ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Discussion
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Felger, J. E.
Right arrow Articles by Holbert, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Felger, J. E.
Right arrow Articles by Holbert, D.
Related Collections
Right arrow Valve disease

Ann Thorac Surg 2001;72:1203-1209
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Evolution of mitral valve surgery: toward a totally endoscopic approach

Jason E. Felger, MDa, W. Randolph Chitwood, Jr, MDa, L. Wiley Nifong, MDa, Don Holbert, PhDa

a Division of Cardiothoracic Surgery, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA

Address reprint requests to Dr Chitwood, Department of Surgery, Division of Cardiothoracic Surgery, Brody School of Medicine, East Carolina University, 600 Moye Blvd, Greenville, NC 27858
e-mail: chitwoodw{at}mail.ecu.edu

Presented at the Thirty-seventh Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 29–31, 2001.

Background. Our study evaluates a series of video-assisted minimally invasive mitral operations, showing safe progression toward totally endoscopic techniques.

Methods. Consecutive patients with isolated mitral valve disease underwent either manually directed (n = 55) or voice-activated robotically directed (n = 72) video-assisted mitral operations. Cold blood cardioplegia, a transthoracic aortic clamp, a 5-mm endoscope, and a 5-cm minithoracotomy were used. This video-assisted minimally invasive mitral operation cohort was compared with a previous sternotomy-based mitral operation cohort (n = 100).

Results. Group demographics, New York Heart Association classification, and cardiac function were similar. Repairs were performed in 61.8% manually directed (n = 34), 75.0% robotically directed (n = 54), and 54% sternotomy-based (N = 54) mitral operations. The robotically directed technique showed a significant decrease in blood loss, ventilator time, and hospitalization compared with the sternotomy-based technique. Manually directed mitral operations compared with robotically directed mitral operations had decreased arrest times (128.0 ± 4.5 minutes compared with 90.0 ± 4.6 minutes; p < 0.001) and decreased perfusion times (173.0 ± 5.7 minutes compared with 144.0 ± 4.6 minutes; p < 0.001). In the minimally invasive mitral operation cohort, complications included reexploration for bleeding (2.4%; n = 3) and one stroke (0.8%), whereas the 30-day mortality was 2.3% (n = 3).

Conclusions. Video-assisted mitral surgery provides safe and effective results when compared with conventional sternal approaches. These positive results show a safe and stepwise evolution toward a totally endoscopic mitral valve operation.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
R. M. Suri, H. V. Schaff, S. R. Meyer, and W. C. Hargrove III
Thoracoscopic versus open mitral valve repair: a propensity score analysis of early outcomes.
Ann. Thorac. Surg., October 1, 2009; 88(4): 1185 - 1190.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. Modi, E. Rodriguez, W. C. Hargrove III, A. Hassan, W. Y. Szeto, and W. R. Chitwood Jr.
Minimally invasive video-assisted mitral valve surgery: A 12-year, 2-center experience in 1178 patients.
J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1481 - 1487.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
E. Bean, G. Chanoit, S. Jernigan, G. Bolotin, J. Osborne, and G. Buckner
Evaluation of a novel atrial retractor for exposure of the mitral valve in a porcine model.
J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1492 - 1495.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
P. Modi, A. Hassan, and W. R. Chitwood Jr.
Minimally invasive mitral valve surgery: a systematic review and meta-analysis
Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 943 - 952.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. R. Chitwood Jr., E. Rodriguez, M. W.A. Chu, A. Hassan, T. B. Ferguson, P. W. Vos, and L. W. Nifong
Robotic mitral valve repairs in 300 patients: a single-center experience.
J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 436 - 441.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. F. Loulmet, N. C. Patel, J. M. Jennings, and V. A. Subramanian
Less Invasive Intracardiac Surgery Performed Without Aortic Clamping
Ann. Thorac. Surg., May 1, 2008; 85(5): 1551 - 1555.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
W. R. Chitwood Jr. and E. Rodriguez
Minimally Invasive and Robotic Mitral Valve Surgery
Card. Surg. Adult, January 1, 2008; 3(2008): 1079 - 1100.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
H. Jeanmart, F. P. Casselman, Y. De Grieck, I. Bakir, J. Coddens, L. Foubert, G. Van Vaerenbergh, Y. Vermeulen, and H. Vanermen
Avoiding vascular complications during minimally invasive, totally endoscopic intracardiac surgery
J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 1066 - 1070.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. A. Murphy, J. S. Miller, D. A. Langford, and A. B. Snyder
Endoscopic robotic mitral valve surgery
J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 776 - 781.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Folliguet, F. Vanhuyse, X. Constantino, M. Realli, and F. Laborde
Mitral valve repair robotic versus sternotomy
Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 362 - 366.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
L. W. Nifong, W.R. Chitwood, P.S. Pappas, C.R. Smith, M. Argenziano, V.A. Starnes, P.M. Shah, and for the Multi-center Robotic Mitral Repair Group
Robotic mitral valve surgery: A United States multicenter trial
J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1395 - 1404.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. R. Chitwood Jr
Current Status of Endoscopic and Robotic Mitral Valve Surgery
Ann. Thorac. Surg., June 1, 2005; 79(6): S2248 - S2253.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. Lapenna, L. Torracca, M. De Bonis, G. La Canna, G. Crescenzi, and O. Alfieri
Minimally Invasive Mitral Valve Repair in the Context of Barlow's Disease
Ann. Thorac. Surg., May 1, 2005; 79(5): 1496 - 1499.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. C. Reade, C. E. Bower, B. M. Bailey, D. M. Maziarz, S. Masroor, A. P. Kypson, L. W. Nifong, and W. R. Chitwood Jr
Robotic Mitral Valve Annuloplasty With Double-Arm Nitinol U-Clips
Ann. Thorac. Surg., April 1, 2005; 79(4): 1372 - 1376.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. C. Reade, J. O. Johnson, G. Bolotin, W. L. Freund Jr, N. L. Jenkins, C. E. Bower, S. Masroor, A. P. Kypson, L. W. Nifong, and W. R. Chitwood Jr
Combining Robotic Mitral Valve Repair and Microwave Atrial Fibrillation Ablation: Techniques and Initial Results
Ann. Thorac. Surg., February 1, 2005; 79(2): 480 - 484.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. R. Chitwood Jr
INVITED COMMENTARY
Ann. Thorac. Surg., February 1, 2005; 79(2): 490 - 491.
[Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
D. W. Miller, R. T. Schlinkert, and D. K. Schlinkert
Robot-Assisted Laparoscopic Cholecystectomy: Initial Mayo Clinic Scottsdale Experience
Mayo Clin. Proc., September 1, 2004; 79(9): 1132 - 1136.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. J. Tatooles, P. S. Pappas, P. J. Gordon, and M. S. Slaughter
Minimally invasive mitral valve repair using the da Vinci robotic system
Ann. Thorac. Surg., June 1, 2004; 77(6): 1978 - 1984.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
M. A Sobieski II, M. S Slaughter, D. E Hart, P. S Pappas, and A. J Tatooles
Peripheral cardiopulmonary bypass with modified assisted venous drainage and transthoracic aortic crossclamp: optimal management for robotic mitral valve repair
Perfusion, September 1, 2003; 18(5): 307 - 311.
[Abstract] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
G. Wimmer-Greinecker, S. Dogan, T. Aybek, M. F. Khan, S. Mierdl, C. Byhahn, and A. Moritz
Totally endoscopic atrial septal repair in adults with computer-enhanced telemanipulation
J. Thorac. Cardiovasc. Surg., August 1, 2003; 126(2): 465 - 468.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. W. Nifong, V. F. Chu, B. M. Bailey, D. M. Maziarz, V. L. Sorrell, D. Holbert, and W. R. Chitwood Jr
Robotic mitral valve repair: experience with the da Vinci system
Ann. Thorac. Surg., February 1, 2003; 75(2): 438 - 443.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
F. P. Casselman, S. V. Slycke, H. Dom, D. L. Lambrechts, Y. Vermeulen, and H. Vanermen
Endoscopic mitral valve repair: Feasible, reproducible, and durable
J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 273 - 282.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
A. M. Gillinov and D. M. Cosgrove III
Mitral Valve Repair
Card. Surg. Adult, January 1, 2003; 2(2003): 933 - 950.
[Full Text]

Home page
 Card Surg AdultHome page
W. R. Chitwood Jr. and L. W. Nifong
Minimally Invasive and Robotic Valve Surgery
Card. Surg. Adult, January 1, 2003; 2(2003): 1075 - 1092.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. R. Chitwood Jr
Developing and financing new technology
J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 223 - 230.
[Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
N. Trehan, Y. K Mishra, M. Sharma, S. Bazaz, Y. Mehta, K. K. Sharma, and S. Shrivastava
Robotically Controlled Video-Assisted Port-Access Mitral Valve Surgery
Asian Cardiovasc Thorac Ann, June 1, 2002; 10(2): 133 - 136.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 by The Society of Thoracic Surgeons.