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A systematic review of left ventricular cardio-endoscopic surgery

Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic...

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Autores principales: Soylu, Erdinc, Kidher, Emaddin, Ashrafian, Hutan, Stavridis, George, Harling, Leanne, Athanasiou, Thanos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445499/
https://www.ncbi.nlm.nih.gov/pubmed/28545585
http://dx.doi.org/10.1186/s13019-017-0599-z
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author Soylu, Erdinc
Kidher, Emaddin
Ashrafian, Hutan
Stavridis, George
Harling, Leanne
Athanasiou, Thanos
author_facet Soylu, Erdinc
Kidher, Emaddin
Ashrafian, Hutan
Stavridis, George
Harling, Leanne
Athanasiou, Thanos
author_sort Soylu, Erdinc
collection PubMed
description Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes. A systematic review of the literature identified 34 studies, incorporating 54 subjects undergoing treatment of left ventricular tumours, thrombus or hypertrophic myocardium using a cardio-endoscopic technique. There were no mortalities (0%; 0/47). In 12 studies, the follow-up period was longer than 30 days. There were no post-operative complications apart from one case of atrial fibrillation (2.2%; 1/46). Complete resection of left ventricular lesion was achieved in all cases (100%; 50/50). These successful results demonstrate that the cardio-endoscopic technique is a useful adjunct in resection of left ventricular tumours, thrombus and hypertrophic myocardium. This approach facilitates accurate resection of pathological tissue from left ventricle whilst avoiding exposure related valvular damage and adverse effects associated with ventriculotomy. Future research should focus on designing adequately powered comparative randomised trials focusing on major cardiac and cerebrovascular morbidity outcomes in both the short and long-term. In this way, we may have a more comprehensive picture of both the safety and efficacy of this technique and determine whether such devices could be safely adopted for routine use in minimal access or robotic intra-cardiac surgery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-017-0599-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-54454992017-05-30 A systematic review of left ventricular cardio-endoscopic surgery Soylu, Erdinc Kidher, Emaddin Ashrafian, Hutan Stavridis, George Harling, Leanne Athanasiou, Thanos J Cardiothorac Surg Review Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes. A systematic review of the literature identified 34 studies, incorporating 54 subjects undergoing treatment of left ventricular tumours, thrombus or hypertrophic myocardium using a cardio-endoscopic technique. There were no mortalities (0%; 0/47). In 12 studies, the follow-up period was longer than 30 days. There were no post-operative complications apart from one case of atrial fibrillation (2.2%; 1/46). Complete resection of left ventricular lesion was achieved in all cases (100%; 50/50). These successful results demonstrate that the cardio-endoscopic technique is a useful adjunct in resection of left ventricular tumours, thrombus and hypertrophic myocardium. This approach facilitates accurate resection of pathological tissue from left ventricle whilst avoiding exposure related valvular damage and adverse effects associated with ventriculotomy. Future research should focus on designing adequately powered comparative randomised trials focusing on major cardiac and cerebrovascular morbidity outcomes in both the short and long-term. In this way, we may have a more comprehensive picture of both the safety and efficacy of this technique and determine whether such devices could be safely adopted for routine use in minimal access or robotic intra-cardiac surgery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-017-0599-z) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-25 /pmc/articles/PMC5445499/ /pubmed/28545585 http://dx.doi.org/10.1186/s13019-017-0599-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Soylu, Erdinc
Kidher, Emaddin
Ashrafian, Hutan
Stavridis, George
Harling, Leanne
Athanasiou, Thanos
A systematic review of left ventricular cardio-endoscopic surgery
title A systematic review of left ventricular cardio-endoscopic surgery
title_full A systematic review of left ventricular cardio-endoscopic surgery
title_fullStr A systematic review of left ventricular cardio-endoscopic surgery
title_full_unstemmed A systematic review of left ventricular cardio-endoscopic surgery
title_short A systematic review of left ventricular cardio-endoscopic surgery
title_sort systematic review of left ventricular cardio-endoscopic surgery
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445499/
https://www.ncbi.nlm.nih.gov/pubmed/28545585
http://dx.doi.org/10.1186/s13019-017-0599-z
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