Myocardial Protection Using HTK Solution in Minimally Invasive Mitral Valve Surgery (2024)

FAQs

Myocardial Protection Using HTK Solution in Minimally Invasive Mitral Valve Surgery? ›

Myocardial protection is provided by a single dose of antegrade Custodial-HTK cardioplegia

This solution is essentially an 'intracellular-type' solution and it is formulated as a low sodium and zero calcium solution. Hence, it acts by preventing the rapid sodium-induced spike of the action potential and the activation of the L-type calcium channel and should act as a 'polarizing' solution.

Myocardial protection is achieved using continuous retrograde cold blood cardioplegia through the coronary sinus supplemented with direct antegrade coronary ostia infusion once the aorta is opened. A left ventricular sump is inserted through the right superior pulmonary vein.

TMVR is a minimally invasive structural heart disease treatment to replace a damaged mitral valve without open-heart surgery. A flexible, hollow tube (catheter) is inserted through a blood vessel to reach the heart and replace the mitral valve.

Complex repairs often require a minimally invasive approach, and our success rate is nearly 100 percent.

HTK solution is based on the principle of inactivating organ function by withdrawal of extracellular sodium and calcium, together with intensive buffering of the extracellular space by means of histidine/histidine hydrochloride, so as to prolong the period during which the organs will tolerate interruption of ...

Del Nido cardioplegia prevents spontaneous contractions during arrest, reduces troponin release, and results in superior myocardial function in isolated aged hearts. Del Nido cardioplegia has the potential to provide superior myocardial protection for older patients undergoing cardiac surgery.

The SAVER portion of the operation is performed immediately after CABG and MV repair or replacement if indicated. During SAVER, the infarcted anterior wall segment is incised parallel to the left anterior descending artery. Internal inspection of the ventricle identifies scarred and viable myocardium.

[1] Cardioplegia varies by composition, delivery methods, temperature, and additives; however, all solutions must include potassium chloride (15-35 meq/L) important for inducing cardiac arrest, and other electrolytes such as Mg2+, low-dose Ca2+, Cl-. Na+.

What is life expectancy after mitral valve repair? ›

Almost as many (90%) can go 20 years. Most people don't need another mitral valve surgery after a successful repair. You'll need an echocardiogram each year so your provider can check on your valve function.

Mitral valve repair and mitral valve replacement may be done as an open-heart surgery or as a minimally invasive surgery. The method used depends on how severe the mitral valve disease is and if it's getting worse.

Patient Characteristics

The study population included a total of 47279 patients, of whom 17360 (36.7%) underwent mitral valve repair and 29919 (63.3%) underwent mitral valve replacement. Median age was 75 years.

Medical history: You may not be a surgery candidate if you have severe coronary artery disease or aortic valve disease.

You will probably be able to do many of your usual activities after 4 to 6 weeks. But for at least 6 weeks, you will not be able to lift heavy objects or do activities that strain your chest or upper arm muscles. At first you may notice that you get tired easily and need to rest often.

Risks of Heart Valve Repair or Replacement

Possible risks associated with treatment include: Bleeding during or after treatment or damage to the blood vessels. Blood clots that can cause heart attack, stroke, or lung problems. Infection at the incision site.

Mechanism of Action: Pristinamycin is a streptogramin antibacterial which reversibly binds to 50s subunit of bacterial ribosome blocking the transpeptidation and inhibiting protein synthesis of susceptible bacteria thus inhibiting cell growth.

DMF is known to stabilize the transcription factor Nrf2, which in turn induces the expression of antioxidant response element genes. It has also been shown that DMF influences autophagy and participates in the transcriptional control of inflammatory factors by inhibiting NF-κB and its downstream targets.

Potassium nitrate diffuses through enamel and dentin into the nerve endings of sensory fibers, reducing the excitability of nerve fibers by inhibiting the movement of sodium and potassium ions around the sensory fibers. This action results in the modulation or suppression of the painful sensation.

Sodium zirconium cyclosilicate captures potassium throughout the entire gastrointestinal (GI) tract and reduces the concentration of free potassium in the GI lumen, thereby lowering serum potassium levels and increasing fecal potassium excretion to resolve hyperkalemia.