JTCS Medtronic Endurant
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Tadasu Kohno
Toshiya Ohtsuka
Akira Furuse
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kaneko, Y.
Right arrow Articles by Konishi, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kaneko, Y.
Right arrow Articles by Konishi, T.

J Thorac Cardiovasc Surg 1996;111:279-280
© 1996 Mosby, Inc.

BRIEF COMMUNICATIONS

VIDEO-ASSISTED OBSERVATION IN MITRAL VALVE SURGERY

Yukihiro Kaneko, MDa, Tadasu Kohno, MDa, Toshiya Ohtsuka, MDa, Toshiro Ohbuchi, MDa, Akira Furuse, MDa, Toshio Konishi, MDb


Tokyo and Yokohama, Japan

Accepted for publication May 18, 1995. Exposure of the tissue to be operated on is of central importance to the success of surgery. Operation on the mitral valve may be difficult when exposure is not satisfactory, as is the case when the left atrium is not enlarged or the atrioventricular ring is adhering to the pericardium because of a previous operation. By using video-assisted visualization in combination with direct observation, we were able to achieve a highly satisfactory view of the mitral valve in all such cases. We describe a method of video-assisted visualization used for mitral valve observation and detail its benefits.

Application of videoscopy in congenital heart surgery and in aortic valve repair has been reported previously.Go Go 1,2 In those reports, videoscopes were held by assistant surgeons. The view on the screen might therefore not be stable. In our technique, we use a videoscope holder to obtain a stable view on the video screen. Before cardiopulmonary bypass, a rigid 30-degree anged scope (A5288 OES TELESCOPE 30°; Olympus Optical Co. Ltd., Tokyo, Japan) is held by a videoscope holder with a flexible arm (Flex arm; Nisco Co. Ltd., Tokyo, Japan) fixed to the operating table (Fig. 1). The videoscope is connected to two video monitors and a video recorder. After the mitral valve is exposed through the combined transseptal superior approach,Go 3 an assistant standing to the left of the operator introduces the videoscope into the left atrium (Fig. 2). The position of the videoscope is adjusted by bending the malleable arm of the holder. A magnified view is obtained by placing the videoscope close to the valve. The subvalvular apparatus can be observed through the scope by inserting a small mirror into the left ventricle. By means of video assistance, the mitral valve can be observed from any desired direction and at desired magnification.



View larger version (115K):
[in this window]
[in a new window]
  		Fig. 1. Preoperative setup for viewing from the patient's cranial side. The videoscope is held by a holder with a flexible arm.

 


View larger version (130K):
[in this window]
[in a new window]
  		Fig. 2. View of a stenotic mitral valve through the videoscope. Fused antermedial commissure and chordae from the posterior papillary muscle attached to the anterior leaflet can be seen.

 
The operator can observe the mitral valve both directly and on the screen while carrying out the surgical maneuver. Illumination from the tip of the videoscope lights up the mitral valve, facilitating better observation even when the operator watches the valve directly. The video screen is much more informative than direct observation, and assistants are therefore able to assist the operation more efficiently. Video assistance is especially useful when an inexperienced resident performs the operation, because a senior surgeon can advise him or her in detail while watching the video screen. Anesthesiologists, cardiopulmonary bypass operators, residents, nurses, and students in the operating room can also watch the video screen. In addition, the surgical procedure can be recorded on a videotape much more clearly with the videoscope than with a video camera set behind the operator.

We have applied this method to several mitral commissurotomy and mitral valve repair operations without any obvious problems. The videoscope did not interfere with surgical maneuvers. We recommend this method for satisfactory mitral valve observation and clear recording of the operation.

Footnotes

From the Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo,a Tokyo, Japan, and the Department of Cardiovascular Surgery, Yokohama Rosai Hospital,b Yokohama, Japan. Back

(J THORAC CARDIOVASC SURG 1996;111:279-80) Back

References

  1. Burke RP, Michielon G, Wernovsky G. Video-assisted cardioscopy in congenital heart operations. Ann Thorac Surg 1994;58:864-8.[Abstract/Free Full Text]
  2. Furuse A, Kohno T, Ohtsuka T. Intraoperative visualization of the aortic valve from the left ventricle. J THORAC CARDIOVASC SURG 1995;109:395.[Free Full Text]
  3. Berreklouw E, Ercan H, Schönberger JP. Combined superior-transseptal approach to the left atrium. Ann Thorac Surg 1991;51:293-5.[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
 Eur J Cardiothorac SurgHome page
O. Reuthebuch, M. Roth, W. Skwara, W.-P. Klovekorn, and E. P. Bauer
Cardioscopy: potential applications and benefit in cardiac surgery
Eur J Cardiothorac Surg, June 1, 1999; 15(6): 824 - 829.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. R. Chitwood Jr., C. L. Wixon, J. R. Elbeery, J. F. Moran, W. H. H. Chapman, and R. M. Lust
VIDEO-ASSISTED MINIMALLY INVASIVE MITRAL VALVE SURGERY
J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 773 - 782.
[Abstract] [Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. R. Chitwood Jr., J. R. Elbeery, W. H. H. Chapman, J. M. Moran, R. L. Lust, W. A. Wooden, and D. H. Deaton
VIDEO-ASSISTED MINIMALLY INVASIVE MITRAL VALVE SURGERY: THE "MICRO-MITRAL" OPERATION
J. Thorac. Cardiovasc. Surg., February 1, 1997; 113(2): 413 - 414.
[Full Text]

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Tadasu Kohno
Toshiya Ohtsuka
Akira Furuse
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kaneko, Y.
Right arrow Articles by Konishi, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kaneko, Y.
Right arrow Articles by Konishi, T.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS