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Intervention: Nanotechnology in Reconstructive Intervention and Surgery
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Surgical robotics, especially magnetic telerobotic control of catheter tips, has made a significant impact on cardiothoracic surgery and catheterization procedures for cardiovascular surgery [194-196]. Remote image-guided magnetic catheter guidance systems have been used for mapping and ablative surgery to treat atrial fibrillation [196] and tachycardia conditions [197-200]. Robotic-assisted catheter surgery has been used extensively for mitral valve repair [201-203]. Robotic catheter guidance has been employed in minimally invasive surgery for coronary artery stenoses [204] and to facilitate navigation in septal ablation for hypertrophic obstructive cardiomyopathy [205], a condition in which the heart muscle thickens, associated with sudden cardiac death syndrome.
Coanda Effect in a Human Body
Published in Noor A. Ahmed, Coanda Effect, 2019
Mitral valve surgery remains the standard of care for patients with symptomatic severe mitral valve regurgitation. Recurrent mitral regurgitation following mitral valve repair is less common, occurring in 10–15% of patients during the first 10 years after surgery [55].
Mitral valve surgery: current status and future prospects of the minimally invasive approach
Published in Expert Review of Medical Devices, 2021
Karel M. Van Praet, Jörg Kempfert, Stephan Jacobs, Christof Stamm, Serdar Akansel, Markus Kofler, Simon H. Sündermann, Timo Z. Nazari Shafti, Katharina Jakobs, Stefan Holzendorf, Axel Unbehaun, Volkmar Falk
The gold standard for treating significant primary MR is native MV repair [11]. Mitral valve repair can be performed with excellent functional results, very few complications, short hospital stay, low perioperative rates of morbidity and mortality as well as excellent long-term outcomes and high patient satisfaction [2,12]. In comparison with patients receiving MV replacement for primary MR [4,13], those receiving MV repair have better short- and long-term outcomes. In functional MR [4,14], the optimal surgical technique is still controversial. In this case, MV repair using an undersized annuloplasty ring to restore leaflet coaptation and MV competence would be the preferred technique. Other means to support the repair by lifting the papillary muscles toward the annulus may be beneficial [15]. Valve replacement should be considered mainly in patients with known echocardiographic risk factors for residual or early recurrent MR [4,8], and when MV repair is not an option. MV replacement with preservation of the subvalvular apparatus should be preferred to maintain and support the atrio-ventricular coupling. In patients with ischemic functional MR, Acker et al [16]. observed no significant difference in LV reverse remodeling or survival at 12 months between patients who underwent MV repair and those who underwent MV replacement. Replacement provided a more durable correction of MR, but there was no significant between-group difference in clinical outcomes [16]. In their meta-analysis, Salmasi et al [17]. found that recurrence of MR was significantly higher in the MV repair group, as was the rate of reoperation. Although MV replacement for ischemic MR had a higher 30-day mortality rate compared with MV repair, repair was associated with a higher rate of MR recurrence and the need for reoperation. Valve replacement remains an attractive option for ischemic MR [17].
The role of robotic technology in minimally invasive surgery for mitral valve disease
Published in Expert Review of Medical Devices, 2021
Johannes Bonatti, Bob Kiaii, Cem Alhan, Stepan Cerny, Gianluca Torregrossa, Gianluigi Bisleri, Caroline Komlo, T. Sloane Guy
The vast array of surgical techniques for mitral valve repair which can be routinely offered via a sternotomy or minimally invasive non robotic approaches can also be performed with the aid of a robotic platform, although with appropriate modifications to facilitate the adoption of this approach.