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Review
. 2013 Nov;5 Suppl 6(Suppl 6):S680-5.
doi: 10.3978/j.issn.2072-1439.2013.10.14.

Port Access (Thru-Port System) video-assisted mitral valve surgery

Ilaria Chirichilli  1 , Riccardo D'Ascoli, David Rose, Giacomo Frati, Ernesto Greco
Affiliations
Review

Port Access (Thru-Port System) video-assisted mitral valve surgery

Ilaria Chirichilli et al. J Thorac Dis. 2013 Nov.

Abstract

The aim of this review is to focus the attention on the "state of the art" of port-access and video-assisted mitral valve surgery appraising the results compared to the traditional approach, describing different technical strategies and analyzing how to avoid and manage its related complications concomitantly elucidating which procedure is associated with the most favorable risk-benefit and cost-benefit profile. Our default strategy is to use the minimally invasive approach combining video-assisted right mini-thoracotomy with endo-cardiopulmonary bypass and endo-aortic balloon occlusion (EBO) whenever possible. This choice is supported by the evidence that, after an initial learning curve, it is a safe and effective approach in terms of short- and long-term results, mainly for redo operations and even for elderly patients with moderately elevated peri-operative risk.

Keywords: Mitral valve; mitral valve repair; mitral valve replacement; port-access; videoscopy.

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Figures

Video 1
Video 1
Surgical procedure of mitral annuloplasty.
Figure 1
Figure 1
Skin incision (4-6 cm) performed in the right infra-mammary fold or just underneath the nipple in case of a male.
Figure 2
Figure 2
Set-up. (A) 10-mm Port in the third right intercostals space on the anterior axillaries line to position the 30°, 10-mm axial camera; (B) Working port; (C) CO2 insufflation line; (D) 30°, 10-mm axial camera; (E) 5-mm port in the fifth right intercostal space at the mid axillary line for atrial venting and pleural drainage tube.
Figure 3
Figure 3
(A) External clamp (Cygnet®; Novare); (B) Endo-aortic clamp (IntraClude®; Edwards Life Sciences).
Figure 4
Figure 4
Full HD Intra-operative view of the mitral valve.
See this image and copyright information in PMC

References

    1. Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet 2006;368:1005-11 - PubMed
    1. Prifti E, Frati G, Bonacchi M, et al. Accessory mitral valve tissue causing left ventricular outflow tract obstruction: case reports and literature review. J Heart Valve Dis 2001;10:774-8 - PubMed
    1. Pompili MF, Stevens JH, Burdon TA, et al. Port-access mitral valve replacement in dogs. J Thorac Cardiovasc Surg 1996;112:1268-74 - PubMed
    1. Mohr FW, Falk V, Diegeler A, et al. Minimally invasive port-access mitral valve surgery. J Thorac Cardiovasc Surg 1998;115:567-74; discussion 574-6 - PubMed
    1. Viganò M, Minzioni G, Spreafico P, et al. Minimally invasive surgery with the Port-Access method. Preliminary experience. G Ital Cardiol 1998;28:1225-9 - PubMed