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Minimally Invasive Heart Surgery

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 October 2024 | Viewed by 2905

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Special Issue Editor

Dr. Manuel Wilbring

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Guest Editor

Department of Cardiac Surgery, University Heart Center, Dresden, Germany
Interests: minimally invasive cardiac surgery; aortic surgery; LVAD surgery

Special Issue Information

Dear Colleagues,

We are experiencing an era of remarkable development in cardiac surgery, with TAVI setting the ball rolling around 20 years ago. Some might see the development over the past decade as a rivalry or a threat, but others might see it as an opportunity.

This external (percutaneous) pressure has translated into a profound change in everyday cardiac surgery.

Let us take aortic valve surgery as an example. Cosgrove and Rao published papers on minimally invasive procedures in the early 1990s, but there was little further development in the following 20 years because it was not required. In 2007, the year before the broader clinical implementation of TAVI, the proportion of minimally invasive aortic valve procedures was minor at less than 5%. It was only after TAVI’s use in aortic valve therapies began to increase that progress became necessary. The proportion of minimally invasive aortic valve surgeries was close to 40% in Germany in 2021. This emphasizes the potential of developments that have occurred in the last decade.

Today, there are many possibilities: risk-adjusted hybrid strategies; minimally invasive access routes for valve surgery; CABG, or even assisted surgery; less invasive cannulation and perfusion strategies; and patient-orientated individualized treatment concepts.

This Special Issue welcomes all innovative and future-orientated ideas, whether they are techniques, strategies or innovative conceptual approaches.

I am eager to receive your ideas for the advancement of future innovation.

Dr. Manuel Wilbring
Guest Editor

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Keywords

minimally invasive
aortic valve
mitral valve
hybrid approaches
techniques
strategies

Published Papers (3 papers)

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Research

10 pages, 616 KiB

Open AccessArticle

Combined Minimally Invasive Mitral Valve Surgery and Percutaneous Coronary Intervention: A Hybrid Concept for Patients with Mitral Valve and Coronary Pathologies

by Martín Moscoso-Ludueña, Maximilian Vondran, Marc Irqsusi, Holger Nef, Ardawan J. Rastan and Tamer Ghazy

J. Clin. Med. 2023, 12(17), 5553; https://doi.org/10.3390/jcm12175553 - 26 Aug 2023

Viewed by 733

Abstract

We evaluated the feasibility of hybrid percutaneous coronary intervention (PCI) and minimally invasive mitral valve surgery (MIMVS) in patients with concomitant coronary and mitral disease. Of 534 patients who underwent MIMVS at our institution between 2012 and 2018, those with combined mitral and single vessel coronary pathologies who underwent MIMVS and PCI were included. Patients were excluded if they had endocarditis or required emergency procedures. Preprocedural, procedural, and postprocedural data were retrospectively analyzed. In total, 10 patients (median age, 75 years; 7 males) with a median ejection fraction (EF) of 60% were included. Nine patients underwent PCI before and one after MIMVS. The success rate was 100% in both procedures. There were no postoperative myocardial infarctions or strokes. Two patients developed delirium and one required re-thoracotomy for bleeding. The median stay in intensive care and the hospital was 3 and 8 days, respectively. The 30-day survival rate was 100%. A hybrid PCI and MIMVS approach is feasible in patients with mitral valve and single vessel coronary disease. In combined pathologies, the revascularization strategy should be evaluated independent from the mitral valve pathology in the presence of MIMVS expertise. Extension of this recommendation to multivessel disease should be evaluated in future studies. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

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14 pages, 2643 KiB

Open AccessArticle

Minimally Invasive Isolated Aortic Valve Replacement in a Potential TAVI Cohort of Patients Aged ≥ 75 Years: A Propensity-Matched Analysis

by Ali Taghizadeh-Waghefi, Asen Petrov, Philipp Jatzke, Manuel Wilbring, Utz Kappert, Klaus Matschke, Konstantin Alexiou and Sebastian Arzt

J. Clin. Med. 2023, 12(15), 4963; https://doi.org/10.3390/jcm12154963 - 28 Jul 2023

Cited by 2 | Viewed by 721

Abstract

(1) Background and Objectives: Transcatheter aortic valve implantation is guideline-recommended from the age of 75. However, this European guideline recommendation is based on limited evidence, since no interaction between age and primary outcome has been found in guideline-stated references. This study aimed to compare the short-term outcomes of minimally invasive isolated aortic valve replacement in patients aged ≥ 75 with those of younger patients; (2) Patients and Methods: This retrospective cohort study included 1339 patients who underwent minimally invasive isolated aortic valve replacement at our facility between 2014 and 2022. This cohort was divided into two age-based groups: <75 and ≥75 years. Operative morbidity and mortality were compared between groups. Further analysis was performed using propensity score matching; (3) Results: After matching, 347 pairs of patients were included and analyzed. Despite the higher EuroSCORE II in the ≥75 group (2.2 ± 1.3% vs. 1.80 ± 1.34%, p ≤ 0.001), the 30-day mortality (1.4% vs. 1.2%; p = 0.90) and major adverse cardiac and cerebrovascular events, such as perioperative myocardial infarction (0.0% vs. 1.2%, p = 0.12) and stroke (1.4% vs. 2.6%, p = 0.06), were comparable between both treatment groups; (4) Conclusions: Minimally invasive aortic valve replacement is a safe treatment method for patients aged ≥ 75. Our results indicate that the unilateral cut-off of 75 years is not a limiting factor for performing minimally invasive aortic valve replacement. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

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14 pages, 6835 KiB

Open AccessArticle

Patient-Centred Outcomes after Totally Endoscopic Cardiac Surgery: One-Year Follow-Up

by Jade Claessens, Pieter Goris, Alaaddin Yilmaz, Silke Van Genechten, Marithé Claes, Loren Packlé, Maud Pierson, Jeroen Vandenbrande, Abdullah Kaya and Björn Stessel

J. Clin. Med. 2023, 12(13), 4406; https://doi.org/10.3390/jcm12134406 - 30 Jun 2023

Cited by 1 | Viewed by 990

Abstract

Patient-centred outcomes have grown in popularity over recent years in surgical care research. These patient-centred outcomes can be measured through the health-related quality of life (HRQL) without professional interpretations. In May 2022, a study regarding patient-centred outcomes up to 90 days postoperatively was published. Fourteen days after surgery, the HRQL decreased and returned to baseline levels after 30 days. Next, the HRQL significantly improved 90 days postoperatively. However, this study only focuses on a short-term follow-up of the patients. Hence, this follow-up study aims to assess the HRQL one year after totally endoscopic cardiac surgery. At baseline, 14, 30, and 90 days, and one year after surgery, the HRQL was evaluated using a 36-item short form and 5-dimensional European QoL questionnaires (EQ-5D). Using the 36-item short form questionnaire, a physical and mental component score is calculated. Over the period of one year, this physical and mental component score and the EQ-5D index value significantly improve. According to the visual analogue scale of the EQ-5D, patients score their health significantly higher one year postoperatively. In conclusion, after endoscopic cardiac surgery, the HRQL is significantly improved 90 days postoperatively and remains high one year afterward. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

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