1
|
Xu K, Ma Z, Li B, Wang Z, Song H, Bai X, Meng X, Liu K, Zhao X. Totally thoracoscopic surgical resection of left ventricular benign tumor. JTCVS Tech 2023; 20:116-122. [PMID: 37555023 PMCID: PMC10405254 DOI: 10.1016/j.xjtc.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE The study objective was to explore the feasibility and safety of totally endoscopic resection of a left ventricular tumor through small chest incisions without robotic assistance. METHODS Four patients with a left ventricular tumor (1 papillary fibroelastoma, 1 lipoma, and 2 myxomas) underwent surgery with peripheral cardiopulmonary bypass. The mean age of patients was 58 ± 15 years. There were 3 female patients and 1 male patient. Through 3-port incisions in the right chest, pericardiotomy, bicaval cannulation, cardiac arrest, and atriotomy, left ventricular tumor resection was performed under thoracoscopy. RESULTS All patients had successful resections. The cardiopulmonary bypass and aortic crossclamp times were 110 ± 14 minutes and 58 ± 19 minutes, respectively. The length of stay in the intensive care unit was 38 ± 27 hours. There were no mortalities or complications in this cohort. Patients were discharged 7 days after the operation. Transthoracic echocardiography showed that the cardiac tumor was completely removed without any residue 3 months after surgery. CONCLUSIONS Totally endoscopic left ventricular tumor resection without a robotically assisted surgical system is feasible and reproducible. This technique could minimize surgical trauma and achieves complete tumor resection.
Collapse
Affiliation(s)
- Kai Xu
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Zengshan Ma
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Bowen Li
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Zhenhua Wang
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Han Song
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Xiao Bai
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Xiangbin Meng
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Kai Liu
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Xin Zhao
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| |
Collapse
|
2
|
Sun Z, Zhang Z, Wei S. Comparison between Different Tricuspid Valve Procedures through Postoperative Inflammation and Myocardial Enzymes. Braz J Cardiovasc Surg 2021; 36:212-218. [PMID: 33113321 PMCID: PMC8163275 DOI: 10.21470/1678-9741-2020-0158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Introduction The thoracoscopic procedure for tricuspid valve (TV) diseases is a minimally invasive method of treatment. This study focuses on comparing the changes in postoperative inflammatory reaction and myocardial injury markers after thoracoscopic and sternotomy/thoracotomy TV procedures. Methods We retrospectively analyzed 88 patients (53 males, aged 50.9±16.2 years) with TV diseases (single-valve disease) (72 cases of TV plasty) between January 2018 and April 2019. A total of 56 patients underwent thoracoscopic procedure (50 cases of TV plasty). The leukocyte and C-reactive protein (CRP) levels were monitored as indicators of systemic inflammatory reaction. The lactate dehydrogenase, creatine kinase, creatine kinase myocardial band, aspartate aminotransferase, and troponin-T levels were recorded as markers of myocardial injury. Results The CRP and white blood cells levels of patients in the sternotomy approach group were continuously higher than those in patients in the thoracoscopic approach group. And the levels of myocardial enzymes in patients in the thoracoscopic approach group were significantly lower than those in patients in the sternotomy approach group. Conclusion Compared with sternotomy/thoracotomy procedures on TV, the thoracoscopic procedure can reduce postoperative myocardial injury significantly and systemic inflammatory reaction to a certain extent. It is technically feasible, safe, effective, and worthy of widespread adoption in clinical practice.
Collapse
Affiliation(s)
- Zuoyong Sun
- Department of Cardiothoracic Surgery, Binzhou People's Hospital, Binzhou, Shandong, People's Republic of China
| | - Zhigang Zhang
- Department of Infectious Diseases, Binzhou People's Hospital, Binzhou, Shandong, People's Republic of China
| | - Shixiong Wei
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China
| |
Collapse
|
3
|
Cui H, Zhang L, Wei S, Li L, Ren T, Wang Y, Jiang S. Early clinical outcomes of thoracoscopic mitral valvuloplasty: a clinical experience of 100 consecutive cases. Cardiovasc Diagn Ther 2020; 10:841-848. [PMID: 32968639 DOI: 10.21037/cdt-20-440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background We reported our experience of 100 consecutive cases of thoracoscopic mitral valvuloplasty in the early period. Methods Between September 2017 and December 2019, 100 consecutive cases (aged 49.2±14.7 years; 56% male) of thoracoscopic mitral valvuloplasty had been completed in our institution. The safety and feasibility of this technique was evaluated by its early clinical outcomes. Results Mitral valve (MV) repair was performed by means of Carpentier techniques, including leaflet folding in 5 cases, cleft suture in 10, commissuroplasty in 15 including 2 commissurotomy, edge to edge in 1, artificial chordae implantation in 76 cases with an average of 2.5±1.6 (1 to 4) pairs, and prosthetic annuloplasty in all cases. Intraoperative transoesophageal echocardiography (TEE) revealed no mitral regurgitation (MR) in 95 cases and a mild in 2 cases with all coaptation length more than 5 mm. The rest 3 cases with moderate or more MR were successfully reconstructed during a second pump-run. The average cardiopulmonary bypass (CPB) time was 164.4±51.0 min and aortic clamping time was 119.7±39.1 min, and the latest 10 cases were 140.2±45.3 and 96.3±25.4 min, respectively (P<0.05). There was only one operative death from avulsion of left atrial suture after operation and 2 intraoperative re-exploration through a conversion to sternotomy for bleeding. Severe MR was observed in 2 patients 3 months after operation, and MV replacement (MVR) was performed through median sternotomy. Conclusions Totally thoracoscopic mitral valvuloplasty was technically feasible, safe, effective, and reproducible in clinical practice after crossing the learning curve.
Collapse
Affiliation(s)
- Huimin Cui
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lin Zhang
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Shixiong Wei
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lianggang Li
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Tong Ren
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yao Wang
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Shengli Jiang
- Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
4
|
Affiliation(s)
- Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan, University College of Medicine, Taipei 10002, Taiwan
| |
Collapse
|