Do statins slow the process of calcification of aortic tissue valves?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether statins slow the process of calcification of aortic tissue valves. Altogether 207 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question.

Epicardial radiofrequency ablation and aortic valve replacement through right mini-thoracotomy.

The Cobra Adhere XL (Estech, San Ramon, CA, USA) is a multiple-electrode, temperature-controlled, monopolar radiofrequency probe with a vacuum-assisted stabilization system. We describe a new technique for epicardial ablation of atrial fibrillation in patients undergoing aortic valve replacement through right mini-thoracotomy.

Surgical treatment of double and triple heart valve disease through a limited single-access right minithoracotomy.

Heart valve disease can be extensive and may include double (mitral-aortic, mitral-tricuspid), or triple (mitral, aortic, and tricuspid) valvular regurgitation. The surgical correction of significant valvular regurgitation usually consists of the repair or replacement of all valves affected by a pathologic process. The median full-length sternotomy still serves as a classic approach for single, double, and triple valve operations in most patients.

Hybrid repair of a Kommerell's diverticulum aneurysm.

Aneurysms of the right aortic arch with an aberrant left subclavian artery are rare. We report the case of a 77-year-old woman with a Kommerell's diverticulum aneurysm, who underwent a successful hybrid repair, combining surgical off-pump bypass of the aortic arch vessels followed by endovascular aneurysm repair.

A technique of an upper V-type ministernotomy in the second intercostal space.

Since cardiac surgeons found themselves able to offer a less invasive access to heart and great vessels, one of the first techniques to satisfy the tendency of minimizing the surgical trauma during general cardiac surgical procedure was a ministernotomy. In the current paper, we present the technique of V-type ministernotomy in the 2nd intercostal space, which has been employed in our department from June 2007 in 85 consecutive patients (mean age: 58+/-18 years); those operations consisted of the aortic valve replacement (AVR), surgery of the ascending aorta and epiaortic arterial segment.

A new vacuum-assisted probe for minimally invasive radiofrequency ablation.

Purpose: The Cobra Adhere XL (Estech, San Ramon, CA) is a multiple-electrode, temperature-controlled, monopolar radiofrequency probe with a vacuum-assisted stabilization system. We evaluated this new technology for epicardial ablation of atrial fibrillation in mitral valve patients through a right mini-thoracotomy.

Description: Between June and August 2008, 12 patients underwent minimal invasive surgery for mitral disease and ablation for atrial fibrillation with the Cobra Adhere XL (Estech).

Multiple recurrent periprosthetic leak after a mitral valve replacement in a 30-year-old man.

Partial detachment of intracardiac prosthesis is a common reality in cardiac surgical practice. Its identification and surgical correction can be very crucial for a patient, as well as for the surgeon. In this paper, we report a case of a 30-year-old man with partial detachment of mechanical mitral valve prosthesis.

Stentless aortic valve implantation in heavily calcified aorta.

Two male patients who underwent an aortic valve replacement are presented in this study. After assessment, an aortic valve stenosis was diagnosed in both patients, and a multislice computed tomography scan confirmed the heavily calcified aorta and severe aortic stenosis. The computed tomography scan demonstrated the huge calcium deposits and their distribution in detail.

Is a minimally invasive approach for re-operative mitral valve surgery superior to standard resternotomy?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is a minimally invasive approach superior to standard sternotomy for re-operative mitral valve surgery?'. Altogether 48 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question.

Triple heart valve surgery through a right antero-lateral minithoracotomy.

Triple valve surgery remains a complex intervention, with prolonged cardiopulmonary bypass (CPB) and cross-clamp times. A median sternotomy is the standard approach in the surgical treatment of multiple valve disease. In this report, we attempt to describe our approach for the correction of the triple heart valve disease through a right antero-lateral minithoracotomy, because avoiding sternotomy can bring less wound infections, faster recovery and a shorter hospital stay.

Minimally invasive mitral valve surgery through right thoracotomy in patients with patent coronary artery bypass grafts.

We report our institutional experience, with 25 consecutive patients with patent coronary artery bypass grafts (71.8+/-12.7 years), who underwent video-assisted minithoracotomic approach for mitral valve surgery.

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.