Hybrid Approach in Acute and Chronic Aortic Disease.

The management of patients with aortic disease that involves the ascending aorta, the aortic arch, and the descending aorta represent a surgical challenge. Open surgical repair remains the gold standard for aortic arch pathologies. However, this operation requires a cardiopulmonary bypass and a period of profound hypothermia and circulatory arrest, which carries a substantial rate of mortality and morbidity.

Outcomes of Video-assisted Minimally Invasive Cardiac Myxoma Resection.

Background: Myxomas are the most frequent cardiac tumours. Their diagnosis requires prompt removal. In our centre, for valve surgery we use a minimally invasive approach.

Alternative incision sutureless aortic valve replacement: propensity matched comparison between partial sternotomy and right anterior minithoracotomy.

Background: Sutureless aortic valve prostheses have the potential to augment the adoption of alternative incision approaches for aortic valve replacement (AVR). Still, we lack the evidence on which surgical approach is best associated with sutureless AVR.

Methods: Data on 483 patients undergoing sutureless small incision AVR between 2010-2014 in two European institutions (207 with ministernotomy [MS] and 276 via right anterior minithoracotomy [RAMT]) have been retrospectively analyzed.

Hypothesis-free secretome analysis of thoracic aortic aneurysm reinforces the central role of TGF-β cascade in patients with bicuspid aortic valve.

Background: Ascending thoracic aortic aneurysm (ATAA) is a major cause of morbidity and mortality worldwide. The pathogenesis of medial degeneration of the aorta remains undefined. High-throughput secretome analysis by mass spectrometry may be useful to elucidate the molecular mechanisms involved in aneurysm formation as well as to identify biomarkers for early diagnosis or targets of therapy.

Early and long-term outcomes of minimally invasive mitral valve surgery through right minithoracotomy: a 10-year experience in 1604 patients.

Background: To report early and long-term outcomes of patients undergoing minimally invasive mitral valve surgery (MIMVS) through right mini-thoracotomy (RT) over a 10-year period.

Methods: From September 2003 to December 2013, a total of 1604 consecutive patients underwent MIMVS through RT.

Results: The mean age was 63 ± 13 years, 770 (48 %) patients were female and 218 (13.

Minimally invasive mitral valve repair through right minithoracotomy in the setting of degenerative mitral regurgitation: early outcomes and long-term follow-up.

Background: Mitral valve (MV) repair is the gold standard for the treatment of degenerative MV regurgitation. Recently, minimally invasive mitral valve surgery (MIMVS) has shown excellent postoperative outcomes compared with conventional surgery. The aim of our study is to report early and long-term outcomes of patients undergoing MIMVS through right mini-thoracotomy (RT) over an eight year period.

Right anterior minithoracotomy for aortic valve replacement: 10-year experience of a single center.

Objective: Minimally invasive aortic valve replacement (AVR) has been associated with several better outcomes over the standard full sternotomy approach. We revised our 10-year experience with right anterior minithoracotomy (RAMT) for AVR.

Methods: Between 2004 and 2014, a total of 593 patients (310 men; median age: 73.

Minimally invasive aortic valve replacement: 12-year single center experience.

Background: This study reports the single center experience on minimally invasive aortic valve replacement (MIAVR), performed through a right anterior minithoracotomy or ministernotomy (MS).

Methods: Eight hundred and fifty-three patients, who underwent MIAVR from 2002 to 2014, were retrospectively analyzed. Survival was evaluated using the Kaplan-Meier method.

Minimally invasive septal myectomy for the treatment of hypertrophic obstructive cardiomyopathy and intrinsic mitral valve disease.

Objective: Transaortic left ventricular septal myectomy described by Morrow is a classical procedure for the treatment of systolic anterior motion of the mitral apparatus associated with hypertrophic obstructive cardiomyopathy (HOCM). We aimed to review our results of transmitral septal myectomy and mitral valve repair/replacement in patients with intrinsic mitral valve disease associated with HOCM, operated on through a minimally invasive approach.

Methods: Between 2005 and 2014, 19 patients [7 men (37%); mean (SD) age, 69.

Sutureless aortic valve replacement for aortic incompetence.

Objective: Sutureless prostheses for surgical aortic valve replacement (AVR) are usually used in degenerative calcified aortic stenosis. Less is known on the application of sutureless prostheses for pure aortic incompetence.

Methods: Between 2011 and 2014, 442 patients were operated on with the Perceval aortic sutureless valve implant.

Full sternotomy versus right anterior minithoracotomy for isolated aortic valve replacement in octogenarians: a propensity-matched study †.

Objectives: Surgical aortic valve replacement (AVR) is increasingly performed in elderly patients with good perioperative outcomes and long-term survival, resulting in significant health-related quality-of-life benefits. This study aimed to evaluate the outcome of patients aged ≥ 80 years undergoing isolated AVR through a right anterior minithoracotomy (RAMT) and compare it with a full sternotomy (FS).

Methods: Two hundred and eighty-three elderly patients aged 80 years or more underwent isolated AVR between February 2001 and September 2013.

Perceval S sutureless aortic valve prosthesis implantation via a right anterior minithoracotomy.

The rapid development and refinement of techniques over the past decade have led to the realization that a minimally invasive approach enables aortic valve surgery to be performed with results, at the very least, equivalent to those of traditional (open) valve surgery done in experienced centres. Minimally invasive aortic valve replacement (MIAVR) has now evolved into a safe, efficient treatment option providing greater patient satisfaction and fewer complications. For rapidly ageing population of industrialized countries, aortic valve replacement (AVR) has become the most frequent heart valve surgery.

Root replacement with stentless Freestyle bioprostheses for active endocarditis: a single centre experience.

Objectives: Few studies have examined the use of stentless Freestyle bioprostheses in patients with active valve endocarditis (VE). The aim of this study was to evaluate outcomes of stentless Freestyle bioprostheses in patients undergoing full-root replacement.

Methods: From February 2000 to June 2010, 180 patients with VE underwent cardiac surgery at our institution, of which 71 (39.

Sutureless aortic valve replacement through a right minithoracotomy.

During the past decade, interest in the development of less-invasive cardiac valve surgery has undergone a steady increase, with many surgeons having supplanted full sternotomy with minimal-access incisions. While the minimally invasive approaches for the treatment of mitral disease have been standardized, the preferred route for aortic valve replacement (AVR) remains a matter of debate. Although AVR through a right minithoracotomy avoids opening the sternum, it does require a greater surgical ability and may be a challenging procedure, even for expert surgeons.

Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study.

Objective: Minimally invasive aortic valve surgery by way of a right anterior minithoracotomy has shown excellent results in terms of mortality, morbidities, and patient satisfaction. The aim of the present study was to compare minimally invasive aortic valve surgery by way of a right anterior minithoracotomy with conventional full sternotomy on early outcomes and midterm survival.

Methods: A retrospective, observational, cohort study was undertaken of prospectively collected data from 637 consecutive patients undergoing isolated aortic valve surgery from January 2005 to July 2010.

Evaluation of platelet count after isolated biological aortic valve replacement with Freedom Solo bioprosthesis.

Objective: The risk of thrombocytopenia in patients undergoing aortic valve replacement (AVR) with the Freedom Solo (FS) bioprosthesis is controversial. The aim of our study was to evaluate the postoperative evolution of platelet count and function after AVR in patients undergoing isolated biological AVR with FS.

Methods: Between May 2005 and June 2010, 322 patients underwent isolated biological AVR.

Might type A acute dissection repair with the addition of a frozen elephant trunk improve long-term survival compared to standard repair?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with an acute type A dissection (TAAD) is a frozen elephant trunk in addition to standard aortic dissection repair advantageous in terms of improved long-term mortality and closure of the distal false lumen? Altogether more than 138 papers were found using the reported search, of which six represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Minimally invasive mitral valve surgery via right minithoracotomy.

From early experience in cardiac surgery on the mitral valve, access was gained in different ways: through left and right antero-lateral extended thoracotomy for closed and correspondingly for open mitral commissurotomy, from right parasternal access with rib resection, and via median sternotomy. Median sternotomy remains the most common approach for mitral valve procedures, such as replacement or repair, allowing good visualisation, exposure and working field. Applying the largely spread access as median sternotomy, surgeons always wanted to overcome the necessity of large incisions, get a better surgical view, to dissect with better respect to structural integrity and have better aesthetic results.

Valve-sparing replacement of the noncoronary sinus of Valsalva in patients with a bicuspid aortic valve.

Progressive dilatation of the aortic root and ascending aorta is frequent in patients with bicuspid aortic valve, and isolated dilatation of the noncoronary sinus has been reported. We describe our technique for the selective replacement of the noncoronary sinus of Valsalva in patients with bicuspid aortic valve.

The double balloon cannula: a means to prevent backward flow of retrograde cardioplegia to the right atrium.

Retrograde cardioplegia (RC) delivery may result in suboptimal myocardial protection, due to leakage of cardioplegia to the right atrium. This study was undertaken to assess the efficacy of a double balloon cannula (DBC) occluding the coronary sinus ostium during RC. Fifteen patients were randomly assigned to receive RC via a conventional cannula or via the DBC.