Minimally Invasive Aortic Valve Surgery

Minimally invasive aortic valve surgery by definition means performing procedures through alternative approaches without the need to divide the sternum completely. Even though this contributes towards lowering the mortality and morbidity of patients, minimally invasive techniques have to be tailored to the unique patient as well as surgeon characteristics. With the advancements made in invasive cardiology techniques, the line between invasive cardiology and minimally invasive cardiac surgery is becoming thinner and thinner. We are presenting state-of-the-art techniques and outcomes for surgical aortic valve replacement via upper mini-sternotomy or anterior right mini-thoracotomy. In addition, aortic valve repair and valve-sparing procedures through a minimally invasive approach are discussed

Left ventricular pseudoaneurysm following atrioventricular groove rupture after mitral valve replacement

Left ventricular pseudoaneurysm is a partial cardiac rupture, contained by the surrounding pericardium that maintains communication with the left ventricular lumen. Whereas most cases of left ventricular pseudoaneurysms are related to myocardial infarction (loss of myocardial integrity), only a handful are associated with valve surgery. We present a female patient, who was admitted for elective mitral valve replacement. After the implantation of the mechanical valve, we encountered a rupture of the atrioventricular groove. After 3 months, a left ventricular pseudoaneurysm was found and the patient was reoperated. The valve was explanted and the inspection of the annulus and previously implanted pericardial patch revealed a loosened stitch on the inferior (ventricular) side. The defect was reinforced with additional stitches and the valve was reimplanted. In conclusion, we report an unusual case with two serious complications after mitral valve replacement – atrioventricular groove rupture and left ventricular pseudoaneurysm

Veno-arterial extracorporeal membrane oxygenation for post-infarction ventricular septal defect in a low-volume center

Managing patients with post-ischaemic ventricular septal defects (VSD) and postcardiotomy cardiogenic shock can be extremely challenging in a low-volume cardiac surgery unit. We present a case of a 68-year-old patient who received veno-arterial extracorporeal membrane oxygenation support due to cardiogenic shock after VSD repair. The patient was successfully weaned off support after 86 h. In the postoperative period, mediastinitis occurred, and negative pressure wound therapy was instituted

Veno-arterial extracorporeal membrane oxygenation for post-infarction ventricular septal defect in a low-volume center

Managing patients with post-ischaemic ventricular septal defects (VSD) and postcardiotomy cardiogenic shock can be extremely challenging in a low-volume cardiac surgery unit. We present a case of a 68-year-old patient who received veno-arterial extracorporeal membrane oxygenation support due to cardiogenic shock after VSD repair. The patient was successfully weaned off support after 86 h. In the postoperative period, mediastinitis occurred, and negative pressure wound therapy was instituted