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Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 23340

Special Issue Editor

Dr. Bart van Putte

E-Mail Website
Guest Editor
1. St. Antonius Heart Center, St. Antonius Hospital, Nieuwegein, The Netherlands
2. AMC Heart Center, Academic Medical Center, Amsterdam, The Netherlands
3. 2016+2020 European Society of Cardiology (ESC) Guideline Taskforce for Atrial Fibrillation
Interests: thoracoscopic ablation; minimally invasive mitral valve surgery; minimally invasive aortic valve surgery; experimental lung surgery

Special Issue Information

Dear Colleagues,

In this Special Issue, we aim to focus on the current status and future perspectives in cardiothoracic surgery. Historically, cardiothoracic surgery is associated with relatively high morbidity and mortality rates with a substantial impact on patients’ health status. Despite satisfying results for many different operations in this field, the number of cardiothoracic operations are not increasing as one might expect based on the results. Therefore, for many years collegues have been working to reduce the impact of major cadiothoracic surgery in order to limit surgery-related side effects and their (temporary) impact on quality of life. Part of innovative evolution focusses on minimal access surgery in which the operation remains unchanged while the acccess is reduced, like in minimally invasive valve surgery and robotic surgery. The other side of the innovative spectrum includes, for example, thoracoscopic ablation for the treatment of atrial fibrillation and endovascular treament of aortic disease. In these two fields, access is very limited but the operative solution to the disease itself has changed significantly. As a result of all these innovative efforts of numerous surgeons and investigators worldwide, different kinds of cardiothoracic operations have become available for a larger population. In this Special Issue, we would like to provide you with a comprehensive overview of the latest innovations in cardiothoracic surgery.

Dr. Bart van Putte
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Minimally invasive mitral valve surgery
  • Port access mitral valve surgery
  • Minimally invasive aortic valve surgery
  • Endovascular treatment
  • Thoracoscopic ablation
  • Robotic surgery

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Published Papers (6 papers)

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Research

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7 pages, 2512 KiB  
Article
Update on Pulmonary Ossifications in the Differential Diagnosis of Solitary Pulmonary Nodules
by Jan F. Gielis, Lawek Berzenji, Vasiliki Siozopoulou, Marloes Luijks and Paul E. Y. Van Schil
J. Clin. Med. 2021, 10(20), 4795; https://doi.org/10.3390/jcm10204795 - 19 Oct 2021
Cited by 4 | Viewed by 2023
Abstract
Pulmonary ossifications have often been regarded as rare, post-mortem findings without any clinical significance. We have investigated the occurrence of pulmonary ossifications in patients undergoing thoracic procedures, and how this may affect the differential diagnosis of solitary pulmonary nodules. In addition, we have [...] Read more.
Pulmonary ossifications have often been regarded as rare, post-mortem findings without any clinical significance. We have investigated the occurrence of pulmonary ossifications in patients undergoing thoracic procedures, and how this may affect the differential diagnosis of solitary pulmonary nodules. In addition, we have performed a literature search on the occurrence and possible pathogenesis of these ossifications. From January 2008 until August 2019, we identified pulmonary ossifications in 34 patients who underwent elective pulmonary surgery. Pre-operative imaging was unable to differentiate these ossifications from solid tumors. A definitive diagnosis was made by an experienced pathologist (VS, ML). The PubMed database was researched in December 2019 with the search terms “pulmonary ossifications”; “heterotopic ossifications”; and “solitary pulmonary nodule”. In total, 27 patients were male, with a mean age of 63 ± 12 years (age 41 to 82 on diagnosis). All lesions were identified on thoracic CT and marked for resection by a multidisciplinary team. A total of 17 patients were diagnosed with malignancy concurrent with ossifications. There was a clear predilection for the right lower lobe (12 cases, 35.3%) and most ossifications had a nodular form (70.6%). We could not identify a clear association with any other pathology, either cancerous or non-cancerous in origin. Oncologic or pulmonary comorbidities did not influence patient survival. Pulmonary ossifications are not as seldom as thought and are not just a curiosity finding by pathologists. These formations may be mistaken for a malignant space-occupying lesion, both pre-and perioperatively, as they are indistinguishable in imaging. We propose these ossifications as an underestimated addition to the differential diagnosis of a solitary pulmonary nodule. Full article
(This article belongs to the Special Issue Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status)
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Review

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12 pages, 4624 KiB  
Review
Decision Making during the Learning Curve of Minimally Invasive Mitral Valve Surgery: A Focused Review for the Starting Minimally Invasive Surgeon
by Kinsing Ko, Ad F. T. M. Verhagen, Thom L. de Kroon, Wim J. Morshuis and Leen A. F. M. van Garsse
J. Clin. Med. 2022, 11(20), 5993; https://doi.org/10.3390/jcm11205993 - 11 Oct 2022
Cited by 2 | Viewed by 2900
Abstract
Minimally invasive mitral valve surgery is evolving rapidly since the early 1990’s and is now increasingly adopted as the standard approach for mitral valve surgery. It has a long and challenging learning curve and there are many considerations regarding technique, planning and patient [...] Read more.
Minimally invasive mitral valve surgery is evolving rapidly since the early 1990’s and is now increasingly adopted as the standard approach for mitral valve surgery. It has a long and challenging learning curve and there are many considerations regarding technique, planning and patient selection when starting a minimally invasive program. In the current review, we provide an overview of all considerations and the decision-making process during the learning curve. Full article
(This article belongs to the Special Issue Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status)
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13 pages, 1734 KiB  
Review
State-of-the-Art Review: Technical and Imaging Considerations in Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for Ischemic Heart Failure
by Romy Roosmarijn Maria Jacqueline Josepha Hegeman, Martin John Swaans, Jan-Peter van Kuijk and Patrick Klein
J. Clin. Med. 2022, 11(16), 4831; https://doi.org/10.3390/jcm11164831 - 18 Aug 2022
Cited by 3 | Viewed by 1843
Abstract
Negative left ventricular (LV) remodeling consequent to acute myocardial infarction (AMI) is characterized by an increase in LV volumes in the presence of a depressed LVEF. In order to restore the shape, size, and function of the LV, operative treatment options to achieve [...] Read more.
Negative left ventricular (LV) remodeling consequent to acute myocardial infarction (AMI) is characterized by an increase in LV volumes in the presence of a depressed LVEF. In order to restore the shape, size, and function of the LV, operative treatment options to achieve volume reduction and shape reconstruction should be considered. In the past decade, conventional surgical LV reconstruction through a full median sternotomy has evolved towards a hybrid transcatheter and less invasive LV reconstruction. In order to perform a safe and effective hybrid LV reconstruction, thorough knowledge of the technical considerations and adequate use of multimodality imaging both pre- and intraoperatively are fundamental. In addition, a comprehensive understanding of the individual procedural steps from both a cardiological and surgical point of view is required. Full article
(This article belongs to the Special Issue Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status)
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10 pages, 18900 KiB  
Review
Minimally Invasive Sympathicotomy for Palmar Hyperhidrosis and Facial Blushing: Current Status and the Hyperhidrosis Expert Center Approach
by Michiel Kuijpers, Judith E. van Zanden, Petra W. Harms, Hubert E. Mungroop, Massimo A. Mariani, Theo J. Klinkenberg and Wobbe Bouma
J. Clin. Med. 2022, 11(3), 786; https://doi.org/10.3390/jcm11030786 - 31 Jan 2022
Cited by 6 | Viewed by 7550
Abstract
Hyperhidrosis, the medical term for excessive sweating beyond physiological need, is a condition with serious emotional and social consequences for affected patients. Symptoms usually appear in focal areas such as the feet, hands, axillae and face. Non-surgical treatment options such as topical antiperspirants [...] Read more.
Hyperhidrosis, the medical term for excessive sweating beyond physiological need, is a condition with serious emotional and social consequences for affected patients. Symptoms usually appear in focal areas such as the feet, hands, axillae and face. Non-surgical treatment options such as topical antiperspirants or systemic medications are usually offered as a first step of treatment, although these therapies are often ineffective, especially in severe and intolerable cases of hyperhidrosis. In the treatment algorithm for patients suffering from hyperhidrosis, surgical thoracoscopic sympathicotomy offers a permanent solution, which is particularly effective in the treatment of palmar hyperhidrosis and facial blushing. In this review, we describe the current status of thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing. In addition, we share the specific treatment approach, technique and results of our Hyperhidrosis Expert Center. Last, we share recommendations to ensure an effective, reproducible and safe application of single-port thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing, based on our extensive experience. Full article
(This article belongs to the Special Issue Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status)
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13 pages, 1264 KiB  
Review
Sutureless versus Hand-Sewn Coronary Anastomoses: A Systematic Review and Meta-Analysis
by Marieke Hoogewerf, Jeroen Schuurkamp, Johannes C. Kelder, Stephan Jacobs and Pieter A. Doevendans
J. Clin. Med. 2022, 11(3), 749; https://doi.org/10.3390/jcm11030749 - 29 Jan 2022
Cited by 2 | Viewed by 5269
Abstract
Background: Sutureless coronary anastomotic devices are intended to facilitate minimally invasive coronary artery bypass grafting (MICS-CABG) by easing and eventually standardizing the anastomotic technique. Within this systematic review and meta-analysis, we aim to determine patency and to evaluate safety outcomes for the sutureless [...] Read more.
Background: Sutureless coronary anastomotic devices are intended to facilitate minimally invasive coronary artery bypass grafting (MICS-CABG) by easing and eventually standardizing the anastomotic technique. Within this systematic review and meta-analysis, we aim to determine patency and to evaluate safety outcomes for the sutureless anastomoses. Methods: CENTRAL, MEDLINE, and EMBASE were searched from database start till August 2021 in a predefined search strategy combining the key concepts: ‘coronary artery bypass grafting’, ‘sutureless coronary anastomoses’, and ‘hand-sewn coronary anastomoses’ by the Boolean operation ‘AND’. Study characteristics, patient demographics, interventional details, and all available outcome data were extracted. A meta-analysis was performed on patency at longest follow-up. Safety outcomes were presented. Results: A total of eleven trials towards six sutureless anastomotic devices were included, comprising 3724 patients (490 sutureless and 3234 hand-sewn). There was no significant difference in patency at a mean follow-up duration of 546.3 (range 1.5–2691) days, with a risk ratio of 0.77 (95% CI 0.55–1.06). MACE was reported in 4.5% sutureless and 3.9% hand-sewn patients, including all-cause mortality (resp. 1.3 vs. 1.9%), myocardial infarction (resp. 1.6 vs. 1.7%), and coronary revascularization (resp. 1.8 vs. 0.5%). Incomplete hemostasis occurred in 24.8% of the sutureless anastomoses. Intra-operative device failure forced conversion to hand-sewn or redo-anastomosis in 5.8% of the sutureless cases. Conclusion: Based on the systematic review and meta-analysis including six devices, we conclude that sutureless coronary anastomotic devices appear safe and effective when used by well-trained and dedicated surgical teams. Full article
(This article belongs to the Special Issue Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status)
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17 pages, 3951 KiB  
Review
The Impact of Biomedical Engineering on the Development of Minimally Invasive Cardio-Thoracic Surgery
by Riccardo Cocchieri, Bertus van de Wetering, Marco Stijnen, Robert Riezebos and Bastian de Mol
J. Clin. Med. 2021, 10(17), 3877; https://doi.org/10.3390/jcm10173877 - 28 Aug 2021
Cited by 3 | Viewed by 2586
Abstract
(1) We describe the boundary conditions for minimally invasive cardiac surgery (MICS) with the aim to reduce procedure-related patient injury and discomfort. (2) The analysis of the MICS work process and its demand for improved tools and devices is followed by a description [...] Read more.
(1) We describe the boundary conditions for minimally invasive cardiac surgery (MICS) with the aim to reduce procedure-related patient injury and discomfort. (2) The analysis of the MICS work process and its demand for improved tools and devices is followed by a description of the relevant sub-specialties of bio-medical engineering: electronics, biomechanics, and materials sciences. (3) Innovations can represent a desired adaptation of an existing work process or a radical redesign of procedure and devices such as in transcutaneous procedures. Focused interaction between engineers, industry, and surgeons is always mandatory (i.e., a therapeutic alliance for addressing ‘unmet patient or professional needs’. (4) Novel techniques in MICS lean heavily on usability and safe and effective use in dedicated hands. Therefore, the use of training and simulation models should enable skills selection, a safe learning curve, and maintenance of proficiency. (5) The critical technical steps and cost–benefit trade-offs during the journey from invention to application will be explained. Business considerations such as time-to-market and returns on investment do shape the cost–benefit room for commercial use of technology. Proof of clinical safety and effectiveness by physicians remains important, but establishing the technical reliability of MICS tools and warranting appropriate surgical skills come first. Full article
(This article belongs to the Special Issue Minimally Invasive Approaches for Cardiovascular and Thoracic Surgery: The Current Status)
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