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  • 1
    Online Resource
    Online Resource
    Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity
    Springer Science and Business Media LLC ; 2019
    In:  Journal of Cardiothoracic Surgery Vol. 14, No. 1 ( 2019-12)
    Details
    In: Journal of Cardiothoracic Surgery, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2019-12)
    Abstract: Limited aortic annulus exposure during minimal invasive aortic valve replacement (mini-AVR) proves to be challenging and contributes to procedure complexity, resulting in longer procedure times. New innovations like sutureless valves have been introduced to reduce procedure complexity. Additionally, preoperative imaging could also contribute to reducing procedure times. Therefore, we hypothesize that Computed Tomography (CT)-image based measurements are associated with mini-AVR complexity. Methods One hundred patients who underwent a mini-sternotomy and had a preoperative CT scan were included. With a CT-based mini-AVR planning tool, we measured access distance, access angle, annulus dimensions, and calcium volume. The associations of these measurements with cardiopulmonary bypass (CPB) time and aortic cross-clamp (AoX) time were assessed using univariable and multivariable regression models. In the multivariable models, these measurements were adjusted for age and suture technique. Results In the univariable regression models, calcium volume and annulus dimensions were associated with longer CPB and AoX time. After adjusting for age and suture technique, increasing calcium volume was still associated with longer CPB (adjusted β-coefficient 0.002, 95%-CI (0.005, 0.019), p -value = 0.002) and AoX time (adjusted β-coefficient 0.010, 95%-CI (0.004, 0.016), p -value = 0.002). However, after adjusting for these confounders, the association between annulus dimensions and procedure times lost statistical significance. Conclusion Increase in calcium volume are associated with longer CPB and AoX times, with age and sutureless valve implantation as independent confounders. In contrast to previous studies, access angle was not associated with procedure complexity.
    Type of Medium: Online Resource
    ISSN: 1749-8090
    URL: Article
    DOI: 10.1186/s13019-019-0997-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2227224-0
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  • 2
    Online Resource
    Online Resource
    Short-term outcome of the intuity rapid deployment prosthesis: a systematic review and meta-analysis
    Oxford University Press (OUP) ; 2020
    In:  Interactive CardioVascular and Thoracic Surgery Vol. 31, No. 4 ( 2020-10-01), p. 427-436
    Details
    In: Interactive CardioVascular and Thoracic Surgery, Oxford University Press (OUP), Vol. 31, No. 4 ( 2020-10-01), p. 427-436
    Abstract: OBJECTIVES Limited access aortic valve replacement is an alternative approach for the treatment of calcified aortic valve disease. To facilitate limited access aortic valve replacement, rapid deployment valve prostheses have been developed aiming to reduce surgical impact. This systematic review gives an overview of current literature regarding the INTUITY or INTUITY Elite rapid deployment biological valve prosthesis. Methods Cochrane, Embase and MEDLINE were searched to identify relevant studies. All studies reporting on patients who underwent isolated or combined surgical aortic valve replacement with the INTUITY or INTUITY Elite valve prosthesis were considered eligible. Primary end points were technical success rate, 30-day mortality, cerebrovascular accident, paravalvular leak and permanent pacemaker implantation. Secondary end points included procedural data such as aortic cross-clamping time, cardiopulmonary bypass time and procedural approach. Results A total of 16 articles fulfilled the inclusion and exclusion criteria and comprised 4.184 patients. Thirty-day mortality was 2.7% (1.9–3.7%), cerebrovascular accident 2.6% (1.4–4.7%), permanent pacemaker implantation 7.9% (6.6–9.5%) and severe postoperative paravalvular leak requiring a reintervention 3.3% (1.7–6.1%). Technical success rate varied between 93.9% and 100%. Conventional median sternotomy was most commonly performed, ranging from 21.7% to 89.6%. Upper hemi-sternotomy was performed more often than anterior right thoracotomy, ranging from 10.4% to 63.3% and 2.2% to 26.1%. The mean transvalvular pressure gradient ranged between 9.0 and 10.3 mmHg at 1 year postoperatively. Conclusions This review demonstrates that the technical success rate of the INTUITY or INTUITY Elite rapid deployment valve system is high, also in limited access aortic valve replacement. Mortality and cerebrovascular accident rates are low, but the need for postoperative permanent pacemaker implantation and reintervention rate for paravalvular leakage is increased.
    Type of Medium: Online Resource
    ISSN: 1569-9285
    URL: Article
    DOI: 10.1093/icvts/ivaa131
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2096257-5
    detail.hit.zdb_id: 3167862-2
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  • 3
    Online Resource
    Online Resource
    Thoracoscopic left atrial appendage clipping as novel treatment option for peri-device leakage
    Oxford University Press (OUP) ; 2018
    In:  EP Europace Vol. 20, No. 6 ( 2018-06-01), p. 955-955
    Details
    In: EP Europace, Oxford University Press (OUP), Vol. 20, No. 6 ( 2018-06-01), p. 955-955
    Type of Medium: Online Resource
    ISSN: 1099-5129 , 1532-2092
    URL: Article
    DOI: 10.1093/europace/eux377
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2002579-8
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