion to thoracotomy or sternotomy in the endoscopic AVR group. The complication rate did not differ significantly between the 2 groups. The total operating time was significantly shorter in endoscopic AVR (188–206 min); the cardiopulmonary bypass time (130–128 min) and the cross-clamp time (90–95 min) did not differ significantly (median, endoscopic AVR, right transaxillary AVR). Two patients underwent endoscopic double-valve (aortic and mitral) surgery under the same conditions. CONCLUSIONS Endoscopic AVR was possible through 3 ports created in the right anterolateral chest, similar to the procedure for endoscopic mitral valve surgery. By adopting a common approach for both the aortic and the mitral valve operations, endoscopic double-valve surgery can be performed seamlessly.

Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease?

2002 ◽  
Vol 74 (4) ◽  
pp. 1115-1119 ◽  
Author(s):  
Jong-Won Ha ◽  
Seung-Hyuck Choi ◽  
Byung-Chul Chang ◽  
Chung Mo Nam ◽  
Yangsoo Jang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Valve Disease ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Disease

scholarly journals Atrioventricular groove disruption after aortic valve replacement

2017 ◽  
Vol 3 (1) ◽  
pp. 30
Author(s):  
Anupama Barua ◽  
Rose J. Mills ◽  
Pankaj Kaul ◽  
David J. O’Regan
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
High Mortality ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Fatal Complication ◽  
Atrioventricular Groove

Atrioventricular groove (AVG) disruption is a fatal complication after mitral valve surgery with high mortality. Here we present a case of aortic valve replacement complicated with AVG disruption.

scholarly journals Inaugural experience and early results of minimally invasive approach in cardiac surgery in Auvergne region, France

2020 ◽  
Vol 12 (2) ◽  
pp. 84-89
Author(s):  
Adama Sawadogo ◽  
Hoang Nam Nguyen ◽  
Nicolas D'Ostrevy ◽  
Lionel Camilleri ◽  
Kasra Azarnoush
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Valve Surgery ◽  
Medium Size ◽  
Aortic Valve Surgery ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Introduction : Minimally invasive approach in cardiac surgery has become an established and common technique in many cardiac surgery centres throughout the world. We report how we safely introduced minimally invasive approach in cardiac surgery in our department and we aim to demonstrate that this approach is feasible in any medium-size cardiac surgical centre. Methods: it consisted of retrospective and descriptive study on 60 patients who underwent minimally invasive mitral valve (45) or aortic valve surgery (15) from January 2017 to Februry 2018. The approach was 3 to 6-cm right thoracotomy through the 4th and 5th intercostal space. The Cor-KnotTM system was used to tie the knots of the prosthesis in case of mitral valve replacement and aortic valve replacement and the ring if mitral valve repair. Results: There was no conversion of thoracotomy to sternotomy. The average duration in ICU was 4.3± 2.3 days and 3.3 ± 1.5 respectively for mitral and aortic valve surgery. Four mitral patients and 1 aortic patient were reoperated for bleeding. No in-hospital death was observed. The postoperative discharge echocardiogram was normal in 95.6% of the mitral valve patients the trans-aortic mean gradient for the aortic valve patients was 16.3 ± 6 mm Hg. The thirty-day mortality was zero. In the majority of the patients, the scar of the thoracotomy were almost unseen. Conclusion: It is possible to safely implement this new approach in any mid-size cardiac centers. The use of modern technology such as 3D video and Cor Knot allows achievement of excellent short term outcomes.

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