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Feasibility of analyzing circumflex artery anatomy by real time 3D transesophageal echocardiography compared to 3D reconstructed cardiac computed tomography
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Results.
ORAL ABSTRACT PRESENTATIONS
During the follow up the number of patients who developed moderate or severe mitral regurgitation was 9.1% in MI group vs 11.4% in MS group (p¼1). Conclusion. MI approach through thoracotomy is not inferior to MS in terms of in hospital morbidity and long term quality of surgical technique compared to conventional surgery in an initiating programme. OP-013
Discussion. It can be seen that both the pre-operative IgG antistaphylococcal antibodies and the IgG EndoCab are inversely related to the post-operative length of stay, independent of Euroscore predictions. This raises the question as to whether the antibodies are independently predictive of complications, form part of a battery of predictive antibodies or reflect a global immune hypo-responsiveness associated with a poor recovery profile. This warrants further investigation. REFERENCE 1. Hamilton-Davies C et al: Relationship between preoperative immune status, gut perfusion, and outcome following cardiac valve replacement surgery. Chest 112:1189-1196, 1997. OP-012 Minimally invasive mitral valve surgery through right thoracotomy is a safe and effective procedure in short and long term. A propensity score analysis Paula Carmona1, Alejandro Vazquez2, Eva Mateo1, Carlos Errando1, Sergio Cánovas3 1 Consorcio Hospital General Valencia, 2Hospital Politecnico La Fe, 3Hospital Universitario Virgen de la Arrixaca
Background. Minimally invasive (MI) mitral valve surgery has grown in popularity. Starting a minimal access mitral valve program is challenging. We sought to compare short term outcomes and long term quality of surgical technique of mitral valve surgery performed through a MI via right thoracotomy vs median sternotomy (MS) in a developing programme. Material and Method. From 2009 to 2013, 212 consecutive patients underwent mitral valve surgery. 44 by MI approach and 168 by MS. Patients receiving other concomitant procedures, emergent surgery and reoperations were excluded. A propensity score matching was performed to identify appropriate matched pair of patients between groups by building a binary logistic regression model with the main preoperative risk variables and comorbidities. Among other, data on major morbidity and quality of repair and replacement, defined as new onset of at least moderate regurgitation during follow up were collected. Results. Forty four patients were included in each group. Mean follow-up was 26.6 ⫾ 14.6 months for MI group and 28.4 ⫾ 1.1months for MS group, p ¼ 0.63 .There was no in hospital mortality. Mitral valve repair was performed in 70.5% patients in MI group vs 68.2% in the MS group and mitral replacement in 29.5% and 31.8% respectively. No statistically significant differences were found in major complications: Cardiovascular 0% vs 2.3%, neurological 0% vs 2.3%, renal 0% vs 2.3% in MI vs MS group respectively. Reoperation for bleeding was more frequent in MI group 6.8% vs 0% (p¼0.08). The incidence of pneumothorax and pleural effusion that required drainage occurred in 11.4% in the MI group vs 0% (p¼0.05) in the MS group.
Feasibility of analyzing circumflex artery anatomy by real time 3D transesophageal echocardiography compared to 3D reconstructed cardiac computed tomography Carmine Bevilacqua1, Sarah Eibel1, Borek Foldyna2, Lukas Lehmkuhl2, Matthias Gutberlet2, Chirojit Mukherjee1, Joerg Seeburger3, Joerg Ender1 1
Department of Anesthesiology, Heart Center Leipzig, Germany, Department of Radiology, Heart Center Leipzig, Germany, 3Department of Cardiothoracic Surgery, Heart Center Leipzig, Germany
2
Background & Aim. Iatrogenic injury of the circumflex artery (Cx) due to the close proximity to the mitral annulus might be a severe complication during mitral valve surgery. The aim of our study was to investigate the feasibility of measurement of the Cx in Real Time three dimensional transesophageal echocardiography (RT3D TEE) and to compare these measurements with data acquired from three dimensional reconstructions of the coronary arteries based on 128-row multidetector computed tomography (MDCT). Methods. After approval from the Ethics Committee we retrospectively analyzed RT3D TEE datasets as well as MDCT datasets of 10 patients that had previously undergone minimally invasive mitral valve surgery. The diameter of the Cx as well as the horizontal (x) and vertical (y) distance of the Cx from the mitral valve annulus were measured in predefined positions. The measurements from RT3D were then compared to the data derived from the MDCT. Results. The measurements for diameter of the Cx in RT3D varied from 1.1 to 3.4 mm and from 1 to 4 mm in MDCTD respectively. The horizontal distance of the Cx from the annulus in RT3D varied between 2.5 and 8.8 mm and in MDCTD between 5 and 11 mm respectively. The vertical distance of the Cx from the annulus varied between 0 and 8.1 mm (cranially to the annulus) in RT3D and between 0 and 11 mm in MDCTD respectively. The Bland-Altman analysis of the data showed good correlation. Conclusion. The results of our study show a good agreement between the measurements of the circumflex artery distances as acquired by RT3D TEE and MDCT imaging and encourage the the daily use in the intraoperative setting. This is an important landmark for the surgeon to avoid complications during mitral valve surgery.
Oral Abstract Presentations 302 Wednesday, June 24, 2015 12:00 p.m.–12:30 p.m., Room F2/F3 OP-020 Cerebral oxygen saturation in thoracic aortic surgery: a single centre prospective observational study in 215 patients Reto Basciani University Hospital Bern Background & Aim. Near-infrared spectroscopy (NIRS) monitoring of cerebral oxygen saturation has been shown to be useful during
Results.
ORAL ABSTRACT PRESENTATIONS
During the follow up the number of patients who developed moderate or severe mitral regurgitation was 9.1% in MI group vs 11.4% in MS group (p¼1). Conclusion. MI approach through thoracotomy is not inferior to MS in terms of in hospital morbidity and long term quality of surgical technique compared to conventional surgery in an initiating programme. OP-013
Discussion. It can be seen that both the pre-operative IgG antistaphylococcal antibodies and the IgG EndoCab are inversely related to the post-operative length of stay, independent of Euroscore predictions. This raises the question as to whether the antibodies are independently predictive of complications, form part of a battery of predictive antibodies or reflect a global immune hypo-responsiveness associated with a poor recovery profile. This warrants further investigation. REFERENCE 1. Hamilton-Davies C et al: Relationship between preoperative immune status, gut perfusion, and outcome following cardiac valve replacement surgery. Chest 112:1189-1196, 1997. OP-012 Minimally invasive mitral valve surgery through right thoracotomy is a safe and effective procedure in short and long term. A propensity score analysis Paula Carmona1, Alejandro Vazquez2, Eva Mateo1, Carlos Errando1, Sergio Cánovas3 1 Consorcio Hospital General Valencia, 2Hospital Politecnico La Fe, 3Hospital Universitario Virgen de la Arrixaca
Background. Minimally invasive (MI) mitral valve surgery has grown in popularity. Starting a minimal access mitral valve program is challenging. We sought to compare short term outcomes and long term quality of surgical technique of mitral valve surgery performed through a MI via right thoracotomy vs median sternotomy (MS) in a developing programme. Material and Method. From 2009 to 2013, 212 consecutive patients underwent mitral valve surgery. 44 by MI approach and 168 by MS. Patients receiving other concomitant procedures, emergent surgery and reoperations were excluded. A propensity score matching was performed to identify appropriate matched pair of patients between groups by building a binary logistic regression model with the main preoperative risk variables and comorbidities. Among other, data on major morbidity and quality of repair and replacement, defined as new onset of at least moderate regurgitation during follow up were collected. Results. Forty four patients were included in each group. Mean follow-up was 26.6 ⫾ 14.6 months for MI group and 28.4 ⫾ 1.1months for MS group, p ¼ 0.63 .There was no in hospital mortality. Mitral valve repair was performed in 70.5% patients in MI group vs 68.2% in the MS group and mitral replacement in 29.5% and 31.8% respectively. No statistically significant differences were found in major complications: Cardiovascular 0% vs 2.3%, neurological 0% vs 2.3%, renal 0% vs 2.3% in MI vs MS group respectively. Reoperation for bleeding was more frequent in MI group 6.8% vs 0% (p¼0.08). The incidence of pneumothorax and pleural effusion that required drainage occurred in 11.4% in the MI group vs 0% (p¼0.05) in the MS group.
Feasibility of analyzing circumflex artery anatomy by real time 3D transesophageal echocardiography compared to 3D reconstructed cardiac computed tomography Carmine Bevilacqua1, Sarah Eibel1, Borek Foldyna2, Lukas Lehmkuhl2, Matthias Gutberlet2, Chirojit Mukherjee1, Joerg Seeburger3, Joerg Ender1 1
Department of Anesthesiology, Heart Center Leipzig, Germany, Department of Radiology, Heart Center Leipzig, Germany, 3Department of Cardiothoracic Surgery, Heart Center Leipzig, Germany
2
Background & Aim. Iatrogenic injury of the circumflex artery (Cx) due to the close proximity to the mitral annulus might be a severe complication during mitral valve surgery. The aim of our study was to investigate the feasibility of measurement of the Cx in Real Time three dimensional transesophageal echocardiography (RT3D TEE) and to compare these measurements with data acquired from three dimensional reconstructions of the coronary arteries based on 128-row multidetector computed tomography (MDCT). Methods. After approval from the Ethics Committee we retrospectively analyzed RT3D TEE datasets as well as MDCT datasets of 10 patients that had previously undergone minimally invasive mitral valve surgery. The diameter of the Cx as well as the horizontal (x) and vertical (y) distance of the Cx from the mitral valve annulus were measured in predefined positions. The measurements from RT3D were then compared to the data derived from the MDCT. Results. The measurements for diameter of the Cx in RT3D varied from 1.1 to 3.4 mm and from 1 to 4 mm in MDCTD respectively. The horizontal distance of the Cx from the annulus in RT3D varied between 2.5 and 8.8 mm and in MDCTD between 5 and 11 mm respectively. The vertical distance of the Cx from the annulus varied between 0 and 8.1 mm (cranially to the annulus) in RT3D and between 0 and 11 mm in MDCTD respectively. The Bland-Altman analysis of the data showed good correlation. Conclusion. The results of our study show a good agreement between the measurements of the circumflex artery distances as acquired by RT3D TEE and MDCT imaging and encourage the the daily use in the intraoperative setting. This is an important landmark for the surgeon to avoid complications during mitral valve surgery.
Oral Abstract Presentations 302 Wednesday, June 24, 2015 12:00 p.m.–12:30 p.m., Room F2/F3 OP-020 Cerebral oxygen saturation in thoracic aortic surgery: a single centre prospective observational study in 215 patients Reto Basciani University Hospital Bern Background & Aim. Near-infrared spectroscopy (NIRS) monitoring of cerebral oxygen saturation has been shown to be useful during