Bleeding in minimally invasive versus conventional aortic valve replacement.

Background: Observational studies have shown reduced perioperative bleeding in patients undergoing minimally invasive, compared with full sternotomy, aortic valve replacement. Data from randomized trials are conflicting.

Methods: This was a Swedish single center study where adult patients with aortic stenosis, 100 patients were randomly assigned in a 1:1 ratio to undergo either minimally invasive (ministernotomy) or full sternotomy aortic valve replacement.

Implementation of Sweden's first digi-physical hospital-at-home care model for high-acuity patients.

Aim: To evaluate Sweden's first implementation of a 24/7 high-acuity virtual in-patient ward through a digi-physical in-patient care (DPIPC) program, a hospital-at-home care model combining a virtual hospital-based medical command centre and in-person ambulating medical services functioning as an extension of the Department of Medicine at a secondary-level hospital in Stockholm.

Methods: A single-centre descriptive study where adult patients with acute medical illness requiring inpatient-level care were assessed for voluntary treatment in the DPIPC program as a substitute for traditional in-patient care. The primary outcome was patient satisfaction with care.

Routine use of percutaneous femoral cannulation in minimally invasive cardiac surgery.

Objectives: Large series of percutaneous femoral access for extracorporeal circulation in minimally invasive cardiac surgery (MICS) are scarcely reported.

Methods: This is a single-centre study describing the use of percutaneous femoral access in patients undergoing MICS via minithoracotomy. Femoral artery closure was performed with a plug-based closure device.

Reducing cardiac tamponade caused by temporary pacemaker perforation in transcatheter aortic valve replacement.

Background: Cardiac tamponade caused by temporary right ventricular (RV) pacemaker perforation is a rare but serious complication in transcatheter aortic valve replacement (TAVR).

Aims: To study the incidence of temporary pacemaker related cardiac tamponade in TAVR, and the relation to the type of pacemaker lead used in periprocedural temporary transvenous pacing.

Methods: A single center registry of transfemoral TAVRs in 2014-2020.

Percutaneous plug-based vascular closure device in 1000 consecutive transfemoral transcatheter aortic valve implantations.

Background: Arterial access-site related complications constitute a large proportion of adverse events related to cardiac interventions requiring large-bore devices and have significant implications on morbidity, mortality and hospital cost.

Aims: To evaluate the safety and effectiveness of a novel percutaneous plug-based vascular closure device (VCD) in 1000 consecutive patients undergoing transfemoral transcatheter aortic valve implantation (TAVI).

Methods: A single-center observational study evaluating a plug-based VCD (MANTA, Teleflex/Essential Medical Inc.

Percutaneous decannulation of extracorporeal membrane oxygenation using a plug-based closure device.

Background: There is limited experience of using the MANTA plug-based vascular closure device for percutaneous arterial closure of the femoral artery after venoarterial extracorporeal membrane oxygenation.

Objectives: To study femoral artery complications and need for subsequent vascular interventions after percutaneous decannulation of venoarterial extracorporeal membrane oxygenation (VA ECMO) using the MANTA plug-based vascular closure device.

Methods: We studied 34 consecutive patients who underwent percutaneous decannulation of VA ECMO using the MANTA device.

Percutaneous femoral cannulation and decannulation using a plug-based vascular closure device in minimally invasive cardiac surgery.

Minimally invasive cardiac surgery such as a mitral valve procedure requires femoral arterial cannulation for extracorporeal circulation. To avoid complications associated with surgical groin incisions, such as seromas and infections, percutaneous cannulation techniques can be used. This video tutorial illustrates percutaneous femoral cannulation and decannulation using a plug-based vascular closure device.

Minimally invasive versus sternotomy mitral valve surgery when initiating a minimally invasive programme.

Objectives: An increasing number of mitral valve operations are performed using minimally invasive procedures. The initiation of a minimally invasive mitral valve surgery programme constitutes a unique opportunity to study outcome differences in patients with similar characteristics operated on through a sternotomy versus a minimally invasive procedure. The goal of this study was to compare short-term outcomes of patients undergoing mitral valve surgery before versus those having surgery after the introduction of a minimally invasive programme.

Leaflet thickening and stent geometry in sutureless bioprosthetic aortic valves.

Underexpansion of transcatheter heart valves and the surgically implanted Perceval sutureless aortic valve bioprosthesis has been suggested as an underlying mechanism for hypo-attenuated leaflet thickening (HALT). This was a single-center prospective observational study that included 47 patients who underwent surgical aortic valve replacement with the Perceval sutureless bioprosthesis (LivaNova, London, United Kingdom) from 2012 to 2016 and were studied by four-dimensional cardiac computed tomography (CT). The association between overall and regional expansion and the prevalence of HALT was analyzed.

Percutaneous Vascular Closure Device in Minimally Invasive Mitral Valve Surgery.

Background: Minimally invasive mitral valve surgery requires femoral artery cannulation for extracorporeal circulation, predominantly performed through surgical cutdown. Surgical groin incision is frequently associated with complications such as seroma and infection. We evaluated the safety and efficacy of a percutaneous plug-based large-bore vascular closure device (VCD) for femoral artery closure in minimally invasive mitral valve surgery.

Minimally invasive mitral valve surgery is associated with a low rate of complications.

Minimally invasive mitral valve surgery is generally performed through a right minithoracotomy, in contrast to the traditional full median sternotomy approach. Minimally invasive mitral valve surgery is performed with increasing frequency, and by reducing surgical trauma, several observational studies suggest potential benefits with decreased bleeding and postoperative pain, reduced incidence of sternal wound infections, reduced length of hospital stay and shortened recovery period after surgery. In this review, we present an overview of mitral valve surgery, summarize the available evidence regarding the minimally invasive approach and report our experiences from introducing a minimally invasive mitral valve surgery programme at the Karolinska University Hospital in Stockholm, Sweden.

[Minimally invasive mitral valve surgery].

Minimally invasive mitral valve surgery Conventional mitral valve surgery is performed through a full median sternotomy. Minimal invasive mitral valve surgery was introduced in the mid 1990s and is performed through a right mini-thoracotomy. Minimal access mitral valve surgery has grown in popularity and by reducing surgical trauma potential benefits include decreased postoperative bleeding and pain, reduced incidence of sternal wound infections and shortened recovery period after surgery.