The impact of advances in percutaneous catheter interventions on redo cardiac surgery
- PDF / 264,693 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 46 Downloads / 167 Views
REVIEW ARTICLE
The impact of advances in percutaneous catheter interventions on redo cardiac surgery Dhaval Pravin Trivedi 1 & SukeshKumar Reddy Chigarapalli 2 & Deepak Mohan Gangahar 3 & Venkat Ratnam Machiraju 4 Received: 18 May 2020 / Revised: 24 July 2020 / Accepted: 30 July 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
Abstract Toward the end of the twentieth century, redo cardiac surgery accounted for approximately 15–20% of total cardiac surgical volume. Major risk factors for redo cardiac surgery include young age at time of the first operation, progression of native coronary artery disease (CAD), vein graft atherosclerosis, bioprosthetic valve failure and endocarditis, and transplantation for end stage heart failure. Historically, redo coronary artery bypass grafting (CABG) alone carried a mortality risk of around 4%. Factors such as older age, female sex, comorbidities, combined procedures, hemodynamic instability, and emergency procedures contributed to even higher mortality and morbidity. These poor outcomes made it necessary to look for less invasive alternate methods of treatment. Advances in catheter-based interventions have made a major impact on redo cardiac surgeries, making it no longer the first option in a majority of cases. Percutaneous interventions for recurrence following CABG, transcutaneous aortic valve replacement (TAVR) for calcific aortic stenosis, valve in valve (VIV) implantations, device closure of paravalvular leaks (PVL), and thoracic endovascular aortic repair (TEVAR) for residual and recurrent aneurysms and mitral clip to correct mitral regurgitation (MR) in heart failure are rapidly developing or developed, obviating the need for redo cardiac surgery. Our intent is to review these advances and their impact on redo cardiac surgery. Keywords Percutaneous interventions . Redo cardiac surgery . Coronary revascularization . TAVR . Mitral valve
Introduction: Role of catheters in cardiac surgery
* Venkat Ratnam Machiraju [email protected] Dhaval Pravin Trivedi [email protected] SukeshKumar Reddy Chigarapalli [email protected] Deepak Mohan Gangahar [email protected] 1
Department of Cardiothoracic Surgery, Los Angeles Medical Center, Kaiser Permanente, Los Angeles, CA, USA
2
Department of Cardiothoracic Surgery, Asian Institute of Gastroenterology Hospitals, Gachibowli, Hyderabad, TG 500031, India
3
Department of Thoracic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
4
Department of Thoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Cardiac catheterization which began by measuring the intracardiac pressures and later progressed to delineating the anatomy has paved way for the advancement in cardiac surgery as we see it today [1]. Use of a Swan-Ganz catheter became a part of standard of care during cardiac surgical procedures. Diagnostic coronary angiogram, first performed by Mason Sones in the 1960s, later evolved over decades to complex coronary interventions. Rashkind first described a cathete
Data Loading...
