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Tan T, Wei P, Liu Y, Huang H, Zhuang J, Chen J, Liu J, Guo H. Safety and efficacy of two-port thoracoscopic aortic valve replacement. J Cardiothorac Surg 2023; 18:9. [PMID: 36611206 PMCID: PMC9824918 DOI: 10.1186/s13019-022-02086-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 12/11/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Pure aortic valve disease is common and has been treated with sternotomy aortic valve replacement for decades. Minimally invasive cardiac surgery has been widely used in atrioventricular valve lesions, but totally thoracoscopic aortic valve replacement has rarely been reported. METHOD The profiles of 9 patients who were diagnosed with severe aortic valve diseases and treated with two-port thoracoscopic aortic valve replacement between February 2021 and February 2022 were retrospectively reviewed. The clinical data, including baseline characteristics, operative data, postoperative complications, and short-term outcomes, were reported. RESULTS All nine patients successfully underwent two-port thoracoscopic aortic valve replacement, with a cardiopulmonary bypass time of 137.56 ± 27.99 min and an aortic cross-clamp time of 95.33 ± 17.96 min. Seven (77.78%) patients underwent mechanical valve replacement, and two (22.22%) patients underwent bioprosthetic valve replacement. Two (22.22%) patients underwent a concomitant aortic root enlargement procedure. There were no intraoperative or postoperative deaths. The incidence of procedural complications was 0%, while the results of ventilation time, intensive care unit stay length, blood transfusion, chest tube drainage, and kidney function were satisfactory. CONCLUSION Two-port thoracoscopic aortic valve replacement is a safe and effective surgical treatment option for carefully selected patients with pure aortic valve diseases.
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Affiliation(s)
- Tong Tan
- Shantou University Medical College, Shantou, China
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China
| | - Peijian Wei
- Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanjun Liu
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China
| | - Huanlei Huang
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China
| | - Jian Zhuang
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China
| | - Jimei Chen
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China
| | - Jian Liu
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China.
| | - Huiming Guo
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China.
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Geicu L, Busuttil O, D’Ostrevy N, Pernot M, Benali W, Labrousse L, Modine T. Updates on the Latest Surgical Approach of the Aortic Stenosis. J Clin Med 2021; 10:5140. [PMID: 34768660 PMCID: PMC8584939 DOI: 10.3390/jcm10215140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Over the last twenty years, we marked significant progresses in the field of tissue engineering and the development of new aortic valve structural and delivery systems. These continuous iterations on the field, have completely changed the surgical indications and approaches for AVR. Nowadays, therapeutic decisions are endorsed by international guidelines; however, new technical advances need a new integrated approach. The clinical scenarios issued from the interaction between the Guidelines and the newest approaches and technologies are regularly on debate by the Heart Team. We will present some of our most encountered situations and the pattern of our therapeutic decisions. To easily navigate through Guidelines and clinical scenarios, we reported in this review a simplified and easy to use Clinical decision-making algorithm that may be a valuable tool in our daily practice.
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Affiliation(s)
- Lucian Geicu
- Department of Cardiac Surgery, Montreal Heart Institute, Montreal University, Montreal, QC H1T 1C8, Canada; (L.G.); (W.B.)
| | - Olivier Busuttil
- Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de Bordeaux, CEDEX, 33604 Pessac, France; (O.B.); (M.P.); (L.L.)
| | - Nicolas D’Ostrevy
- Cardiac Surgery Department, CHU de Clermont Ferrand, 63003 Clermont Ferrand, France;
| | - Mathieu Pernot
- Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de Bordeaux, CEDEX, 33604 Pessac, France; (O.B.); (M.P.); (L.L.)
| | - Walid Benali
- Department of Cardiac Surgery, Montreal Heart Institute, Montreal University, Montreal, QC H1T 1C8, Canada; (L.G.); (W.B.)
| | - Louis Labrousse
- Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de Bordeaux, CEDEX, 33604 Pessac, France; (O.B.); (M.P.); (L.L.)
| | - Thomas Modine
- Unité Médico-Chirurgicale, Hôpital Haut Lévêque, CHU de Bordeaux, CEDEX, 33604 Pessac, France; (O.B.); (M.P.); (L.L.)
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Wiktorowicz A, Wit A, Dziewierz A, Rzeszutko L, Dudek D, Kleczynski P. Calcium Pattern Assessment in Patients with Severe Aortic Stenosis Via the Chou's 5-Steps Rule. Curr Pharm Des 2020; 25:3769-3775. [PMID: 31566130 DOI: 10.2174/1381612825666190930101258] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Progression of aortic valve calcifications (AVC) leads to aortic valve stenosis (AS). Importantly, the AVC degree has a great impact on AS progression, treatment selection and outcomes. Methods of AVC assessment do not provide accurate quantitative evaluation and analysis of calcium distribution and deposition in a repetitive manner. OBJECTIVE We aim to prepare a reliable tool for detailed AVC pattern analysis with quantitative parameters. METHODS We analyzed computed tomography (CT) scans of fifty patients with severe AS using a dedicated software based on MATLAB version R2017a (MathWorks, Natick, MA, USA) and ImageJ version 1.51 (NIH, USA) with the BoneJ plugin version 1.4.2 with a self-developed algorithm. RESULTS We listed unique parameters describing AVC and prepared 3D AVC models with color pointed calcium layer thickness in the stenotic aortic valve. These parameters were derived from CT-images in a semi-automated and repeatable manner. They were divided into morphometric, topological and textural parameters and may yield crucial information about the anatomy of the stenotic aortic valve. CONCLUSION In our study, we were able to obtain and define quantitative parameters for calcium assessment of the degenerated aortic valves. Whether the defined parameters are able to predict potential long-term outcomes after treatment, requires further investigation.
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Affiliation(s)
- Agata Wiktorowicz
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-501 Kopernika St. 17, Krakow, Poland
| | - Adrian Wit
- Faculty of Physics and Applied Computer Science, University of Science and Technology, Mickiewicza Ave. 30, 30-059 Krakow, Poland
| | - Artur Dziewierz
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-501 Kopernika St. 17, Krakow, Poland
| | - Lukasz Rzeszutko
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-501 Kopernika St. 17, Krakow, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-501 Kopernika St. 17, Krakow, Poland
| | - Pawel Kleczynski
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-501 Kopernika St. 17, Krakow, Poland
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