Henrico, Parham & Retreat Doctors' Hospitals’ Post

Balloon mitral valvuloplasty (BMV) is a minimally invasive procedure used to treat severe mitral stenosis (narrowing of the left ventricle valve), either alongside medications or as a bridging procedure while awaiting further heart surgery. The procedure involves inserting a small, flexible tube called a catheter into the vessel through your groin. A balloon catheter is then threaded across the mitral valve and inflated briefly for a few seconds, stretching the mitral valve. This process allows the mitral valve to move more freely, improving blood flow through your heart and the rest of your body. Balloon Mitral Valvotomy Procedure Performed on Premier Elite Cath lab: Patient was diagnosed with rheumatic heart disease leading to severe mitral stenosis. Echocardiography revealed severe mitral stenosis with a valve area of 0.8 cm². A successful BMV was performed with a 26-mm balloon. Post-BMV echocardiography showed an increased valve area. This procedure resulted in significant clinical improvement, highlighting the efficacy of balloon mitral valvotomy in managing severe mitral stenosis. Providing a minimally invasive procedural strategy for patients with severe mitral valve stenosis, this case illustrates how the Innvolution’s #PremierElite Cath lab system can improve the accuracy and safety of Structural Heart Disease procedures. Gaurav Agarwal Ashvini Suthar Atul Sharma Sachin Garg #innvolution #healthcare #cardiology #heartcare #cardiac #innovation #medtech #medicalequipment #BMV #medicaltechnology #cathlabtech #premierelite

🌟 New exciting case with our #Dynetic35 🌟 We are thrilled to share a recent success story with our Dynetic-35. A 77-year-old woman with multiple previous vascular surgeries, interventions, and a lower-limb amputation on the left leg with necrosis of the amputation stump and rest pain was admitted to the SLK-Klinikum Bad Friedrichshall. CT angiography showed a dissection starting from the aortic bifurcation via the common iliac artery and extending into the external iliac artery with evidence of a hemodynamically relevant flow reduction. Due to a persistent inguinal wound healing disorder on the right side and thus a risk of infection, a transbrachial approach was chosen to offer a safer option for staying within the true lumen compared to crossover procedure. A 5F sheath was inserted into the left brachial artery. Probing the descending aorta with a 0.035'' guidewire, which was exchanged for an 0.035'' Rosen wire with a support catheter. A straight 8F, 65 cm sheath was then inserted. A 11- x 39-mm Viabahn VBX stent graft (Gore) was implanted into the common iliac artery, and a 9- x 38-mm BIOTRONIK #Dynetic35 balloon-expandable cobalt chromium stent system was implanted into the dissection in the external iliac artery. After the intervention, the perfusion was restored and the patient could be fitted with a thigh prosthesis and mobilized. “The excellent deliverability and the good visibility of the Dynetic-35 facilitates direct stenting even in such challenging lesions”, resumes Dr. Thomas Able, Senior Physician Center of Vascular and Endovascular Surgery, SLK-Klinikum Bad Friedrichshall. Learn more about the benefits of Dynetic-35 by visiting https://ow.ly/xQV250SaAR4 #Dynetic35 #ThinStrutDNA #PAD #Endovascular #VI

Ophthopedia Update:The Efficacy of Fibrin Sealant in Sutureless Deep Sclerectomy – Preliminary Outcomes: Précis: Deep sclerectomy with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing non-allergenic, non-toxic and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively. Purpose: To evaluate short– and medium–term postoperative results of deep sclerectomy (DS) with a fibrin sealant. Patients and Methods: This prospective, noncomparative, interventional case-series involves 12 eyes of 12 patients with uncontrolled open-angle glaucoma (OAG) who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon´s fascia and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure (IOP) and glaucoma therapy (GT) reduction, best-corrected visual acuity (BCVA) changes and number of complications registered peri– and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9 and 12 months after surgery. Results: The mean IOP decreased from 24.0±9.1 mmHg to 13.8±6.3 mmHg at one year postoperatively (P #Glaucoma #Ophthalmology #Ophthotwitter

Ophthopedia Update:Efficacy and Safety of an Adjustable Glaucoma Drainage Device (eyewatch System) for Refractory Glaucoma: A 2-Year Prospective Study: Précis: In this study, we report a two-year follow-up after implantation of an adjustable glaucoma drainage device combined to a novel orbital filtering plate. The IOP was efficiently controlled post-operatively with limited complications and an excellent safety profile. Purpose: To report the clinical results at two years after implantation of an eyeWatch system, which comprises of an adjustable glaucoma drainage device (eyeWatch implant) combined with a novel orbital filtering plate (eyePlate), in refractory glaucoma. Patients and Methods: Monocentric, prospective, non-comparative clinical trial. Patients suffering from refractory glaucoma after several failed surgeries were operated using the eyeWatch system. The primary outcome was the success rate, defined as an IOP ≤18 mmHg and reduction of more than 20% from baseline, IOP ≥6 mmHg. Secondary outcomes were mean IOP, visual acuity, number of anti-glaucoma medications, number and type of complications. Results: Forty-two eyes from 42 patients were included. The mean follow-up time was 22.0±4.0 months. The mean baseline IOP decreased from 23.2±7.2 mmHg before surgery to 11.9±4.4 mmHg at 12 months (P #Glaucoma #Ophthalmology #Ophthotwitter

This study investigates the early clinical outcomes of using an automated annular suturing device, the RAM® device, in endoscopic minimally invasive aortic and mitral valve replacement surgeries. Conducted between September 2020 and June 2023, the study involved 66 patients with an average age of 61.8 years. #AorticValveReplacement #AutomatedAnnularSuturingDevice #MinimallyInvasiveValveSurgery #MitralValveReplacement

ICYMI: Cornea Update: Comparison of 20% SF6 and 6% C3F8 Gas for Anterior Chamber Tamponade in Endothelial Keratoplasty: Purpose: The aim of this study was to compare the rates of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping endothelial keratoplasty (DSEK) between patients who had anterior chamber (AC) graft tamponade with 20% sulfur hexafluoride gas (SF6) and 6% perfluoropropane gas (C3F8). Methods: The charts of 431 patients undergoing EK from June 8, 2010, to April 16, 2023, were reviewed. Patients undergoing EK alone as well as combined procedures with cataract extraction and intraocular lens implantation were included. Eyes with tube shunts, anterior chamber intraocular lenses, and large peripheral iridotomy with posterior loss of bubble, and patients undergoing cyclophotocoagulation or synechialysis were excluded. All rebubble procedures were performed within 1 month after initial surgery. Results: A total of 346 eyes using SF6 and 167 eyes using C3F8 were analyzed. Overall, 46 eyes (9%) required rebubbling; 33 eyes (10%) in the SF6 group and 13 eyes (8%) in the C3F8 group. For those patients undergoing DMEK, the odds of requiring rebubbling in the C3F8 group were about 22% lower than that of patients in the SF6 group (operating room [OR]: 0.782; P < 0.001). For patients undergoing DSEK, however, the gas type did not significantly affect rebubbling rates (P = 0.99). Conclusions: For DMEK, utilization of 6% C3F8 as an AC tamponade was associated with a significantly lower odds of graft rebubbling compared with 20% SF6. Gas type did not result in a significant difference for DSEK. Utilization of 6% C3F8 for graft tamponade could be considered to reduce graft detachment rates in DMEK. http://dlvr.it/T2cbxC #Cornea #MostPopularArticles #Ophthalmology

Endometriosis symptoms vary from patient to patient but at PRM we know one thing to be true: persistent pain is not normal. 💡 Nonetheless, the misinformation and dismissal in the endo community can leave patients wondering about A LOT. This is why we've got a new series here and taking all of your questions right to our expert excision docs. This week, Dr. Haverland (@texasendosurgeon), one of our PRM Endo Excision Surgeons in Dallas is tackling a common question about endometriosis... 🎗️How long does endometriosis excision surgery last? Dr. Haverland, of course, shares her opinion of how it works for HER patients and HER surgeries. 🟣 This varies from patient to patient, but the minimum time for endometriosis surgery for me at least is at least two hours. 🟣 Most surgeries take longer than this. They can be anywhere from to eight hours. 🟣 It really depends on the amount of disease and the location of the disease. For Dr. Haverland it's simple: "My theory when I go to surgery is do it once and do it right. I'm not in a rush. It doesn't matter how long it takes, as long as we're very thorough and we evaluate all of the abdomen and pelvis for endometriosis." At PRM, we want patients to know that pain is never normal. You deserve to be heard and you deserve your pain to be taken seriously and to be healed. 💜

Endometriosis is an inflammatory disease process in which tissue that is similar to the inner lining of the uterus grows outside the uterus. It often affects the ovaries, fallopian tubes, and the tissue lining the pelvis, and has also been found in other parts of the body. One of the most common questions we get when it comes to endometriosis excision surgery is related to how to prepare. At PRM, our team of pelvic pain experts and world-renowned excision surgeons are with you every step of the way, answering questions around: 🎗️Diet 🎗️ Exercise 🎗️ Comorbidities 🎗️ The PRM Protocol™ 🎗️Post-Operative Care Preparing for endometriosis surgery involves a multi-faceted approach that addresses both physical and emotional well-being. By desensitizing pelvic nerves through the PRM Protocol™, choosing a skilled surgeon, embracing holistic practices, and prioritizing post-operative care, our patients can empower themselves to navigate the surgical journey with confidence - and we'll be right by their side. Most of our surgeries are outpatient, meaning that patients can go home on the same day. Learn more --> https://bit.ly/44Uy3Qs

Yesterday we performed 3 procedures; trachea resection, surgical stabilisation of rib fractures and VATS Right Upper Lobectomy. (Airway, chest wall and lung) 1. A 15 year old boy with trauma a year ago, complicated with tracheal stenosis @ T1 level, multiple dilatations and tracheostomy were performed before being referred to us. Nonintubated trachea resection was performed involving 2 cm of the trachea, patient able to breath on room air at the recovery itself. Now, let him grow up normally. 2. High impact trauma leading to bilateral rib fractures, severely displaced at the right along with cord contusion @ c4 and c5 level, burst fracture @ t7 vertebrae with t6t7t8 cord injury, compression fracture @ t9 vertebrae and dorsal epidural collection @ t2-t10 level. After the spine fixation, we had to stabilise the right sided fractures to improve ventilation requirements. He is enroute to recovery. 3. Right upper lobe lung ca underwent uniportal VATS Right Upper Lobectomy and systematic lymphadenectomy. An anatomical variant, early branching of A2a was noted and handled carefully. Thoracic surgery is not only about dealing with empyema thoracis and biopsies. It involves all the components in the thoracic cavity and requires good support from the entire team, diligent homework and preparation and continous reading into the anticipated problems, troubleshooting and solutions. For surgical pics https://lnkd.in/g4wUvfuR #thoracichkl #training #trachearesection #chestwall #lungcancer #uniportalvats

#AorticValveStenosisdisease #heartvalvedisease #minimallyinvasivesurgery #TAVI #TAVR Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat aortic stenosis, a condition where the heart's aortic valve becomes narrowed, restricting blood flow. During TAVI, a new valve is inserted into the heart through a catheter, typically through an artery in the leg, and guided to the site of the narrowed valve. It's an alternative to open-heart surgery for some patients, especially those considered high risk or intermediate risk or low risk with advanced age for traditional surgery. TAVI has shown promising outcomes, with shorter recovery times and reduced risk compared to traditional surgery. Here is a TAVI done in a challenging anatomy. An octogenarian , diabetic and hypothyroid presented with breathlessness on mild exertion,recurrent presyncope.she was hospitalised for heart failure recently at an outside facility. She was diagnosed to have severe calcific Aortic stenosis with preserved biventricular function , elevated filling pressures. CT Aortogram and Ct CAG done showed Severe degenerative Aortic valve stenosis with mild to moderate calcium and mild to moderate coronary artery disease . Family and patient has been counselled for Aortic valve replacement (SAVR VS TAVI),Heart team discussion done.Patient and family opted for TAVI/TAVR. Anatomical concerns after CT analysis - SMALL ANNULUS (19mm), LOW LCA HEIGHT (9mm) Left leaflet length 12mm ,Narrow sinuses ie over all effaced aortic root Planning Under GA and TEE Bifemoral approach deployed 20 mm Myval( balloon expanding )valve after coronary protection in 70:30 position. Femoral closure done with per close and angio seal closure devices Post procedure CAG and intra vascular ultrasound showed normal flow in coronary arteries ECHO; normally functioning bio prosthetic heart valve ( No PVL,no significant gradient/ conduction abnormalities) , normal LV function. Ambulated after 12 hrs. Discharged home with in 72hrs