PMID- 10451254
OWN - NLM
STAT- MEDLINE
DCOM- 19990916
LR  - 20191103
IS  - 1043-0679 (Print)
IS  - 1043-0679 (Linking)
VI  - 11
IP  - 3
DP  - 1999 Jul
TI  - Minimally invasive mitral valve surgery using three-dimensional video and robotic 
      assistance.
PG  - 235-43
AB  - Different techniques have been developed for the common goal to minimize surgical 
      trauma for mitral valve surgery. This article focuses on Port-Access (Heartport, 
      Inc, Redwood City, CA) mitral valve replacement or repair (PAMVR) with emphasis 
      on three-dimensional video and robotic assistance. PAMVR was undertaken using a 
      small right anterior minithoracotomy using an endovascular cardiopulmonary bypass 
      (CPB) system. A three-dimensional minicamera allowed visualization of the mitral 
      valve apparatus during this limited access surgery. The three-dimensional (3D) 
      image was displayed inside a helmet just above the real surgical image (VISTA 
      system [Vista, Inc, Westborough, MA]). In addition, the camera was attached to a 
      robotic arm (AESOP [Computer Motion, Inc, Goleta, CA]) that allows stabilization 
      and voice-activated movement of the camera. Fifty patients (16 men, 34 women), 
      aged 36 to 77 years (median, 61.5 years) underwent PAMVR. The underlying diseases 
      were mitral valve insufficiency (n = 36) and combined mitral valve disease (n = 
      14). With optimal visualization, mitral valve repair was performed in 26 patients 
      with quadrangular resection of the posterior leaflet (n = 26) and repair of the 
      anterior leaflet (n = 3) together with insertion of a posterior or complete 
      anuloplasty ring. The valve was replaced in 24 patients with a mechanical valve 
      prosthesis. Intraoperative and postoperative mortality was 0%. One patient (2%) 
      needed reoperation after a failed repair of an anterior leaflet prolaps. 
      Three-month follow-up was complete in 40 patients, with 34 patients (85%) in New 
      York Heart Association (NYHA) class I and 6 patients in class II. In conclusion, 
      using 3D video and robotic assistance, it was possible to minimize the length of 
      skin incision but at the same time to optimally visualize the whole mitral valve 
      apparatus to perform true Port-Access mitral valve surgery, including complex 
      repair techniques.
FAU - Reichenspurner, H
AU  - Reichenspurner H
AD  - Department of Cardiac Surgery, University Hospital Grosshadern, Munich, Germany.
FAU - Boehm, D
AU  - Boehm D
FAU - Reichart, B
AU  - Reichart B
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Semin Thorac Cardiovasc Surg
JT  - Seminars in thoracic and cardiovascular surgery
JID - 8917640
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Surgical Procedures/methods
MH  - Female
MH  - Heart Valve Diseases/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures
MH  - Mitral Valve/*surgery
MH  - Postoperative Complications
MH  - *Robotics
MH  - Treatment Outcome
MH  - Video Recording/methods
EDAT- 1999/08/18 00:00
MHDA- 1999/08/18 00:01
CRDT- 1999/08/18 00:00
PHST- 1999/08/18 00:00 [pubmed]
PHST- 1999/08/18 00:01 [medline]
PHST- 1999/08/18 00:00 [entrez]
AID - S104306799900026X [pii]
AID - 10.1016/s1043-0679(99)70064-x [doi]
PST - ppublish
SO  - Semin Thorac Cardiovasc Surg. 1999 Jul;11(3):235-43. doi: 
      10.1016/s1043-0679(99)70064-x.