Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
Add more filters










Database
Language
Publication year range
1.
Innovations (Phila) ; 12(5): 375-377, 2017.
Article in English | MEDLINE | ID: mdl-29023349

ABSTRACT

Minimally invasive, robotic-assisted cardiac surgery has been shown to decrease transfusion rates, decrease wound infection rates, shorten hospital length of stay, and allow for a faster return to full activity compared with traditional sternotomy approaches. However, its application has chiefly been limited to primary, isolated procedures such as primary mitral valve repair or replacement. We describe the first reported use of a robotic surgery platform to perform reoperative mitral valve replacement using a minimally invasive, totally endoscopic, port-access approach.


Subject(s)
Cardiac Surgical Procedures/methods , Heart Valve Prosthesis Implantation/methods , Minimally Invasive Surgical Procedures/methods , Mitral Valve Insufficiency/surgery , Mitral Valve/surgery , Robotic Surgical Procedures/methods , Cardiopulmonary Bypass/methods , Cardiopulmonary Bypass/standards , Echocardiography, Transesophageal/methods , Humans , Male , Middle Aged , Mitral Valve Insufficiency/diagnostic imaging , Reoperation , Treatment Outcome
2.
Ann Thorac Surg ; 101(5): e177-8, 2016 May.
Article in English | MEDLINE | ID: mdl-27106473

ABSTRACT

Closure of the left atrial appendage (LAA) has become a standard part of any mitral valve operation because it is thought to reduce the potential for late thrombus development and for embolic events. To date, surgeons performing robotic mitral valve operations have been limited to an endocardial approach to LAA closure. However, oversewing the orifice of the LAA is time consuming and lengthens the cross-clamp time, and failures to obtain permanent closure have been reported. We describe our technique for an epicardial approach that is safe and efficient and that gives a secure closure of the LAA.


Subject(s)
Atrial Appendage/surgery , Cardiac Surgical Procedures/instrumentation , Mitral Valve/surgery , Robotic Surgical Procedures/instrumentation , Humans , Pericardium/surgery
3.
Innovations (Phila) ; 10(4): 273-5, 2015.
Article in English | MEDLINE | ID: mdl-26355689

ABSTRACT

An 89-year-old man and an 80-year-old woman were treated surgically for critical aortic stenosis secondary to senile calcific aortic disease and high-grade calcified lesions in the ostium of the right coronary artery. Minimally invasive aortic valve replacement and concurrent coronary artery bypass grafting were performed concurrently through a 5-cm right anterior thoracotomy in the second intercostal space. Surgery was uncomplicated in both cases, with no adverse events. Both patients were alive and well at midterm follow-up. Concurrent minimally invasive aortic valve replacement and coronary artery bypass grafting can be performed successfully through a limited right anterior thoracotomy.


Subject(s)
Aortic Valve Stenosis/surgery , Aortic Valve/pathology , Aortic Valve/surgery , Calcinosis/surgery , Coronary Artery Bypass/methods , Minimally Invasive Surgical Procedures/methods , Aged, 80 and over , Female , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation/methods , Humans , Male , Thoracotomy , Treatment Outcome
4.
Innovations (Phila) ; 9(5): 388-90, 2014.
Article in English | MEDLINE | ID: mdl-25238426

ABSTRACT

The presence of partial anomalous pulmonary venous return and/or persistent left superior vena cava (LSVC) is usually viewed as a contraindication for robotic repair of complex atrial septal defects, such as those of the sinus venosus type. Three patients, aged 29, 73, and 23 years, successfully underwent totally endoscopic, robotic-assisted repair of sinus venosus-type atrial septal defect with partial anomalous pulmonary venous return and persistent LSVC. Two different techniques--direct cannulation or placement of a sump sucker--were successfully used to manage venous return from the persistent LSVC.


Subject(s)
Heart Septal Defects, Atrial/surgery , Pulmonary Veins/abnormalities , Robotic Surgical Procedures , Vena Cava, Superior/abnormalities , Adult , Aged , Endoscopy , Female , Humans , Male , Pericardium/transplantation , Young Adult
5.
Ann Thorac Surg ; 97(3): 782-7, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24266956

ABSTRACT

BACKGROUND: Robotic mitral valve repair has been successfully performed since the late 1990s, but concomitant robotic tricuspid repair has not yet been widely adopted. We report our first 5 years' experience with concomitant robotic mitral-tricuspid valve repair. METHODS: Records were reviewed for all patients who underwent concomitant robotic mitral-tricuspid valve repair in a single practice. Cardiopulmonary bypass was performed with femoral cannulation, antegrade and retrograde cardioplegia, and aortic cross-clamping by balloon occlusion. Access was through 5 ports. Tricuspid repair techniques included De Vega, modified De Vega with annuloplasty band, and annuloplasty band with interrupted suture repair. RESULTS: From August 2006 to December 2011, 50 patients underwent concomitant robotic mitral-tricuspid valve repair. The mean age was 73.4±9.3 years, and all patients had mitral or tricuspid regurgitation grades of 2+ or greater preoperatively. Cross-clamp and cardiopulmonary bypass times decreased significantly with surgeon experience. There were no conversions to sternotomy and one conversion to mitral valve replacement. Six patients required reexploration for bleeding or hemothorax, most of them early in the series. There were no infections, no intraoperative strokes, and no new-onset acute renal failure requiring dialysis. Two postoperative strokes resolved completely. Two patients experienced nitinol clip fracture and mitral ring dehiscence requiring reoperation. There were 2 early deaths. All patients had regurgitation grades of less than 2 at follow-up (p < 0.001). CONCLUSIONS: Combined robotic mitral-tricuspid valve repair can be performed safely and reproducibly, with acceptable early results. Long-term follow-up will be needed to establish this as an alternative to traditional sternotomy approaches.


Subject(s)
Mitral Valve Insufficiency/complications , Mitral Valve Insufficiency/surgery , Robotics , Tricuspid Valve Insufficiency/complications , Tricuspid Valve Insufficiency/surgery , Aged , Cardiac Surgical Procedures/methods , Female , Humans , Male , Retrospective Studies , Time Factors
SELECTION OF CITATIONS
SEARCH DETAIL
...