There is an ever-growing trend towards less-invasive procedures in all fields of medicine. We designed an animal study to prove the concept that trans-apical aortic valve replacement from an incision within the umbilicus through a single channel for instruments is feasible, which would be a major leap towards no-scar cardiac surgery.
In three adult pigs, after creating a single 3-cm incision at a place where the human umbilicus would be, we introduced a 30F sheath through a tunnel created by an endoscopic vein-harvesting device up to the cardiac apex, through it and up to the left ventricle simulating the approach for trans-apical aortic valve replacement.
We used a standard Amplatz nitinol occluder to seal the defect in ventricle wall later. The animals were followed up for 1h. Blood loss was minimal, and no tamponade occurred in any of the animals.
In addition, we performed a test with water column static pressure to evaluate the impact of preclotting on the sealing properties of the occluders: 1min flow-through was 2860+/-176ml for the standard occluders and 348+/-56ml for preclotted occluders
"Towards no-scar cardiac surgery - minimally invasive access through umbilicus for aortic valve replacement."
Eur J Cardiothorac Surg. 2009 Jul 27; Kalejs M, Ferrari E, von Segesser LK
Related:
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In three adult pigs, after creating a single 3-cm incision at a place where the human umbilicus would be, we introduced a 30F sheath through a tunnel created by an endoscopic vein-harvesting device up to the cardiac apex, through it and up to the left ventricle simulating the approach for trans-apical aortic valve replacement.
We used a standard Amplatz nitinol occluder to seal the defect in ventricle wall later. The animals were followed up for 1h. Blood loss was minimal, and no tamponade occurred in any of the animals.
In addition, we performed a test with water column static pressure to evaluate the impact of preclotting on the sealing properties of the occluders: 1min flow-through was 2860+/-176ml for the standard occluders and 348+/-56ml for preclotted occluders
"Towards no-scar cardiac surgery - minimally invasive access through umbilicus for aortic valve replacement."
Eur J Cardiothorac Surg. 2009 Jul 27; Kalejs M, Ferrari E, von Segesser LK
Related:
Online cardiac surgery simulations for aspiring heart surgeons
Cooley & DeBakey - Cardiac Surgery Pioneers
State-of-the-Art Blood Management in Cardiac Surgery
PHC4 releases Cardiac Surgery in Pennsylvania
Cardiac Surgery: Safeguards and Pitfalls in Operative Technique
The heart of the matter: CARDIAC SURGERY, STANDARD OF CARE
Advanced Therapy in Cardiac Surgery | Science & Social Science ...
