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Article

Hypothermic Ventricular Fibrillation in Redo Minimally Invasive Mitral Valve Surgery: A Promising Solution for a Surgical Challenge

Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2024, 13(14), 4269; https://doi.org/10.3390/jcm13144269
Submission received: 6 June 2024 / Revised: 14 July 2024 / Accepted: 16 July 2024 / Published: 22 July 2024
(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

Abstract

Background: Minimally invasive mitral valve surgery (MIMVS) is a treatment for severe mitral valve pathologies. In redo cases, especially after coronary artery bypass grafting (CABG) surgery with patent mammary bypass grafts, establishing aortic clamping followed by antegrade cardioplegia application might be challenging. Here, we present the outcome of hypothermic ventricular fibrillation as an alternative to conventional cardioprotection. Methods: Patients who underwent MIMVS either received hypothermic ventricular fibrillation (study group, n = 48) or antegrade cardioprotection (control group, n = 840) and were observed for 30 postoperative days. Data were retrospectively analyzed and collected from January 2011 until December 2022. Results: Patients in the study group had a higher preoperative prevalence of renal insufficiency (p = 0.001), extracardiac arteriopathy (p = 0.001), insulin-dependent diabetes mellitus (p = 0.001) and chronic lung disease (p = 0.036). Furthermore, they had a longer surgery time and a lower repair rate (p < 0.001). No difference, however, was seen in postoperative incidences of stroke (p = 0.26), myocardial infarction (p = 1) and mitral valve re-operation (p = 1) as well as 30-day mortality (p = 0.1) and postoperative mitral valve insufficiency or stenosis. Conclusions: The patients who underwent redo MIMVS with hypothermic ventricular fibrillation did not have worse outcomes or more serious adverse events compared to the patients who received routine conventional cardioprotection. Therefore, the use of hypothermic ventricular fibrillation appears to be a promising cardioprotective technique in this challenging patient population requiring redo MIMVS.
Keywords: redo minimally invasive mitral valve surgery; hypothermic ventricular fibrillation; outcomes redo minimally invasive mitral valve surgery; hypothermic ventricular fibrillation; outcomes

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MDPI and ACS Style

Salman, J.; Franz, M.; Aburahma, K.; de Manna, N.D.; Tavil, S.; Ali-Hasan-Al-Saegh, S.; Ius, F.; Boethig, D.; Zubarevich, A.; Schmack, B.; et al. Hypothermic Ventricular Fibrillation in Redo Minimally Invasive Mitral Valve Surgery: A Promising Solution for a Surgical Challenge. J. Clin. Med. 2024, 13, 4269. https://doi.org/10.3390/jcm13144269

AMA Style

Salman J, Franz M, Aburahma K, de Manna ND, Tavil S, Ali-Hasan-Al-Saegh S, Ius F, Boethig D, Zubarevich A, Schmack B, et al. Hypothermic Ventricular Fibrillation in Redo Minimally Invasive Mitral Valve Surgery: A Promising Solution for a Surgical Challenge. Journal of Clinical Medicine. 2024; 13(14):4269. https://doi.org/10.3390/jcm13144269

Chicago/Turabian Style

Salman, Jawad, Maximilian Franz, Khalil Aburahma, Nunzio Davide de Manna, Saleh Tavil, Sadeq Ali-Hasan-Al-Saegh, Fabio Ius, Dietmar Boethig, Alina Zubarevich, Bastian Schmack, and et al. 2024. "Hypothermic Ventricular Fibrillation in Redo Minimally Invasive Mitral Valve Surgery: A Promising Solution for a Surgical Challenge" Journal of Clinical Medicine 13, no. 14: 4269. https://doi.org/10.3390/jcm13144269

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