Project description:INTRODUCTION:Totally endoscopic mitral valve repair (TEMVR) is the highest level of minimally invasive cardiac surgery (MICS). It brings many benefits to patients but the downside is that a robotic system is always required. The deployment of robotic surgery is very complicated and expensive. Therefore, we improvised, making it possible to perform TEMVR without the aid of a robotic system. PRESENTATION OF CASE:A 66-year-old male patient presented with severe mitral valve regurgitation due to posterior leaflet prolapse. He was treated with TEMVR without robotic assistance. No chest incision was over 1.2 cm. The repair techniques included posterior leaflet resection and annuloplasty with ring implantation. DISCUSSION:A midline sternotomy is still the standard approach for mitral valve repair. In recent years, MICS has gradually replaced conventional surgery with the most advanced strategy being totally robotic mitral valve repair. However, complex surgical techniques and high cost make it less accessible for the majority of patients. Instead of using robot, we improved mitral valve exposure techniques, surgical port placement and therefore were able to perform TEMVR with MICS instruments. CONCLUSION:TEMVR without robotic assistance is a safe, effective and cost-efficient procedure, which can be adopted in most cardiac centers.

| S-EPMC7508683 | biostudies-literature

Totally endoscopic robotic mitral valve replacement after intraoperative failure of mitral valve repair with bilateral percutaneous cannulation.

Project description: Not available

| S-EPMC10751009 | biostudies-literature

Robotic mitral valve repair for papillary muscle rupture.

Project description: Not available

| S-EPMC9579726 | biostudies-literature

Totally endoscopic aortic valve replacement with concomitant trans-aortic mitral valve repair for mitral regurgitation.

Project description:BackgroundMinimally invasive aortic valve procedures through a hemi-sternotomy or a right anterior mini-thoracotomy have gained popularity over the last several years. Totally endoscopic aortic valve replacement (TEAVR) is an innovative and a less invasive (incision-wise) surgical aortic valve replacement technique. The operative steps of TEAVR have been reported previously from our group. Mitral regurgitation (MR) frequently accompanies aortic valve disease that at times may also require repair. Totally endoscopic surgery in such cases has not been tested.Presentation of the techniqueWe present a surgical technique for a totally endoscopic approach to aortic valve replacement and concomitant mitral valve repair for primary and secondary MR. An aortotomy incision was used avoiding an atriotomy, which results in an increase in cross-clamp (XC) and cardiopulmonary bypass (CPB) times that could be associated with higher mortality and morbidity. Neochords (artificial chordae tendineae) were used for primary MR and an edge-to-edge approach for secondary MR.ConclusionTEAVR and concomitant mitral valve repair can be performed successfully with reasonable XC and CPB times with excellent short-term results.

| S-EPMC8557064 | biostudies-literature

Totally endoscopic mitral valve repair using a three-dimensional endoscope system: initial clinical experience in Korea.

Project description:Background:The lack of depth perception is a significant challenge in two-dimensional (2D) video-assisted/directed minimally invasive cardiac surgery (MICS). Accordingly, restoration of stereoscopic vision is potentially beneficial, and we present a single center experience of a three-dimensional (3D) endoscope system in cardiac surgery without robotic assistance. Methods:We retrospectively reviewed the initial 40 consecutive patients who received totally endoscopic mitral valve (MV) repair using a 3D endoscope system between September 2017 and April 2019. The preoperative characteristics, operative data, and immediate postoperative outcomes, including echocardiographic results, were investigated. Results:In all the patients (n=40, 100%), successful MV repair using the standard repair techniques was achieved regardless of the location of the MV lesion as follows: anterior leaflet (n=8, 20.0%), posterior leaflet (n=15, 37.5%), and both leaflets (n=17, 42.5%). Concomitant tricuspid ring annuloplasty (n=9, 22.5%) and atrial fibrillation ablation (n=7, 17.5%) were performed. There was no mortality. One reoperation for bleeding occurred. One patient had a sternotomy conversion due to aortic dissection immediately after declamping. Postoperative mitral regurgitation (MR) grades were none or trace in 38 patients (95.0%) and mild in 2 patients (5.0%) on predischarge echocardiography. Conclusions:Totally endoscopic MV repair using a 3D endoscope system is technically feasible and safe on the basis of this initial experience.

| S-EPMC7138998 | biostudies-literature

A propensity matched comparison of robotic vs. traditional minimal access approach for mitral valve repair with concomitant cryoablation

Project description: Not available

| S-EPMC10797378 | biostudies-literature

Systematic review of robotic-assisted, totally endoscopic coronary artery bypass grafting.

Project description:BACKGROUND:Advancements in surgical robotic technology over the last two decades have enabled coronary artery bypass grafting to be performed totally endoscopically, and have the potential to significantly change clinical practice in the future. METHODS:A systematic review of studies reporting clinical outcomes of total endoscopic coronary artery bypass grafting (TECABG) was performed. RESULTS:14 appraised studies included 880 beating heart TECABGs, 360 arrested heart TECABGs, 633 one-vessel operations and 357 two-vessel operations. Patients were generally low-risk. There was a significant learning curve. The weighted means for short-term beating heart and arrested heart TECABG results respectively were: intraoperative exclusion rate of 5.7% and 1.9%, intraoperative conversion rate of 5.6% and 15.0%, all-cause mortality of 1.2% and 0.4%, stroke of 0.7% and 0.8%, myocardial infarction of 0.8% and 1.8%, new onset atrial fibrillation of 10.7% and 5.1% and post-operative reintervention rate of 2.6% and 2.3%. The overall rate of short term postoperative graft patency for beating heart and arrested heart TECABG was 98.3% and 96.4% respectively. CONCLUSIONS:Appropriate patient selection was important in minimizing the risk of intraoperative and postoperative complications. Short-term outcomes of both beating and arrested heart TECABG were acceptable, but results so far have been heterogeneous. There were fewer studies reporting intermediate to long-term outcomes, but results were encouraging, and further investigation and development of the procedure is warranted.

| S-EPMC3741883 | biostudies-literature

Totally endoscopic non-robotic excision of aortic valve fibroelastoma: a case report.

Project description:BackgroundPapillary fibroelastomas (PFEs) are a rare subtype of benign primary cardiac tumours, which are most commonly found on the aortic valve. Although median sternotomy is still used frequently there has been different attempts to remove the aortic valve PFEs minimally invasively using robotic and Mini sternotomy approach.Case presentationWe report herein a case of totally endoscopic non robotic removal of PFE of aortic valve.ConclusionsThe encouraging intra and post-operative outcomes and fast recovery using totally endoscopic approach for removal of PFE shows the potential benefits of this technique.

| S-EPMC9675282 | biostudies-literature

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