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The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction

BACKGROUND: The reduction of RV function after cardiac surgery is a well-known phenomenon. It could persist up-to one year after the operation and often leads to an incomplete recovery at follow-up echocardiographic control. The aim of the present study is to analyze the impact of different modaliti...

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Autores principales: Zanobini, Marco, Loardi, Claudia, Poggio, Paolo, Tamborini, Gloria, Veglia, Fabrizio, Di Minno, Alessandro, Myasoedova, Veronika, Mammana, Liborio Francesco, Biondi, Raoul, Pepi, Mauro, Alamanni, Francesco, Saccocci, Matteo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987597/
https://www.ncbi.nlm.nih.gov/pubmed/29866151
http://dx.doi.org/10.1186/s13019-018-0726-5
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author Zanobini, Marco
Loardi, Claudia
Poggio, Paolo
Tamborini, Gloria
Veglia, Fabrizio
Di Minno, Alessandro
Myasoedova, Veronika
Mammana, Liborio Francesco
Biondi, Raoul
Pepi, Mauro
Alamanni, Francesco
Saccocci, Matteo
author_facet Zanobini, Marco
Loardi, Claudia
Poggio, Paolo
Tamborini, Gloria
Veglia, Fabrizio
Di Minno, Alessandro
Myasoedova, Veronika
Mammana, Liborio Francesco
Biondi, Raoul
Pepi, Mauro
Alamanni, Francesco
Saccocci, Matteo
author_sort Zanobini, Marco
collection PubMed
description BACKGROUND: The reduction of RV function after cardiac surgery is a well-known phenomenon. It could persist up-to one year after the operation and often leads to an incomplete recovery at follow-up echocardiographic control. The aim of the present study is to analyze the impact of different modalities of pericardial incision (lateral versus anterior) and of myocardial protection protocols (Buckberg versus Custodiol) onto postoperative RV dynamic by relating two- and three-dimensional echocardiographic parameters in patients undergoing mitral valve repair through minimally invasive or traditional surgery approach. METHODS: We have analyzed 44 consecutive patients with severe degenerative mitral regurgitation who underwent mitral reparation with different surgical approach and cardioplegia type: Group 1 (17 pts): sternotomy with Buckberg cardioplegia protocol; Group 2 (10 pts): sternotomy with Custodiol cardioplegia; Group 3 (17 pts): mini-invasive surgery with Custodiol cardioplegia. Two-dimensional transthoracic echocardiography was performed pre- and 6 months post-surgery to evaluate RV function by tricuspid annular plane systolic excursion (TAPSE). RESULTS: All patients underwent successful and uneventful. A postoperative TAPSE reduction was found in all groups. However, mini-invasive patients experienced a significant reduced variation versus traditional surgery. CONCLUSIONS: Mini-invasive mitral repair, with lateral incision of pericardium, reduces postoperative TAPSE fall, while cardioplegia protocol fails to have an impact onto longitudinal RV function. In our study, the RV seems to experience a clinically irrelevant geometrical modification too, whose entity appears to be less evident in case of lateral pericardial approach. These results could strengthen the use of minimally invasive approach also to preserve RV function.
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spelling pubmed-59875972018-07-10 The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction Zanobini, Marco Loardi, Claudia Poggio, Paolo Tamborini, Gloria Veglia, Fabrizio Di Minno, Alessandro Myasoedova, Veronika Mammana, Liborio Francesco Biondi, Raoul Pepi, Mauro Alamanni, Francesco Saccocci, Matteo J Cardiothorac Surg Research Article BACKGROUND: The reduction of RV function after cardiac surgery is a well-known phenomenon. It could persist up-to one year after the operation and often leads to an incomplete recovery at follow-up echocardiographic control. The aim of the present study is to analyze the impact of different modalities of pericardial incision (lateral versus anterior) and of myocardial protection protocols (Buckberg versus Custodiol) onto postoperative RV dynamic by relating two- and three-dimensional echocardiographic parameters in patients undergoing mitral valve repair through minimally invasive or traditional surgery approach. METHODS: We have analyzed 44 consecutive patients with severe degenerative mitral regurgitation who underwent mitral reparation with different surgical approach and cardioplegia type: Group 1 (17 pts): sternotomy with Buckberg cardioplegia protocol; Group 2 (10 pts): sternotomy with Custodiol cardioplegia; Group 3 (17 pts): mini-invasive surgery with Custodiol cardioplegia. Two-dimensional transthoracic echocardiography was performed pre- and 6 months post-surgery to evaluate RV function by tricuspid annular plane systolic excursion (TAPSE). RESULTS: All patients underwent successful and uneventful. A postoperative TAPSE reduction was found in all groups. However, mini-invasive patients experienced a significant reduced variation versus traditional surgery. CONCLUSIONS: Mini-invasive mitral repair, with lateral incision of pericardium, reduces postoperative TAPSE fall, while cardioplegia protocol fails to have an impact onto longitudinal RV function. In our study, the RV seems to experience a clinically irrelevant geometrical modification too, whose entity appears to be less evident in case of lateral pericardial approach. These results could strengthen the use of minimally invasive approach also to preserve RV function. BioMed Central 2018-06-05 /pmc/articles/PMC5987597/ /pubmed/29866151 http://dx.doi.org/10.1186/s13019-018-0726-5 Text en © The Author(s). 2018 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 Research Article
Zanobini, Marco
Loardi, Claudia
Poggio, Paolo
Tamborini, Gloria
Veglia, Fabrizio
Di Minno, Alessandro
Myasoedova, Veronika
Mammana, Liborio Francesco
Biondi, Raoul
Pepi, Mauro
Alamanni, Francesco
Saccocci, Matteo
The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
title The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
title_full The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
title_fullStr The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
title_full_unstemmed The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
title_short The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
title_sort impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987597/
https://www.ncbi.nlm.nih.gov/pubmed/29866151
http://dx.doi.org/10.1186/s13019-018-0726-5
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