Journal article
Simplified myocardial protective strategy in minimally invasive aortic valve procedures: early clinical results
Chirurgia (Turin, Italy), Vol.29(3), pp.69-72
06/01/2016
Abstract
BACKGROUND: Minimally invasive aortic valve procedures via mini-sternotomy (mini-AVR) are gaining popularity. Myocardial protection in this setting may be provided by a variety of techniques including antegrade, direct antegrade, percutaneous retrograde, or retrograde through the operative field. Percutaneous techniques are time-consuming and potentially cumbersome. Herein we report the early clinical results of a simplified technique of myocardial protection.
METHODS: From 2013 to 2014, 25 patients underwent mini-AVR at our institution. Mini-AVR was performed via ministernotomy, direct aortic cannulation, femoral venous cannulation, and main pulmonary artery venting. Myocardial protection was provided by: 1) induction by infusion of blood cardioplegia ( 4: 1 blood/crystalloid) through the aortic root; 2) maintenance via direct cardioplegic infusion into the left coronary ostium; 3) intermittent infusion of cold blood in the left coronary ostium whenever possible, in between maintenance cardioplegic doses. Perioperative variables including changes in post-operative left ventricular ejection fraction (EF) were analyzed.
RESULTS: Of the 25 patients treated, 20 patients had aortic stenosis and 5 had aortic insufficiency. Patient demographics and relevant preoperative, operative, and postoperative clinical variables were analyzed. Post-operative left ventricular EF measurements were unchanged as compared to pre-operatively (P= 0.83). There were no mortalities or post-operative myocardial infarction.
CONCLUSIONS: Our findings in a limited cohort of patients undergoing mini-AVR via mini- sternotomy suggest that in selective patients with no concomitant coronary artery disease, this simplified strategy of induction and maintenance of myocardial protection is safe, and reproducible.
Details
- Title: Subtitle
- Simplified myocardial protective strategy in minimally invasive aortic valve procedures: early clinical results
- Creators
- Mohammed Hassan - Univ New Mexico, Hlth Sci Ctr, Dept Surg, Div Cardiothorac Surg, Albuquerque, NM 87131 USAAhmed Maraey - Tanta UniversityMarco Ricci - Univ New Mexico, Hlth Sci Ctr, Dept Surg, Div Cardiothorac Surg, Albuquerque, NM 87131 USA
- Resource Type
- Journal article
- Publication Details
- Chirurgia (Turin, Italy), Vol.29(3), pp.69-72
- Publisher
- Edizioni Minerva Medica
- ISSN
- 0394-9508
- eISSN
- 1827-1782
- Number of pages
- 4
- Language
- English
- Date published
- 06/01/2016
- Academic Unit
- Cardiothoracic Surgery
- Record Identifier
- 9984322804002771
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