Minimally Invasive Mitral Valve Surgery: An Update

Hesham Alkady

doi:doi:10.11648/j.ijcts.20170305.11

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Minimally Invasive Mitral Valve Surgery: An Update

Hesham Alkady

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 3, Issue 5)

Received: 16 June 2017 Accepted: 27 September 2017 Published: 17 October 2017

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Abstract

Minimally invasive mitral valve surgery (MIMVS) was introduced in the mid-1990s to refer to a variety of surgical techniques that avoid full sternotomy through smaller or alternative chest wall incisions, as an attempt to reduce complications, but at the same time preserve outcomes of the full sternotomy approach. In this review, different aspects of MIMVS are discussed in relation to its approaches (right parasternal incision, lower ministernotomy, right anterolateral minithoracotomy and left posterior minithoracotomy) as well as strategies (mini-incisions, video-assistance, video direction with robotic assistance and telemanipulation) passing through more than 2 decades of continuous evolution. In the current practice MIMVS shows similar outcome to conventional surgery with even more superior results regarding blood loss, ICU and hospital stay, as well as functional recovery. The accumulating experience with MIMVS encouraged surgeons to extend the application of these techniques to high-risk patients, redo surgeries, concomitant double or triple valve procedures as well as combined coronary artery and mitral valve diseases in a hybrid approach, reducing the need for full median sternotomy. In addition there is an emerging trend of transcatheter valve implantation in the mitral position with small reports of valve-in valve or valve-in- ring implantation as well as valve replacement in case of severe MAC. This new trend may establish itself in the future as a modality in treating native mitral valve diseases in high risk patients. Therefore it is recommended for cardiac centers to build up a program for MIMVS in order to fulfill the recent requirements of cardiac surgery.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 3, Issue 5)
DOI	10.11648/j.ijcts.20170305.11
Page(s)	32-40
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Minimally Invasive Mitral Valve Surgery, Port Access, Totally Endoscopic Mitral Valve Surgery, Robotic Mitral Valve Surgery

References

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Hesham Alkady. (2017). Minimally Invasive Mitral Valve Surgery: An Update. International Journal of Cardiovascular and Thoracic Surgery, 3(5), 32-40. https://doi.org/10.11648/j.ijcts.20170305.11

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Hesham Alkady. Minimally Invasive Mitral Valve Surgery: An Update. Int. J. Cardiovasc. Thorac. Surg. 2017, 3(5), 32-40. doi: 10.11648/j.ijcts.20170305.11

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Hesham Alkady. Minimally Invasive Mitral Valve Surgery: An Update. Int J Cardiovasc Thorac Surg. 2017;3(5):32-40. doi: 10.11648/j.ijcts.20170305.11

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@article{10.11648/j.ijcts.20170305.11,
  author = {Hesham Alkady},
  title = {Minimally Invasive Mitral Valve Surgery: An Update},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {3},
  number = {5},
  pages = {32-40},
  doi = {10.11648/j.ijcts.20170305.11},
  url = {https://doi.org/10.11648/j.ijcts.20170305.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20170305.11},
  abstract = {Minimally invasive mitral valve surgery (MIMVS) was introduced in the mid-1990s to refer to a variety of surgical techniques that avoid full sternotomy through smaller or alternative chest wall incisions, as an attempt to reduce complications, but at the same time preserve outcomes of the full sternotomy approach. In this review, different aspects of MIMVS are discussed in relation to its approaches (right parasternal incision, lower ministernotomy, right anterolateral minithoracotomy and left posterior minithoracotomy) as well as strategies (mini-incisions, video-assistance, video direction with robotic assistance and telemanipulation) passing through more than 2 decades of continuous evolution. In the current practice MIMVS shows similar outcome to conventional surgery with even more superior results regarding blood loss, ICU and hospital stay, as well as functional recovery. The accumulating experience with MIMVS encouraged surgeons to extend the application of these techniques to high-risk patients, redo surgeries, concomitant double or triple valve procedures as well as combined coronary artery and mitral valve diseases in a hybrid approach, reducing the need for full median sternotomy. In addition there is an emerging trend of transcatheter valve implantation in the mitral position with small reports of valve-in valve or valve-in- ring implantation as well as valve replacement in case of severe MAC. This new trend may establish itself in the future as a modality in treating native mitral valve diseases in high risk patients. Therefore it is recommended for cardiac centers to build up a program for MIMVS in order to fulfill the recent requirements of cardiac surgery.},
 year = {2017}
}

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TY  - JOUR
T1  - Minimally Invasive Mitral Valve Surgery: An Update
AU  - Hesham Alkady
Y1  - 2017/10/17
PY  - 2017
N1  - https://doi.org/10.11648/j.ijcts.20170305.11
DO  - 10.11648/j.ijcts.20170305.11
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 32
EP  - 40
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20170305.11
AB  - Minimally invasive mitral valve surgery (MIMVS) was introduced in the mid-1990s to refer to a variety of surgical techniques that avoid full sternotomy through smaller or alternative chest wall incisions, as an attempt to reduce complications, but at the same time preserve outcomes of the full sternotomy approach. In this review, different aspects of MIMVS are discussed in relation to its approaches (right parasternal incision, lower ministernotomy, right anterolateral minithoracotomy and left posterior minithoracotomy) as well as strategies (mini-incisions, video-assistance, video direction with robotic assistance and telemanipulation) passing through more than 2 decades of continuous evolution. In the current practice MIMVS shows similar outcome to conventional surgery with even more superior results regarding blood loss, ICU and hospital stay, as well as functional recovery. The accumulating experience with MIMVS encouraged surgeons to extend the application of these techniques to high-risk patients, redo surgeries, concomitant double or triple valve procedures as well as combined coronary artery and mitral valve diseases in a hybrid approach, reducing the need for full median sternotomy. In addition there is an emerging trend of transcatheter valve implantation in the mitral position with small reports of valve-in valve or valve-in- ring implantation as well as valve replacement in case of severe MAC. This new trend may establish itself in the future as a modality in treating native mitral valve diseases in high risk patients. Therefore it is recommended for cardiac centers to build up a program for MIMVS in order to fulfill the recent requirements of cardiac surgery.
VL  - 3
IS  - 5
ER  -

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Author Information

Hesham Alkady

Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt

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Plain Text BibTeX RIS

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Hesham Alkady. (2017). Minimally Invasive Mitral Valve Surgery: An Update. International Journal of Cardiovascular and Thoracic Surgery, 3(5), 32-40. https://doi.org/10.11648/j.ijcts.20170305.11

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ACS Style

Hesham Alkady. Minimally Invasive Mitral Valve Surgery: An Update. Int. J. Cardiovasc. Thorac. Surg. 2017, 3(5), 32-40. doi: 10.11648/j.ijcts.20170305.11

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Hesham Alkady. Minimally Invasive Mitral Valve Surgery: An Update. Int J Cardiovasc Thorac Surg. 2017;3(5):32-40. doi: 10.11648/j.ijcts.20170305.11

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@article{10.11648/j.ijcts.20170305.11,
  author = {Hesham Alkady},
  title = {Minimally Invasive Mitral Valve Surgery: An Update},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {3},
  number = {5},
  pages = {32-40},
  doi = {10.11648/j.ijcts.20170305.11},
  url = {https://doi.org/10.11648/j.ijcts.20170305.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20170305.11},
  abstract = {Minimally invasive mitral valve surgery (MIMVS) was introduced in the mid-1990s to refer to a variety of surgical techniques that avoid full sternotomy through smaller or alternative chest wall incisions, as an attempt to reduce complications, but at the same time preserve outcomes of the full sternotomy approach. In this review, different aspects of MIMVS are discussed in relation to its approaches (right parasternal incision, lower ministernotomy, right anterolateral minithoracotomy and left posterior minithoracotomy) as well as strategies (mini-incisions, video-assistance, video direction with robotic assistance and telemanipulation) passing through more than 2 decades of continuous evolution. In the current practice MIMVS shows similar outcome to conventional surgery with even more superior results regarding blood loss, ICU and hospital stay, as well as functional recovery. The accumulating experience with MIMVS encouraged surgeons to extend the application of these techniques to high-risk patients, redo surgeries, concomitant double or triple valve procedures as well as combined coronary artery and mitral valve diseases in a hybrid approach, reducing the need for full median sternotomy. In addition there is an emerging trend of transcatheter valve implantation in the mitral position with small reports of valve-in valve or valve-in- ring implantation as well as valve replacement in case of severe MAC. This new trend may establish itself in the future as a modality in treating native mitral valve diseases in high risk patients. Therefore it is recommended for cardiac centers to build up a program for MIMVS in order to fulfill the recent requirements of cardiac surgery.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Minimally Invasive Mitral Valve Surgery: An Update
AU  - Hesham Alkady
Y1  - 2017/10/17
PY  - 2017
N1  - https://doi.org/10.11648/j.ijcts.20170305.11
DO  - 10.11648/j.ijcts.20170305.11
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 32
EP  - 40
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20170305.11
AB  - Minimally invasive mitral valve surgery (MIMVS) was introduced in the mid-1990s to refer to a variety of surgical techniques that avoid full sternotomy through smaller or alternative chest wall incisions, as an attempt to reduce complications, but at the same time preserve outcomes of the full sternotomy approach. In this review, different aspects of MIMVS are discussed in relation to its approaches (right parasternal incision, lower ministernotomy, right anterolateral minithoracotomy and left posterior minithoracotomy) as well as strategies (mini-incisions, video-assistance, video direction with robotic assistance and telemanipulation) passing through more than 2 decades of continuous evolution. In the current practice MIMVS shows similar outcome to conventional surgery with even more superior results regarding blood loss, ICU and hospital stay, as well as functional recovery. The accumulating experience with MIMVS encouraged surgeons to extend the application of these techniques to high-risk patients, redo surgeries, concomitant double or triple valve procedures as well as combined coronary artery and mitral valve diseases in a hybrid approach, reducing the need for full median sternotomy. In addition there is an emerging trend of transcatheter valve implantation in the mitral position with small reports of valve-in valve or valve-in- ring implantation as well as valve replacement in case of severe MAC. This new trend may establish itself in the future as a modality in treating native mitral valve diseases in high risk patients. Therefore it is recommended for cardiac centers to build up a program for MIMVS in order to fulfill the recent requirements of cardiac surgery.
VL  - 3
IS  - 5
ER  -

Copy | Download