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Less Invasive and Video-Assisted Mitral Surgery at a Crossroads
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Less Invasive and Video-Assisted Mitral Surgery at a Crossroads

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiac Surgery".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 3902

Special Issue Editor

Prof. Dr. Ernesto Greco

E-Mail Website
Guest Editor
Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
Interests: cardiac surgery; valvulopathy; aortic surgery; minimally invasive cardiac surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiac surgery has been the last of the surgical fields to adopt minimal invasive techniques. After the introduction of endoscopic techniques into general surgery in the late 1980s, and later into other surgical specialties such as gynecology and thoracic surgery, minimally invasive cardiac surgery began in the 1990s.

Heart surgery procedures are both complex and invasive. These later characteristics, over time, presented a problem in terms of transforming cardiac surgeries in minimally invasive procedures; however, as the same time, they also presented an opportunity and a motivation. Initial efforts concerned coronary artery bypass surgery. Currently, mainly other cardiac procedures are being achieved by minimally invasive approaches. These include mitral valve surgery, aortic valve replacement, and treatment of atrial fibrillation.

In recent years, minimally invasive mitral surgery has evolved to a point where it might be more beneficial than conventional procedures. These new approaches have improved both morbidity and mortality rates. Additionally, patient approval is greater due to superior cosmetic results, shorter hospitalization, and lesser restriction of physical activities and, consequently, decreased overall cost. The rapid progress in video-assisted surgery using 30° or 120° video scopes also with 3D technology accelerated the evolution of a minimally invasive approach to cardiac surgery that has now become a reality.

The debate continues concerning the role of less invasive surgery mitral surgery. Opponents of minimally invasive cardiac surgery point at an increased learning curve, prolonged operative times, and versatility to address complex mitral pathology. However, excellent results are currently being achieved in term of morbidity and mortality, in addition to outstanding long-term outcomes.

The aim of this Special Issue is to discuss and highlight topics and findings on less invasive and video-assisted mitral surgery with the most authoritative surgeons around the world. This may also be an opportunity for cardiac surgeons and cardiologists to provide their area of knowledge.

Prof. Dr. Ernesto Greco
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • videoscopy mitral surgery
  • micro-incision
  • minimally invasive mitral valve repair
  • invasiveness
  • video-assisted technology

Published Papers (2 papers)

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Research

16 pages, 1235 KiB  
Article
At the Crossroads of Minimally Invasive Mitral Valve Surgery—Benching Single Hospital Experience to a National Registry: A Plea for Risk Management Technology
by Riccardo Cocchieri, Bertus van de Wetering, Sjoerd van Tuijl, Iman Mousavi, Robert Riezebos and Bastian de Mol
J. Cardiovasc. Dev. Dis. 2022, 9(8), 261; https://doi.org/10.3390/jcdd9080261 - 11 Aug 2022
Cited by 2 | Viewed by 1485
Abstract
Almost 30 years after the first endoscopic mitral valve repair, Minimally Invasive Mitral Valve Surgery (MIMVS) has become the standard at many institutions due to optimal clinical results and fast recovery. The question that arises is can already good results be further improved [...] Read more.
Almost 30 years after the first endoscopic mitral valve repair, Minimally Invasive Mitral Valve Surgery (MIMVS) has become the standard at many institutions due to optimal clinical results and fast recovery. The question that arises is can already good results be further improved by an Institutional Risk Management Performance (IRMP) system in decreasing risks in minimally invasive mitral valve surgery (MIMVS)? As of yet, there are no reports on IRMP and learning systems in the literature. (2) Methods: We described and appraised our five-year single institutional experience with MIMVS in isolated valve surgery included in the Netherlands Heart Registry (NHR) and investigated root causes of high-impact complications. (3) Results: The 120-day and 12-month mortality were 1.1% and 1.9%, respectively, compared to the average of 4.3% and 5.3% reported in the NHR. The regurgitation rate was 1.4% compared to 5.2% nationwide. The few high-impact complications appeared not to be preventable. (4) Discussion: In MIMVS, freedom from major and minor complications is a strong indicator of an effective IRMP but remains concealed from physicians and patients, despite its relevance to shared decision making. Innovation adds to the complexity of MIMVS and challenges surgical competence. An IRMP system may detect and control new risks earlier. (5) Conclusion: An IRMP system contributes to an effective reduction of risks, pain and discomfort; provides relevant input for shared decision making; and warrants the safe introduction of new technology. Crossroads conclusions: investment in machine learning and AI for an effective IRMP system is recommended and the roles for commanding and operating surgeons should be considered. Full article
(This article belongs to the Special Issue Less Invasive and Video-Assisted Mitral Surgery at a Crossroads)
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9 pages, 415 KiB  
Article
A Propensity Score Analysis of Early and Long-Term Outcomes of Retrograde Arterial Perfusion for Endoscopic and Minimally Invasive Heart Valve Surgery in Both Young and Elderly Patients
by Hind Elhassan, Abdelrahman Abdelbar, Rebecca Taylor, Grzegorz Laskawski, Palanikumar Saravanan, Andrew Knowles and Joseph Zacharias
J. Cardiovasc. Dev. Dis. 2022, 9(2), 44; https://doi.org/10.3390/jcdd9020044 - 28 Jan 2022
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Abstract
(1) Background: Minimal invasive cardiac surgery via right anterolateral thoracotomy for heart valve surgery and other intracardiac procedures proven to have lower postoperative complications. We aim to compare the neurological complications and post-operative outcomes in two cohort groups as well as survival rates [...] Read more.
(1) Background: Minimal invasive cardiac surgery via right anterolateral thoracotomy for heart valve surgery and other intracardiac procedures proven to have lower postoperative complications. We aim to compare the neurological complications and post-operative outcomes in two cohort groups as well as survival rates up to 5 years postoperatively; (2) Methodology: Retrospective observational study for patients who had minimally invasive cardiac valve surgery with retrograde femoral arterial perfusion between 2007 and 2021 (n = 596) and the categorized patients into two groups based on their age (≥70 years old and below 70). Propensity match analysis was conducted. The primary endpoint consisted of major postoperative complications and the secondary endpoint was the long-term survival rate. (3) Results: There was no difference between the two groups in terms of postoperative outcomes. Patients ≥ 70 years old had no increased risk for neurological complications (p = 0.75) compared with those below 70 years old. The mortality rate was also not significant between the two groups (p = 0.37) as well as the crude survival rates. (4) Conclusions: The use of retrograde femoral arterial perfusion in elderly patients is not associated with increased risk compared to the younger patients’ group for a spectrum of primary cardiac valve procedures. Hence, minimally invasive approaches could be offered to elderly patients who might benefit from it. Full article
(This article belongs to the Special Issue Less Invasive and Video-Assisted Mitral Surgery at a Crossroads)
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