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Intensive care and anesthesia management for HARPOON beating heart mitral valve repair


1 Cardiac Anaesthesia and Intensive Care, University Hospital Southampton NHS Trust, Southampton, UK
2 Cardiac Anaesthesia, Royal Brompton Hospital Trust, London, UK
3 Anesthesia and Intensive Care Unit, Padova, University of Padova, Italy
4 Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
5 Division of Cardiac Surgery, University of Maryland School of Medicine; Division of Cardiac Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA

Correspondence Address:
Paul Diprose
Cardiac Anaesthesia and Intensive Care, University Hospital Southampton NHS Trust, Southampton
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_200_18

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Year : 2020  |  Volume : 23  |  Issue : 3  |  Page : 321-326

 

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Patients with severe mitral valve regurgitation secondary to degenerative disease are known to benefit from mitral valve repair surgery. Novel techniques for achieving mitral valve repair on the beating heart have been developed and are being introduced into clinical practice. The HARPOON Beating Heart Mitral Valve Repair System (MVRS) in recent studies has demonstrated efficacy and safety for the repair of degenerative mitral valve disease on the beating heart. The device uses transoesophageal echocardiographic guidance to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on prolapsed mitral valve leaflets in the beating heart. It requires general anaesthesia and there are specific intensive care and anaesthesia considerations for the safe management of these cases. This article describes the general principles of intensive care and anaesthesia management employed for the initial patients treated with the HARPOON Beating Heart MVRS, the outcomes for these patients, and the potential challenges for the future management of these cases.






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1 Cardiac Anaesthesia and Intensive Care, University Hospital Southampton NHS Trust, Southampton, UK
2 Cardiac Anaesthesia, Royal Brompton Hospital Trust, London, UK
3 Anesthesia and Intensive Care Unit, Padova, University of Padova, Italy
4 Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
5 Division of Cardiac Surgery, University of Maryland School of Medicine; Division of Cardiac Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA

Correspondence Address:
Paul Diprose
Cardiac Anaesthesia and Intensive Care, University Hospital Southampton NHS Trust, Southampton
UK
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_200_18

Rights and Permissions

Patients with severe mitral valve regurgitation secondary to degenerative disease are known to benefit from mitral valve repair surgery. Novel techniques for achieving mitral valve repair on the beating heart have been developed and are being introduced into clinical practice. The HARPOON Beating Heart Mitral Valve Repair System (MVRS) in recent studies has demonstrated efficacy and safety for the repair of degenerative mitral valve disease on the beating heart. The device uses transoesophageal echocardiographic guidance to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on prolapsed mitral valve leaflets in the beating heart. It requires general anaesthesia and there are specific intensive care and anaesthesia considerations for the safe management of these cases. This article describes the general principles of intensive care and anaesthesia management employed for the initial patients treated with the HARPOON Beating Heart MVRS, the outcomes for these patients, and the potential challenges for the future management of these cases.






[FULL TEXT] [PDF]*


        
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