“Robotic assisted surgical myotomy in a 27-year-old man with myocardial bridging of the left anterior descending coronary artery.”
Bol Alima, M., F. Vanden Eynden, et al. (2010).
Interactive Cardiovascular and Thoracic Surgery.
Myocardial bridging (MB) is a frequent condition usually considered benign but it may be associated with myocardial ischemia. When bridging is symptomatic, therapeutic options are numerous and in the absence of guidelines all options are conceivable. This is a case of a 27-year-old man who benefited from a new surgical approach: myotomy for MB of the left anterior descending coronary artery with the help of left robotic thoracoscopy. Keywords: Myocardial bridging; Robotic surgery.
“A Cost-analysis Study of Robotic Versus Conventional Mitral Valve Repair.”
Kam, J. K., S. D. Cooray, et al. (2010).
Heart Lung and Circulation.
Background: Robotic mitral valve repair has been performed in Australia since 2004. The aim of this study was to perform a cost-analysis of robotic mitral valve repair (MVR) with direct comparison to conventional MVR surgery. Methods: All isolated MVRs performed within one metropolitan hospital network, between June 2005 and June 2008, were retrospectively compared. Ad hoc cost analysis was conducted. Results: There were 107 robotic and 40 conventional MVRs performed. The post-operative degrees of mitral regurgitation were comparable. Total operating time was 18% longer in robotic compared to conventional (239 min vs. 202 min, p < 0.001, 95% CI: 11-27%). In robotic, Intensive Care Unit stay was reduced by 19% (p = 0.002, 37 h vs. 45 h), and length of hospital stay was reduced by 26% (p < 0.001, 6.47 days vs. 8.76 days). Mean hospital cost, without including capital costs, was not significantly increased (AUD$18,503 vs. AUD$17,880 p = 0.176, 95% CI: -282 to 1,530). Conclusions: Robotic mitral repair can be performed with similar immediate repair success rates as conventional surgery with a shorter recovery time, but a slightly longer operative time. There is no significant increase in cost over conventional surgery. Crown Copyright © 2010.
“A novel running annuloplasty suture technique for robotically assisted mitral valve repair.”
Mihaljevic, T., C. M. Jarrett, et al. (2010).
Journal of Thoracic and Cardiovascular Surgery 139(5): 1343-1344.
“Hybrid myocardial revascularization: An integrated approach to coronary revascularization.”
Popma, J. J., S. Nathan, et al. (2010).
Catheterization and Cardiovascular Interventions 75(SUPPL. 1).
Coronary artery bypass surgery is beneficial in patients with complex coronary artery disease. The longevity of the left internal mammary artery (LIMA) placed to the left anterior descending (LAD) artery (LIMA-LAD) is between 92-99% at 15 years, and contributes substantially to the survival advantage in patients treated with surgical revascularization. The long-term patency of saphenous vein grafts (SVGs), commonly used (>95%) in surgical revascularization procedures, is less well-established, with up to 26% of SVGs failing in the first year. In selected patients, particularly in those patients with vessels poorly suited to SVGs, hybrid myocardial revascularization (HMR) has been used, combining a minimally invasive approach to the LIMA-LAD with drug-eluting stent placement of the non-LAD vessels. The advantages and disadvantages of hybrid myocardial revascularization are reviewed in this report. © 2010 Wiley-Liss, Inc.
“Port-access surgery as elective approach for mitral valve operation in re-do procedures.”
Ricci, D., C. Pellegrini, et al. (2010).
European Journal of Cardio-Thoracic Surgery 37(4): 920-925.
Background: Re-do mitral valve procedures performed through median sternotomy carry substantial mortality and morbidity. To avoid complications of sternal re-entry and to provide adequate mitral valve exposure, antero-lateral thoracotomy has been suggested by some authors. Methods: From October 1997 to January 2007, 677 mitral valve operations have been performed in our centre using port-access video-assisted right mini-thoracotomy. Among these, 241 (35.6%) were performed on patients who had undergone one or more previous cardiac surgery procedures. Results: Mean cardio-pulmonary bypass time and endo-clamp time were 117 ± 46 min and 71 ± 31 min, respectively. Arterial cannulation was performed either on the ascending aorta, with the endo-direct cannula (112 patients, 46.5%), or peripherally with a femoral artery approach (129 patients, 53.5%). Conversion to median sternotomy was necessary in only two patients (0.8%) due to aortic dissection (one case) and left ventricle free wall rupture (one case). Median intensive care unit stay was 24 h, median mechanical ventilation time was 12 h; median hospital stay was 8 days. Bleeding requiring surgical revision occurred in 12 patients (4.9%). Hospital mortality was 4.9% (12/241 patients). Conclusions: Port-access video-assisted right mini-thoracotomy allows good results in a difficult subset of patients; it allows minimal adhesion dissection, short ICU and hospital stay. In our practice, this technique has become the treatment of choice for mitral valve re-do surgery. © 2009 European Association for Cardio-Thoracic Surgery.
“History of cardiac surgery in Belgium. Part III: Evolution from 1960 to the present day.”
Suy, R. (2010).
Acta Chirurgica Belgica 110(1): 120-133.