Initial Single-center Experience Research Articles

A Single-Center Comparative Study of Open Transabdominal and Laparoscopic Transanal Ileal Pouch-Anal Anastomosis with Total Mesorectal Excision. Has the Bar Been Raised?

BackgroundMost ulcerative colitis (UC) patients requiring surgery undergo transabdominal ileal pouch-anal anastomosis (IPAA) performed minimally invasively or open. Although one multicenter study demonstrated acceptably low morbidity after transanal pouch, our initial single-center experience with transanal IPAA (ta-IPAA) was associated with an unacceptably high rate of anastomotic leak. The aim of this study was to compare the short-term outcomes of ta-IPAA and transabdominal IPAA with growing experience of transanal proctectomy and determine whether one approach offered any advantage or benefit over the other. MethodsSingle-center series of consecutive ulcerative colitis patients underwent 3-stage IPAA, either ta-IPAA or transabdominal IPAA at a tertiary referral center. The primary outcome measure was overall complications until immediately prior to stoma closure. Secondary outcomes included postoperative clinical measures. ResultsThe study group consisted of 113 patients, which included 37 (33%) patients undergoing transabdominal or open IPAA and 76 (67%) patients undergoing ta-IPAA. The overall complication rate was numerically higher in the ta-IPAA group (56%) compared to the transabdominal group (38%) (p = 0.07) as was the incidence of anastomotic leak in the ta-IPAA group (12 vs. 5%) (p = 0.17). Mean length of hospital stay was significantly higher in the transanal IPAA group (p = 0.04). Operating time, opioid use and pain scores were similar between groups. ConclusionTransanal IPAA has a higher incidence of overall complications and anastomotic leak compared to transabdominal IPAA. Postoperative length of stay is significantly higher in patients undergoing ta-IPAA. Operating room time, opiate use and pain scores are comparable between the two surgical approaches. Transanal IPAA appears to offer little advantage over transabdominal IPAA.

A prospective, randomized comparison of standard prone position versus flank-free modified supine position in percutaneous nephrolithotomy: A single-center initial experience.

Background:Percutaneous nephrolithotomy (PCNL) is the first choice for treatment of large renal stone >2 cm. The prone position is the classical position preferred by most surgeons. Aiming to improve patient anesthesia and surgery-related inconveniences of the prone position, Valdivia et al., 1987, described the performance of PCNL with the patient in the supine position. Hence, we aimed to study the safety and efficacy of flank-free modified supine position in PCNL compared to the standard prone position.Patients and Methods:This is a prospective randomized study for 60 patients with large renal stones planned for PCNL operation during the period from November 2017 to May 2019. Patients were divided into two groups (30 patients each group): Group A – patients underwent PCNL in the prone position and Group B – patients underwent PCNL in the modified flank supine position. Patients’ demographics, stone size, Hounsfield unit with intraoperative details as fluoroscopy time, operative time, and complications were recorded. Postoperatively, need for or not to blood transfusions, hospital stay, stone-free status, and postoperative complications were assessed.Results:There was no statistically significant difference between the prone and supine positions regarding stone size (4 cm vs. 4.5 cm, P = 0.16), Hounsfield unit (940 HU vs. 955 HU, P = 0.78), body mass index (31.2 kg/m2 vs. 32.5 kg/m2, P = 0.49), fluoroscopy time (6.9 min vs. 7.3 min, P = 0.5), operative time (89.5 min vs. 90.4 min, P = 0.9), residual stones (10% vs. 20%, P = 0.8), and hospital stay (45.6 h vs. 48.6 h, P = 0.5). Fever occurred in 3.3% of cases in each group and urine leakage observed in one patient with prone position. No blood transfusion was needed in both the groups.Conclusions:PCNL in the modified supine position proved to be a safe and effective choice compared to the prone position for adult patients with large renal calculi.

Initial single-center experience with Middle Meningeal Artery embolization for treatment of Chronic Subdural Hematoma

Initial single-center experience with Middle Meningeal Artery embolization for treatment of Chronic Subdural Hematoma

Subjective workload measurement of the transition from a conventional operative microscope to a Robotic Digital Microscope. A pilot study

•Evaluate the subjective workload for transition of an experienced neurosurgeon from a conventional operative microscope /OPMI/ to a Robotic Digital Microscope /RDM/.•Show a single center initial experience of the use an exoscope.•The exoscope improves ergonomics.•Operative exoscope could reduce work-related musculoskeletal disorders.

Balloon Pulmonary Angioplasty in Patients With Inoperable or Recurrent/Residual Chronic Thromboembolic Pulmonary Hypertension: A Single-Centre Initial Experience

Patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) are often treated with pulmonary arterial hypertension-specific drugs. However, most of these patients remain symptomatic, despite medical treatment. Balloon pulmonary angioplasty (BPA) is an emerging therapeutic intervention for patients with inoperable CTEPH. This study aimed to report the initial experience of BPA in a tertiary referral centre for CTEPH. A total of 26 consecutive patients, who underwent 91 BPA sessions, were included in the study. All patients underwent a detailed examination, including 6-minute walking distance (6MWD), and right heart catheterisation at baseline and 3 months after the last BPA session. The mean age of the patients was 51±17 years. Fifteen (15) patients had inoperable CTEPH and 11 patients had residual or recurrent CTEPH post pulmonary endarterectomy (PEA). Functional class improved in 17 of 26 (65%) patients. The 6MWD increased from a mean 315±129 to 411±140 m (p<0.001), and NT pro-BNP reduced from a median 456 to 189 pg/mL (p=0.001). The number of patients who required supplemental oxygen decreased from 11 (42.3%) to five (19%) (p=0.031) after BPA treatment. The mean pulmonary artery pressure decreased from a mean 47.5±13.4 to 38±10.9 mmHg (p<0.001), the pulmonary vascular resistance decreased from a mean 9.3±4.7 to 5.8±2.8 Wood units (p<0.001), and the cardiac index increased from a mean 2.4±0.7 to 2.9±0.6 L/min/m2 (p=0.008). Balloon pulmonary angioplasty improved haemodynamics, 6MWD, and functional class, and reduced the requirement for supplemental oxygen, with an acceptable risk-benefit ratio in patients with inoperable CTEPH and with residual/recurrent CTEPH.

Starting A New Robotic Surgery Program for Mitral Valve Repair. Lessons Learned from The First Nine Months.

(1) Background: Although transcatheter technology is rapidly growing and represents a promising strategy, the surgical approach remains the best way to repair a degenerative mitral valve regurgitation. In this context, robotic surgery is technologically the most advanced method of minimally invasive mitral valve repair. The aim of this study is to present the preliminary results of the initial single-center experience with a new robotic mitral valve repair program. (2) Methods: We retrospectively reviewed the records of patients who underwent robotic mitral valve repair at our Institution between January and September 2021. (3) Results: A total of 29 patients underwent mitral valve repair with annuloplasty and chordal implantation to treat degenerative mitral regurgitation. The procedure’s success was achieved in 97% of patients. The 30-day cardiac-related mortality was 0%. The median CPB and cross-clamp times were 189 and 111 min, respectively, with a progressive reduction from the beginning of the robotic program. (4) Conclusions: Considering all the limitations related to the small sample, the presented results of robotic mitral valve repair appear to be encouraging and acceptable. A careful patient selection, a dedicated team, and a robust experience in surgical mitral valve repair are the fundamentals to start a new robotic mitral surgery program.

COVID-19 in Liver and Kidney Transplant Recipients: An Initial Single-center Experience in Iran

COVID-19 in Liver and Kidney Transplant Recipients: An Initial Single-center Experience in Iran

Regular hours vs. on-call endovascular interventions for acute stroke treatment: initial single-center experience by interventional cardiologists

Abstract Background Endovascular treatment for acute stroke with large vessel occlusion became the mainstay therapy but remains limited due to lack of trainees and specialized centers. To offer this therapeutical option to a vast population, interventional cardiologists joined interdisciplinary stroke teams. Because of limited experience, it remains unclear if the timing of the procedure (i.e., regular hours vs. on-call time) may influence quality, time-effectiveness and outcomes. Purpose To investigate if the timing of the procedure (i.e., regular hours vs. on-call time) significantly influences procedural parameters and outcomes of patients undergoing acute endovascular stroke treatment. Methods Consecutive patients undergoing acute endovascular stroke treatment from 07/2012 – 10/2020, treated by cardiologists, were reviewed. Baseline characteristics, procedural aspects and clinical outcomes were retrospectively collected. Cases were divided into two groups, depending on the timing of the procedure: on-call time (OC, i.e., weekend days, public holidays and documented “call in” of the on-call service) vs. regular hours (RH, i.e., all other procedures) and outcomes subsequently compared. Results One-hundred-thirteen consecutive patients underwent endovascular treatment for acute stroke; of those 77 (68.1%) during regular hours and 36 (31.9%) during on-call time. Patients were in their early 70ies and risk factors such as arterial hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation were evenly distributed. Modified Ranking Scale (mRS) at presentation was 5 in both groups and decreased to 3 at discharge. The anterior circulation was most often affected (RH: 90.9% vs. OC: 94.4%, p=0.518) and a stent retriever only strategy commonly chosen (RH: 42.8% vs. OC: 30.5%, p=0.211), followed by a combined approach of stent retriever use and aspiration (RH: 25.9% vs. OC: 27.7%, p=0.752). Door-to-needle time (RH: 0:55h IQR [0:45–1:22] vs. OC: 1:05h IQR [0:54–1:30], p=0.237) and procedure duration (RH: 0:48h IQR [0:30–1:25] vs. OC: 0:58h IQR [0:35–1:46], p=0.214) were comparable. Contrast agent use and radiation time (RH: 17.6 min IQR [11.7–29.3] vs. OC: 17.6 min IQR [12.1–33.6]) did not differ between groups, however patients in the OC group experienced a higher dose area product (RH: 4827mGy cm2 IQR [1567–14092] vs. 12727mGy cm2 [6732–18889], p&amp;lt;0.001). The combined quality endpoint, comprising of TICI IIb/III flow after the procedure, no embolization to new territory and no symptomatic intracranial bleeding during in hospital stay was met in 85.5% of patients in the RH group and 80.5% of the on-call group (p=0.485). Death during in-hospital stay was observed in 22% of patients in the RH group and 11.1% of the OC group (p=0.163). Conclusions Endovascular intervention for acute stroke treatment during on-call time is as effective and safe as if performed during regular hours but associated with a higher dose area product. Funding Acknowledgement Type of funding sources: None.

Same-day discharge after elective coronary angioplasty: a single-center initial experience

Percutaneous coronary intervention (PCI) is usually a procedure based on patient's hospitalization. However, the increasingly widespread use of radial access, the technical evolution of the devices employed and current pharmacotherapy standards have simplified this procedure with satisfying outcomes and significantly reduced complications. It can be assumed that overnight hospitalization may not impact patient safety. The purpose of this study is to describe the experience of a single center in the same-day discharge of elective patients undergoing PCI. A retrospective analysis of the cath-lab database was carried out for the years 2016-2019. All elective PCI patients discharged on the same day were identified. All were observed in a hospital setting for at least 6 h and then, after discharge, interviewed by telephone within 24 h and at 30 days. During the time interval examined, 36 patients (mean age 66 ± 10 years) who had procedural same-day discharged were identified. From 2016 to 2019, they represented 1.69%, 1.79%, 5.78% and 5.90%, respectively, of the patients electively admitted for PCI annually. All suffered from chronic coronary syndrome, were on dual antiplatelet therapy and treated with radial approach for single-vessel (88.8%) or multivessel (12.2%) PCI. Two in-hospital access site bleedings, no adverse events in the first 24 h and a new readmission, due to gastrointestinal bleeding, at 30-day follow-up were reported. The results of this initial experience help to confirm that the same-day discharge after a PCI is possible and safe for the patient. If this strategy could be the standard of care to increase patient satisfaction, to improve hospital performance by reducing costs and to increase efficiency without adversely affecting procedural outcomes should be confirmed in larger and unselected groups of patients.

Can mini PCNL achieve the same results as RIRS? The initial single center experience

BackgroundUrolithiasis is a prevalent disease worldwide with high recurrence rate, minimally invasive interventions have largely replaced open ones, namely PCNL and RIRS. Miniaturization, optical improvements, and modern laser types made these procedures safe and effective in the management of single renal stones.Aim of the study: Is to compare the effectiveness of mini PCNL with RIRS in the treatment of single renal stone of ≤25 mm. Patients and methodsThis prospective study that included 60 patients with single renal stones of ≤25 mm and were treated by either mini PCNL (group A) or RIRS (group B). The study was performed during the period from October 2020 to April 2021. ResultsThe mean operative time RIRS group was 43.6 ± 10.493, while for miniPCNL it was 36.6 ± 7.035 (P = 0.004). The stone free rate in RIRS and miniPCNL group was 70% and 90% respectively (P = 0.053). The need for JJ stent was higher in RIRS compared to miniPCNL group (70% vs. 40%) respectively (P = 0.02). The duration of hospital stay in miniPCNL was 38.2 h compared to 16.7 h for RIRS group (p = 0.0001). The rate of postoperative hemoglobin drop was higher in MiniPCNL compared to RIRS (P = 0.0001). There was no significant difference regarding complication rates between both groups. ConclusionMini-PCNL FOR the treatment of renal stones sized ≤25 mm has high stone free rate, shorter operative time, less requirement for JJ stent and near similar post-operative pain and complications compared to RIRS.

Real-time 3D, 2D trans esophageal echocardiography for the evaluation of rheumatic mitral stenosis initial single center experience

Abstract : Mitral stenosis (MS) is one form of heart disease of a valvular nature. Narrowing of the mitral valve orifice occurs in the Mitral stenosis. The most common cause of MS is rheumatism fever. Other uncommon causes of MS are calcification of the mitral valve leaflets, congenital heart disease, infective endocarditis, mitral annular calcification, endomyocardial fibroelastosis. The study aims to determine the consistency and viability of using 3dimensional transthoracic echocardiography 3DTEE planimetry (MVA 3D) for mitral valve area (MVA) dimensions in patients that have rheumatic mitral stenosis (RhMS). : A cross-sectional study with analytic elements. The data collection was carried out in the Shahid Al- Mihrab outpatient department. Forty-one patient patients underwent Transesophageal echo (TEE) to eliminate atrial thrombi in the left side, referring to our outpatient department for echocardiographic examination and evaluation of RhMS and suitability for percutaneous mitral valvoplasty (PTMV). The investigator and administrator arranged a self-restricted survey form to collect data from the members by straight meeting with participants. Forty-one patients had MS due to rheumatic heart disease (RhHD), where all (100%) assess MVA measurement by 3DTEE. It was significantly low if compare with mitral valve area by transthorasic echo planimetry (MVA TTE planimetry), mitral valve area by transthorasic echo (MVATTEPHT). However, mitral valve area by continuity equation by transthoracic echo (MVAconTTE) measurement was feasible in 5 patients only (12%), were no significant correlation between them. Mitral valve area by transesophageal echo,3dimension (MVA3DTEE) the best agreement with MVA2DTTE PLANEIMETRY was demonstrated (95 percent agreement limits and then with MVAPHTTTE (95 percent agreement limits. The mean ± SD of MVA3D TEE was 1.06 ± 0.79 cm2 in patients with minimal fusion, the mean ± SD of MVA3DTEE was 0.79±0.21 cm2, in patients with partial fusion, and the mean ± SD of MVA3D TEE was 0.69 ± 0.15 cm2 with complete fusion. There was a significant difference in the mean MVA3D TEE among the different degrees of fusions by 3D TEE (p=0.02). Three-dimensional (3D) TEE echocardiography has demonstrated accuracy for measuring MV area for both calcific also improved the “description” of valve anatomy, and provided an advantage for less experienced operators as a method for MV area measurements.

PO24: High Dose-Rate Tandem and Ovoid 3D CT Based Brachytherapy in Cervical Cancer: Initial Single Center Experience

PO24: High Dose-Rate Tandem and Ovoid 3D CT Based Brachytherapy in Cervical Cancer: Initial Single Center Experience

PO24: High Dose-Rate Tandem and Ovoid 3D CT Based Brachytherapy in Cervical Cancer: Initial Single Center Experience

PO24: High Dose-Rate Tandem and Ovoid 3D CT Based Brachytherapy in Cervical Cancer: Initial Single Center Experience

Initial single-center experience of PIPAC in patients with unresectable peritoneal metastasis

IntroductionPeritoneal carcinomatosis remains a condition with poor prognosis and limited therapeutic options. Pressurized intrapertioneal aerosol chemotherapy (PIPAC) has been developed as a new tool for delivering intraperitoneal chemotherapy with low morbidity. The aim of this study was to evaluate the initial experience of PIPAC in patients with peritoneal carcinomatosis at our hospital. MethodsA prospective study between January 2019 and February 2020 was carried at a tertiary public hospital. Primary tumor, ascites volume, PCI, chemotherapy regimen, operative time, morbidity, length of hospital stay and mortality were recorded for analysis. ResultsWe analyzed 9 PIPAC procedures performed in 5 patients. Median PCI was 27.6 (24–35). Median surgical time was 93min (70–125). Only one adverse event occurred out of 9 procedures (Clavien-Dindo II). Median length of hospital stay was 2 days (1–4). Mortality was 0%. ConclusionPIPAC seems to be a feasible and safe procedure to treat peritoneal carcinomatosis, with low morbidity and short hospital stay.

Management of Orthodontic patients in COVID-19 pandemic, a single center initial experience.

The year 2020 will be marked for years to come with pandemics related to the new coronavirus disease 2019 (COVID-19) experiencing lockdowns and quarantine in a trial to create social distancing and reduce transmission of infection. It was considered a global concern as per world health organization (WHO). With the lockdown only emergency dental treatments were allowed with the complete closure of the orthodontic practice in a trial to help flatten the curve. The aim of this clinical report is to describe the clinical outcome of orthodontist and assistant who took care of several COVID-19 cases possibly carriers of SARS-COV-2 or reported recent infection and recovery. The possible measures that can keep both dental health care workers and patients safe added to the actions taken to help adapt to the new normal were elaborated. Methods: A case series of one carrier and other five cases of recently recovered patients were managed in clinic. Different scenarios will be discussed for the purpose of comparing the management, possible measures that were applied and precautions that could make the practice safer . Furthermore, we followed up other patients who had procedures in same clinic during upcoming 48 hours for 14 days through phone calls or recall visits. Results: No transmission of infection to the dental health care workers as per nasopharyngeal swab as well for the follow up patients .Conclusion: The infection control measures described in this clinical report were sufficient enough to prevent transmission of infection from a confirmed carrier patient.

From Wide Open Spaces to Tiny Robot Holes: Single-Center Comparison of Implant Techniques for Left Ventricular Assist Device (LVAD) Implantation

<h3>Purpose</h3> Current studies are just beginning to reveal possible benefits of thoracotomy for LVAD implant but most have not included both durable device types or additional techniques such as robotic assistance. This review serves to evaluate our initial single-center experience with LVAD implant via thoracotomy (with both hemisternotomy and robotic assistance). <h3>Methods</h3> Primary sternotomy, reop sternotomy, thoracotomy with hemisternotomy, and robotic assisted thoracotomy implants of HeartWare and HeartMate 3 LVADs 2018-2020 were evaluated. Narcotic use, cost, outflow graft position, operative data, and mortality were compiled and t-test performed between primary sternotomy and other groups on selected data. <h3>Results</h3> All patients were alive or transplanted at 6 months post-implant. Compared to primary sternotomy, reop sternotomy and robot assisted thoracotomy had longer bypass times and robot assisted thoracotomy had less red blood cell and FFP use. Outflow graft position with robotic assist was consistently away from the sternum (Fig 1). <h3>Conclusion</h3> There were no significant differences between mortality and narcotic use between primary sternotomy, reop sternotomy, and thoracotomy LVAD implants. Despite the cost of robotic disposable equipment, overall cost was not significantly different. Lower blood product usage and more preferable outflow graft position with robotic assist may result in fewer antibodies and easier reentry for transplant. A multi-center data review should be undertaken to capitalize on gains as we continue to advance non-sternotomy approach.

Initial single-center experience with a new external support device for the creation of the forearm native arteriovenous fistula for hemodialysis.

To assess and compare the maturation rate of the native radiocephalic arteriovenous fistula (RC-AVF) created with and without a nitinol external support (VasQ™ Laminate Medical Technologies Ltd, Tel Aviv, Israel). Data of all consecutive patients who underwent the creation of native RC-AVFs at our center between October 2018 and January 2020 was prospectively collected and retrospectively analyzed.Selected patients who had a suitable vein and a radial artery with triphasic flow at preoperative duplex ultrasound exam and were selected for the creation of a radiocephalic fistula were included. Exclusion criteria were: malignant tumors, acute renal failure, previous upper limb revascularization, and septic status. Patency and maturation, vein, and artery diameter and blood flow rate were assessed at the following intervals: post-operatively, 24 h post-operatively, 1 month, 3 months, and 6 months post-operatively. Forty-nine patients (31 males, mean age 65.7 years old) were included. Patients who received VasQ™ devices were 25 (VasQ group), the other 24 formed the control group. All patients underwent radio-cephalic AVF placement (21 on the wrist, 20 on the forearm, 8 on the proximal forearm). There were no perioperative complications and fatalities. At 1, 3, and 6 months, primary patency rates were 96 ± 4%, 96 ± 4%, 91 ± 6% (VasQ group) versus 87 ± 7%, 87 ± 7%, 80 ± 9% (control group, P 0.17), secondary patency rates were 96 ± 4%, 96 ± 4%, 91 ± 6% (VasQ group) versus 95 ± 4%, 90 ± 7%, 90 ± 7% (control group, P 0.79). A significantly larger vein diameter increase postoperatively (P 0.009) and a greater maturation rate (96% vs 74%, p 0.044) were found in the VasQ group compared to the control group. The use of the VasQ™ device was associated with higher maturation rates and larger vein diameters postoperatively. The patency rates were slightly higher but not significantly. Further studies are needed to confirm these findings.

Initial single centre experience of Aquablation of the prostate using the AquaBeam system with athermal haemostasis for the treatment of benign prostatic hyperplasia: 1-year outcomes.

Aquablation using the AquaBeam system combines real-time image guidance and robotics to enable precise and heat-free removal of prostatic tissue with a high velocity water jet. The aim of this study is to report the outcomes of Aquablation up to 1year in a single centre within the UK employing an athermal approach to haemostasis. Fifty-five consecutive men underwent Aquablation between September 2017 and December 2018 (as part of OPEN WATER trial). Standard Aquablation was performed with the AquaBeam system (PROCEPT® BioRobotics) with 2 passes of Aquablation followed by bladder washout with application of continuous bladder irrigation via a catheter on a continuous traction device. Patients were followed up at 3 and 12months. The data were prospectively collected on patient demographics, uroflowmetry, prostate volume, International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) and International Index of Erectile Function (IIEF-15). The mean age was 64.1 ± 7.9years. Operating time was 26.9 ± 9.2min. Mean prostate volume decreased from 58.2 ± 23.9cc to 33.2 ± 12.9cc (p < 0.0001). There were significant improvements at the 12month follow-up in maximum urinary flow rate (9.9 ± 5.1ml/s vs. 23.9 ± 11.6ml/s), IPSS (21.7 ± 7.4 vs. 6.1 ± 4.2) and quality of life score (4.8 ± 1.1 vs. 1.4 ± 1.4) (p < 0.0001). There was no significant change in IIEF-15 and MSHQ-EjD scores. There were 8 (14.5%) Clavien grade 2 or higher complications. Our single centre experience suggests Aquablation using an entirely athermal approach is a safe cavitating procedure resulting in significant LUTS improvement comparable to standard cavitating procedures with greater preservation of sexual function.

Aortic Neocuspidization with Autologous Pericardium: Initial Experience of Single Center

Background: Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results. The aim of this study was to present initial experience of the AVNeo procedure of a single center. Methods: The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. Results: The mean age of patients was aged 58.21 ± 13.14 years and 16 (66.7%) of them were men. 16 patients were operated on for aortic stenosis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bicuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed in 13 (54.17%) patients. No patients needed reoperation for bleeding, pacemaker implantations, conversion to classical prosthetic aortic valve replacement, or infective endocarditis. Two patients died due to non-cardiac reasons. Preoperative peak and mean aortic valve pressures improved significantly at 1st and 6th months (Preop: 89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmHg 1st month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6th month: 18.13 ± 3.02 mmHg and 6.93 ± 1.83 mmHg). Conclusion: In conclusion, the AVNeo procedure is a feasible technique for aortic valve pathologies, with the advantages of avoiding anticoagulants and the applicability of concomitant surgical procedures. Although this procedure requires meticulous experience, results similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.

Minimally invasive double tubular resection of intradural extramedullary meningioma: Single center initial experience

Minimally invasive double tubular resection of intradural extramedullary meningioma: Single center initial experience