{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:38:57Z","timestamp":1761129537423,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","issue":"2","funder":[{"name":"Capio Forskningsstiftelsen"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2018,5,29]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Minimally invasive aortic valve replacementsurgery (MIAVR) is an alternative surgical technique to conventional aortic valve replacement surgery (AVR) in selected patients. The randomised study Cardiac Function after Minimally Invasive Aortic Valve Implantation (CMILE) showed that right ventricular (RV) longitudinal function was reduced after both MIAVR and AVR, but the reduction was more pronounced following AVR. However, postoperative global RV function was equally impaired in both groups. The purpose of this study was to explore alterations in RV mechanics and contractility following MIAVR as compared with AVR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A predefined post hoc analysis of CMILE consisting of 40 patients with severe aortic valve stenosis who were eligible for isolated surgical aortic valve replacement were randomised to MIAVR or AVR. RV function was assessed by echocardiography prior to surgery and 40 days post-surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Comparing preoperative to postoperative values, RV longitudinal strain rate was preserved following MIAVR (\u22121.5\u00b10.5\u2009vs \u22121.5\u00b10.4 1\/s, p=0.84) but declined following AVR (\u22121.7\u00b10.3\u2009vs \u22121.4\u00b10.3 1\/s, p&lt;0.01). RV longitudinal strain reduced following AVR (\u221227.4\u00b12.9%\u2009vs \u221218.8%\u00b14.7%, p&lt;0.001) and MIAVR (\u221226.5\u00b15.3%\u2009vs \u221220.7%\u00b14.5%, p&lt;0.01). Peak systolic velocity of the lateral tricuspid annulus reduced by 36.6% in the AVR group (9.3\u00b12.1 vs 5.9\u00b11.5 cm\/s, p&lt;0.01) and 18.8% in the MIAVR group (10.1\u00b12.9 vs 8.2\u00b11.4 cm\/s, p&lt;0.01) when comparing preoperative values with postoperative values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>RV contractility was preserved following MIAVR but was deteriorated following AVR. RV longitudinal function reduced substantially following AVR. A decline in RV longitudinal function was also observed following MIAVR, however, to a much lesser extent.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2018-000842","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T03:45:21Z","timestamp":1532317521000},"page":"e000842","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Right ventricular mechanics and contractility after aortic valve replacement surgery: a randomised study comparing minimally invasive versus conventional approach"],"prefix":"10.1136","volume":"5","clinical-trial-number":[{"clinical-trial-number":"nct01972555","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6106-4281","authenticated-orcid":false,"given":"Nashmil","family":"Hashemi","sequence":"first","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Sciences, Unit of Cardiology, Danderyd University Hospital, Stockholm, Sweden"},{"name":"Department of Clinical Physiology, Capio S:t G\u00f6rans Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars-\u00c5ke","family":"Brodin","sequence":"additional","affiliation":[{"name":"Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreia","family":"Gomes-Bernardes","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology, Capio S:t G\u00f6rans Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrik","family":"Sartipy","sequence":"additional","affiliation":[{"name":"Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Svenarud","sequence":"additional","affiliation":[{"name":"Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Dal\u00e9n","sequence":"additional","affiliation":[{"name":"Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0853-5141","authenticated-orcid":false,"given":"Magnus","family":"B\u00e4ck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahbubul","family":"Alam","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Sciences, Unit of Cardiology, Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reidar","family":"Winter","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Sciences, Unit of Cardiology, Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,23]]},"reference":[{"key":"2025081709443103000_5.2.e000842.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.08.031"},{"key":"2025081709443103000_5.2.e000842.2","first-page":"160","article-title":"Minimally invasive aortic valve replacement: 12-year single center experience","volume":"4","author":"Gilmanov","year":"2015","journal-title":"Ann Cardiothorac Surg"},{"key":"2025081709443103000_5.2.e000842.3","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv014"},{"key":"2025081709443103000_5.2.e000842.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.08.010"},{"key":"2025081709443103000_5.2.e000842.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00337-4"},{"key":"2025081709443103000_5.2.e000842.6","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00511-N"},{"key":"2025081709443103000_5.2.e000842.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2007.02.017"},{"key":"2025081709443103000_5.2.e000842.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.12.021"},{"key":"2025081709443103000_5.2.e000842.9","doi-asserted-by":"publisher","DOI":"10.1016\/1053-0770(92)90141-S"},{"key":"2025081709443103000_5.2.e000842.10","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002129"},{"key":"2025081709443103000_5.2.e000842.11","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-301203"},{"key":"2025081709443103000_5.2.e000842.12","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1213\/ANE.0000000000001108","article-title":"Early Left and Right Ventricular Response to Aortic Valve Replacement","volume":"124","author":"Duncan","year":"2017","journal-title":"Anesth Analg"},{"key":"2025081709443103000_5.2.e000842.13","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv227"},{"key":"2025081709443103000_5.2.e000842.14","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.109520"},{"key":"2025081709443103000_5.2.e000842.15","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1053\/euje.2000.0031","article-title":"Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations","volume":"1","author":"D\u2019hooge","year":"2000","journal-title":"Eur J Echocardiogr"},{"key":"2025081709443103000_5.2.e000842.16","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/icvts\/ivx422","article-title":"Comparison of right ventricular function after ministernotomy and full sternotomy aortic valve replacement: a randomized study","volume":"26","author":"Dal\u00e9n","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025081709443103000_5.2.e000842.17","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jtcvs.2014.05.014","article-title":"AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"2014","author":"Nishimura","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025081709443103000_5.2.e000842.18","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"2025081709443103000_5.2.e000842.19","doi-asserted-by":"publisher","DOI":"10.1067\/mje.2002.120202"},{"key":"2025081709443103000_5.2.e000842.20","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1476-7120-7-22","article-title":"State diagrams of the heart\u2013a new approach to describing cardiac mechanics","volume":"7","author":"Larsson","year":"2009","journal-title":"Cardiovasc Ultrasound"},{"key":"2025081709443103000_5.2.e000842.21","unstructured":"Lundb\u00e4ck S , Johnson J , Bergholm F , et al . Stockholm, SE), assignee. A cardiac state monitoring system. Sweden 2016."},{"key":"2025081709443103000_5.2.e000842.22","unstructured":"Lundb\u00e4ck S , iGHAS JJ . SE), assignee. State space model of a heart. United States 2012."},{"key":"2025081709443103000_5.2.e000842.23","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.ijcard.2016.07.014","article-title":"Echocardiographic assessment of the right ventricle: Impact of the distinctly load dependency of its size, geometry and performance","volume":"221","author":"Dandel","year":"2016","journal-title":"Int J Cardiol"},{"key":"2025081709443103000_5.2.e000842.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.03.050"},{"key":"2025081709443103000_5.2.e000842.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.11.013"},{"key":"2025081709443103000_5.2.e000842.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.10.049"},{"key":"2025081709443103000_5.2.e000842.27","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-015-0578-8"},{"key":"2025081709443103000_5.2.e000842.28","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12421"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2018-000842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T16:44:43Z","timestamp":1755449083000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2018-000842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,7,23]]},"published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1136\/openhrt-2018-000842"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2018-000842","relation":{},"ISSN":["2053-3624"],"issn-type":[{"type":"electronic","value":"2053-3624"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}