International Perfusion Association

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IPA

Category: Valve

Robo MVR

A Historical Perspective and Update on Robotic Mitral Valve Surgery

This study reviews the evolution of minimally invasive mitral valve repair, emphasizing the use of robotic platforms from 2005 to 2023. Analyzing 1,412 robotic repairs, it highlights improvements in outcomes, including reduced cross-clamp and bypass times and high repair durability. Degenerative disease was the most common indication, with 98.1% repair success and a ten-year survival rate exceeding 91%. The findings support robotic surgery as a durable, teachable, and safe option for mitral valve repair.

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November 19, 2024
Surgery in Progress

New Approach to the Mitral Valve Through the Left Anterior Minithoracotomy for Combined Valve and Coronary Surgical Procedures

A new technique for accessing the mitral valve via the left anterior minithoracotomy has been developed for patients requiring both mitral valve surgery and coronary artery bypass grafting. From October 2020 to September 2022, 24 patients underwent this procedure, which involved specialized exposure maneuvers and conventional surgical techniques. The approach proved successful with no need for conversion to sternotomy, no major complications, and no mortality within 30 days post-procedure.

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June 8, 2024
Valve Suture

First Experiences with Automated Annular Suturing Device in Totally Endoscopic Aortic and Mitral Valve Replacement

This study investigates the early clinical outcomes of using an automated annular suturing device, the RAM® device, in endoscopic minimally invasive aortic and mitral valve replacement surgeries. Conducted between September 2020 and June 2023, the study involved 66 patients with an average age of 61.8 years. The results showed no intraoperative complications, no paravalvular leaks, and zero 30-day and in-hospital mortality, indicating the procedure’s safety and effectiveness. Larger studies are recommended to further evaluate the device’s efficacy.

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June 4, 2024
AVR 2

Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach

This study compares long-term outcomes between mini-sternotomy and full sternotomy approaches for valve-sparing aortic root reimplantation. The mini-sternotomy group had longer surgical times but similar in-hospital outcomes and shorter hospital stays compared to the full sternotomy group. Over a median follow-up of 5.5 years, survival rates were comparable, with no need for repeat interventions on the aortic valve. The mini-sternotomy approach shows promise for its potential advantages, including cosmetic outcomes.

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May 16, 2024
TAVR 2024

Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement

This study explores the prognostic implications of changes in cardiac damage following transcatheter aortic valve replacement (TAVR). Analyzing 1,863 patients from the SwissTAVI Registry, researchers found significant variations in cardiac damage stages pre- and post-TAVR, affecting long-term survival. Nearly half of the patients experienced changes in cardiac stage, highlighting the importance of cardiac damage evaluation for predicting outcomes after TAVR.

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April 30, 2024
Valve Suction

Development of Endocavitary Suction Device for MiECC on Minimally Invasive Mitral Valve Surgery

This paper introduces a new endocavitary suction device designed to enhance minimally invasive extracorporeal circulation (MiECC) systems during mitral valve surgeries. By reducing blood contact with air and foreign surfaces, it aims to diminish the inflammatory response and improve biocompatibility. The device, coupled with the MiECC technique in minimally invasive mitral valve surgery (MIMVS), addresses limitations in endo-cavitary aspiration, aiming to eliminate gaseous micro-embolic activity and hemolysis while adjusting CO2 levels. This innovation could revolutionize cardiac chamber surgery by facilitating safer, less invasive procedures, ultimately improving patient outcomes and reducing healthcare costs.

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April 7, 2024
Valve Knot

Efficacy of Automated Fasteners Versus Hand-Tied Knots in Cardiac Surgery: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis compares the efficacy of COR-KNOT® automated fasteners to hand-tied knots in cardiac valve surgery. Analyzing data from 1,411 participants across eight observational studies and two randomized controlled trials, the findings indicate that COR-KNOT significantly reduces aortic cross-clamp (AXT) and cardiopulmonary bypass (CPB) times, as well as the incidences of valvular regurgitation and need for prolonged ventilatory support, without negatively impacting mortality, atrial fibrillation, left ventricular ejection fraction, or renal failure rates. These results support the use of COR-KNOT devices in cardiac surgery to enhance surgical efficiency and patient outcomes.

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March 17, 2024
Redo AVR

Recent Outcomes of Surgical Redo Aortic Valve Replacement in Prosthetic Valve Failure

This study analyzed the clinical outcomes of redo surgical aortic valve replacement (AVR) for prosthetic valve failure from 2010 to 2021 across four tertiary centers, involving 324 patients. The primary focus was on operative mortality, with secondary outcomes including overall survival, cardiac death, and aortic valve-related events. The findings revealed that redo AVR poses a relatively high risk, particularly in patients with endocarditis, resulting in a 4.6% overall operative mortality. However, for patients without endocarditis, the operative mortality decreased significantly to 2.5%. Risk factors identified for operative mortality included endocarditis, longer cardiopulmonary bypass time, and lower left ventricular ejection fraction. The study concludes that redo AVR offers excellent outcomes for patients without endocarditis, especially those with acceptable left ventricular ejection fraction.

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March 9, 2024
Valve AVR

Outcomes of Minimally Invasive Aortic Valve Replacement in Obese Patients: A Propensity-Matched Study

This study compared minimally invasive aortic valve replacement (MIAVR) to conventional approaches (CAVR) in 203 obese patients, using propensity-matched analysis to ensure comparability. Results indicated no significant difference in 30-day mortality rates, with MIAVR patients benefiting from faster extubation times, reduced need for continuous positive airway pressure therapy, and shorter ICU stays, though hospital stays were comparable. This suggests that MIAVR is a safe, effective option for obese patients, offering notable postoperative respiratory and recovery advantages.

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March 5, 2024
TAVR Valve

Right Anterior versus Right Transaxillary Access for Minimally Invasive Aortic Valve Replacement: A Propensity Matched Competitive Analysis

This study compares the procedural and clinical outcomes of two minimally invasive techniques for aortic valve replacement: right anterior thoracotomy (RAT-AVR) and transaxillary access (MICLATS-AVR). With a cohort of 918 patients, after propensity score matching, both methods showed comparable major adverse cardio-cerebral events, cardiopulmonary bypass, and aortic cross-clamp times. However, MICLATS-AVR patients had a significantly shorter hospital stay and lower rates of postoperative wound issues, suggesting MICLATS-AVR as a safe, efficient, and feasible alternative for aortic valve replacement.

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February 28, 2024
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