{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:36:50Z","timestamp":1793752610330,"version":"4.6.1"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T00:00:00Z","timestamp":1635552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T00:00:00Z","timestamp":1635552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Minimally invasive aortic valve procedures through a hemi-sternotomy or a right anterior mini-thoracotomy have gained popularity over the last several years. Totally endoscopic aortic valve replacement (TEAVR) is an innovative and a less invasive (incision-wise) surgical aortic valve replacement technique. The operative steps of TEAVR have been reported previously from our group. Mitral regurgitation (MR) frequently accompanies aortic valve disease that at times may also require repair. Totally endoscopic surgery in such cases has not been tested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of the technique<\/jats:title>\n                    <jats:p>We present a surgical technique for a totally endoscopic approach to aortic valve replacement and concomitant mitral valve repair for primary and secondary MR. An aortotomy incision was used avoiding an atriotomy, which results in an increase in cross-clamp (XC) and cardiopulmonary bypass (CPB) times that could be associated with higher mortality and morbidity. Neochords (artificial chordae tendineae) were used for primary MR and an edge-to-edge approach for secondary MR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TEAVR and concomitant mitral valve repair can be performed successfully with reasonable XC and CPB times with excellent short-term results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-021-01694-6","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T07:02:43Z","timestamp":1635577363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Totally endoscopic aortic valve replacement with concomitant trans-aortic mitral valve repair for mitral regurgitation"],"prefix":"10.1186","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-7886","authenticated-orcid":false,"given":"Antonios","family":"Pitsis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Tsotsolis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harisios","family":"Boudoulas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos Dean","family":"Boudoulas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,30]]},"reference":[{"issue":"3","key":"1694_CR1","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1093\/icvts\/ivaa102","volume":"31","author":"A Pitsis","year":"2020","unstructured":"Pitsis A, Boudoulas H, Boudoulas KD. Operative steps of totally endoscopic aortic valve replacement. Interact Cardiovasc Thorac Surg. 2020;31(3):424.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"1","key":"1694_CR2","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1093\/icvts\/ivaa046","volume":"31","author":"A Pitsis","year":"2020","unstructured":"Pitsis A, et al. Preoperative determination of artificial chordae tendineae length by transoesophageal echocardiography in totally endoscopic mitral valve repair. Interact Cardiovasc Thorac Surg. 2020;31(1):20\u20137.","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"1694_CR3","doi-asserted-by":"crossref","unstructured":"Maisano F et al. The edge-to-edge technique: a simplified method to correct mitral insufficiency. Eur J Cardiothorac Surg, 1998;13(3):240\u20135 (discussion 245\u20136)","DOI":"10.1016\/S1010-7940(98)00014-1"},{"issue":"1","key":"1694_CR4","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s13019-019-0926-7","volume":"14","author":"A Pitsis","year":"2019","unstructured":"Pitsis A, et al. Mitral valve repair: moving towards a personalized ring. J Cardiothorac Surg. 2019;14(1):108.","journal-title":"J Cardiothorac Surg"},{"issue":"3","key":"1694_CR5","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.pcad.2020.03.004","volume":"63","author":"KD Boudoulas","year":"2020","unstructured":"Boudoulas KD, et al. Floppy mitral valve\/mitral valve prolapse: a complex entity with multiple genotypes and phenotypes. Prog Cardiovasc Dis. 2020;63(3):308\u201326.","journal-title":"Prog Cardiovasc Dis"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-021-01694-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-021-01694-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-021-01694-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T07:10:21Z","timestamp":1635577821000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-021-01694-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,30]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1694"],"URL":"https:\/\/doi.org\/10.1186\/s13019-021-01694-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-102684\/v1","asserted-by":"object"}]},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,30]]},"assertion":[{"value":"30 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All patients involved provided written consent to use clinical information for scientific publications.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AP is a consultant for teaching and training for Abbott, Medtronic, LSI SOLUTIONS. NT, HB, KDB have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"318"}}