First Experiences with MANTA Vascular Closure Device in Minimally Invasive Valve Surgery.


Journal

The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387

Informations de publication

Date de publication:
Aug 2021
Historique:
pubmed: 24 11 2020
medline: 24 11 2021
entrez: 23 11 2020
Statut: ppublish

Résumé

 To more minimize the minimally invasive valve surgeries, percutaneous vascular access and closure has been used for the establishment of extracorporeal circulation. This study investigates early clinical outcomes of patients who received MANTA for femoral artery closure as first experiences in minimally invasive valve surgery.  Between January 2019 and July 2019, 103 consecutive patients (mean age: 58 ± 11 years) underwent video-assisted minimally invasive valve surgery through right anterior minithoracotomy at two cardiac surgery referral centers in Germany. Percutaneous cannulation for cardiopulmonary bypass and femoral artery closure with MANTA were performed in all patients: 18-F and 14-F MANTA were used in 88 (85.4%) and 15 (14.6%) patient, respectively. Mitral, aortic, tricuspid, and double valve surgeries were performed in 51 (49.5%), 39 (37.9%), 7 (6.8%), and 6 (5.8%), patients, respectively. Clinical data were prospectively entered into our institutional database.  Cardiopulmonary bypass time and cross-clamping time were 69 ± 23 and 38 ± 14 minutes, respectively. Except for two patients with late pseudoaneurysm on 15th and 23th postoperative day, neither major nor minor vascular complications nor vascular closure device failure according to the Valve Academic Research Consortium-2 definition criteria was observed. Additionally, no wound healing disorders or conversion to surgical closure was observed.  MANTA as percutaneous femoral artery closure after decannulation of cardiopulmonary bypass is a safe, feasible, and effective approach and yields excellent early outcomes. Larger size studies are needed to evaluate more the efficacy and safety of MANTA.

Sections du résumé

BACKGROUND BACKGROUND
 To more minimize the minimally invasive valve surgeries, percutaneous vascular access and closure has been used for the establishment of extracorporeal circulation. This study investigates early clinical outcomes of patients who received MANTA for femoral artery closure as first experiences in minimally invasive valve surgery.
METHODS METHODS
 Between January 2019 and July 2019, 103 consecutive patients (mean age: 58 ± 11 years) underwent video-assisted minimally invasive valve surgery through right anterior minithoracotomy at two cardiac surgery referral centers in Germany. Percutaneous cannulation for cardiopulmonary bypass and femoral artery closure with MANTA were performed in all patients: 18-F and 14-F MANTA were used in 88 (85.4%) and 15 (14.6%) patient, respectively. Mitral, aortic, tricuspid, and double valve surgeries were performed in 51 (49.5%), 39 (37.9%), 7 (6.8%), and 6 (5.8%), patients, respectively. Clinical data were prospectively entered into our institutional database.
RESULTS RESULTS
 Cardiopulmonary bypass time and cross-clamping time were 69 ± 23 and 38 ± 14 minutes, respectively. Except for two patients with late pseudoaneurysm on 15th and 23th postoperative day, neither major nor minor vascular complications nor vascular closure device failure according to the Valve Academic Research Consortium-2 definition criteria was observed. Additionally, no wound healing disorders or conversion to surgical closure was observed.
CONCLUSIONS CONCLUSIONS
 MANTA as percutaneous femoral artery closure after decannulation of cardiopulmonary bypass is a safe, feasible, and effective approach and yields excellent early outcomes. Larger size studies are needed to evaluate more the efficacy and safety of MANTA.

Identifiants

pubmed: 33225434
doi: 10.1055/s-0040-1718773
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

455-460

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Ali El-Sayed Ahmad (AE)

Division of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, Siegburg, Germany.

Saad Salamate (S)

Division of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, Siegburg, Germany.

Mohamed Amer (M)

Division of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, Siegburg, Germany.

Sami Sirat (S)

Division of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, Siegburg, Germany.

Nadejda Monsefi (N)

Division of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, Siegburg, Germany.

Farhad Bakhtiary (F)

Division of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, Siegburg, Germany.

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