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Anesthetic Considerations for Non-Robotic-and Robotic Minimally Invasive Mitral Valve Surgery

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Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery
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Abstract

Minimally invasive mitral valve surgery (MIMVS) presents suitable patients with a less invasive alternative to median sternotomy, with comparable mortality, repair success and durability. MIMVS and robotic assisted MIMVS encompasses various techniques, which require specific anesthetic management. This includes specific cannulation techniques and its monitoring as well as different techniques for one lung ventilation. The value of intra- and postoperative pain therapy will be discussed.

Finally, it is essential to be aware of procedure specific complications in order to limit their occurrence and to recognize and appropriately manage these when they occur.

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References

  1. Nagendran J, Catrip J, Losenno KL, Adams C, Kiaii B, Chu MW. Minimally invasive mitral repair surgery: why does controversy still persist? Expert Rev Cardiovasc Ther. 2017;15(1):15–24.

    Article  CAS  Google Scholar 

  2. Ailawadi G, Agnihotri AK, Mehall JR, Wolfe JA, Hummel BW, Fayers TM, et al. Minimally invasive mitral valve surgery I: patient selection, evaluation, and planning. Innovations (Phila). 2016;11(4):243–50.

    Article  Google Scholar 

  3. Falk V, Cheng DC, Martin J, Diegeler A, Folliguet TA, Nifong LW, et al. Minimally invasive versus open mitral valve surgery: a consensus statement of the international society of minimally invasive coronary surgery (ISMICS) 2010. Innovations (Phila). 2011;6(2):66–76.

    Article  Google Scholar 

  4. Cheng DC, Martin J, Lal A, Diegeler A, Folliguet TA, Nifong LW, et al. Minimally invasive versus conventional open mitral valve surgery: a meta-analysis and systematic review. Innovations (Phila). 2011;6(2):84–103.

    Article  Google Scholar 

  5. Kowalewski M, Malvindi PG, Suwalski P, Raffa GM, Pawliszak W, Perlinski D, et al. Clinical safety and effectiveness of Endoaortic as compared to transthoracic clamp for small thoracotomy mitral valve surgery: meta-analysis of observational studies. Ann Thorac Surg. 2017;103(2):676–86.

    Article  Google Scholar 

  6. Rehfeldt KH, Andre JV, Ritter MJ. Anesthetic considerations in robotic mitral valve surgery. Ann Cardiothorac Surg. 2017;6(1):47–53.

    Article  Google Scholar 

  7. Kottenberg-Assenmacher E, Kamler M, Peters J. Minimally invasive endoscopic port-access intracardiac surgery with one lung ventilation: impact on gas exchange and anaesthesia resources. Anaesthesia. 2007;62(3):231–8.

    Article  CAS  Google Scholar 

  8. Bernstein WK, Walker A. Anesthetic issues for robotic cardiac surgery. Ann Card Anaesth. 2015;18(1):58–68.

    Article  Google Scholar 

  9. Vernick W, Atluri P. Robotic and minimally invasive cardiac surgery. Anesthesiol Clin. 2013;31(2):299–320.

    Article  Google Scholar 

  10. Lehr EJ, Guy TS, Smith RL, Grossi EA, Shemin RJ, Rodriguez E, et al. Minimally invasive mitral valve surgery III: training and robotic-assisted approaches. Innovations (Phila). 2016;11(4):260–7.

    Article  Google Scholar 

  11. Chauhan S, Sukesan S. Anesthesia for robotic cardiac surgery: an amalgam of technology and skill. Ann Card Anaesth. 2010;13(2):169–75.

    Article  Google Scholar 

  12. Modolo NS, Modolo MP, Marton MA, Volpato E, Monteiro Arantes V, do Nascimento Junior P, et al. Intravenous versus inhalation anaesthesia for one-lung ventilation. Cochrane Database Syst Rev. 2013;7:CD006313.

    Google Scholar 

  13. Neuburger PJ, Ngai JY, Chacon MM, Luria B, Manrique-Espinel AM, Kline RP, et al. A prospective randomized study of paravertebral blockade in patients undergoing robotic mitral valve repair. J Cardiothorac Vasc Anesth. 2015;29(4):930–6.

    Article  Google Scholar 

  14. Mukherjee C, Koch E, Banusch J, Scholz M, Kaisers UX, Ender J. Intrathecal morphine is superior to intravenous PCA in patients undergoing minimally invasive cardiac surgery. Ann Card Anaesth. 2012;15(2):122–7.

    Article  Google Scholar 

  15. Wolfe JA, Malaisrie SC, Farivar RS, Khan JH, Hargrove WC, Moront MG, et al. Minimally invasive mitral valve surgery II: surgical technique and postoperative management. Innovations (Phila). 2016;11(4):251–9.

    Article  Google Scholar 

  16. Chan EY, Lumbao DM, Iribarne A, Easterwood R, Yang JY, Cheema FH, et al. Evolution of cannulation techniques for minimally invasive cardiac surgery: a 10-year journey. Innovations (Phila). 2012;7(1):9–14.

    Article  Google Scholar 

  17. Moss E, Halkos ME, Binongo JN, Murphy DA. Prevention of unilateral pulmonary edema complicating robotic mitral valve operations. Ann Thorac Surg. 2017;103(1):98–104.

    Article  Google Scholar 

  18. Bainbridge DT, Chu MW, Kiaii B, Cleland A, Murkin J. Percutaneous superior vena cava drainage during minimally invasive mitral valve surgery: a randomized, crossover study. J Cardiothorac Vasc Anesth. 2015;29(1):101–6.

    Article  Google Scholar 

  19. Ender J, Sgouropoulou S. Value of transesophageal echocardiography (TEE) guidance in minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2013;2(6):796–802.

    Google Scholar 

  20. Ender J, Selbach M, Borger MA, Krohmer E, Falk V, Kaisers UX, et al. Echocardiographic identification of iatrogenic injury of the circumflex artery during minimally invasive mitral valve repair. Ann Thorac Surg. 2010;89(6):1866–72.

    Article  Google Scholar 

  21. Neuburger PJ, Chacon MM, Luria BJ, Manrique-Espinel AM, Ngai JY, Grossi EA, et al. Does paravertebral blockade facilitate immediate extubation after totally endoscopic robotic mitral valve repair surgery? Innovations (Phila). 2015;10(2):96–100.

    Article  Google Scholar 

  22. Rodrigues ES, Lynch JJ, Suri RM, Burkhart HM, Li Z, Mauermann WJ, et al. Robotic mitral valve repair: a review of anesthetic management of the first 200 patients. J Cardiothorac Vasc Anesth. 2014;28(1):64–8.

    Article  Google Scholar 

  23. Cao C, Gupta S, Chandrakumar D, Nienaber TA, Indraratna P, Ang SC, et al. A meta-analysis of minimally invasive versus conventional mitral valve repair for patients with degenerative mitral disease. Ann Cardiothorac Surg. 2013;2(6):693–703.

    Google Scholar 

  24. Murzi M, Cerillo AG, Gasbarri T, Margaryan R, Kallushi E, Farneti P, et al. Antegrade and retrograde perfusion in minimally invasive mitral valve surgery with transthoracic aortic clamping: a single-institution experience with 1632 patients over 12 years. Interact Cardiovasc Thorac Surg. 2017;24(3):363–8.

    Google Scholar 

  25. Tutschka MP, Bainbridge D, Chu MW, Kiaii B, Jones PM. Unilateral postoperative pulmonary edema after minimally invasive cardiac surgical procedures: a case-control study. Ann Thorac Surg. 2015;99(1):115–22.

    Article  Google Scholar 

  26. Keyl C, Staier K, Pingpoh C, Pache G, Thoma M, Gunkel L, et al. Unilateral pulmonary oedema after minimally invasive cardiac surgery via right anterolateral minithoracotomy. Eur J Cardiothorac Surg. 2015;47(6):1097–102.

    Article  Google Scholar 

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Correspondence to J. Ender .

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Ackermann, M., Zakhary, W., Ender, J. (2021). Anesthetic Considerations for Non-Robotic-and Robotic Minimally Invasive Mitral Valve Surgery. In: Cheng, D.C., Martin, J., David, T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-47887-2_8

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  • DOI: https://doi.org/10.1007/978-3-030-47887-2_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47886-5

  • Online ISBN: 978-3-030-47887-2

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