Preface

This edited volume is a collection of reviewed and relevant research chapters, concerning developments within the cardiac surgery procedures field of study. The book includes scholarly contributions by various authors and has been edited by experts in the field. Each contribution comes as a separate chapter complete in itself but directly related to the book's topics and objectives.

The book includes chapters dealing with minimally invasive ventricular assist device surgery; cannulation for cardiopulmonary bypass; tips and pitfalls in robotic mitral valve surgery; aortic root reconstruction; minimally invasive right anterior mini-thoracotomy aortic valve replacement; minimally invasive approach in surgery for congenital heart disease; revascularization strategies in off-pump coronary artery bypass; surgical treatment of hypertrophic obstructive cardiomyopathy; and transcatheter cardiac surgery.

The target audience comprises scholars and specialists in the field.

**II**

**Chapter 8 107**

**Chapter 9 121**

Surgical Treatment of Hypertrophic Obstructive Cardiomyopathy *by Francesca Nicolo', Antonio Lio, Marina Comisso, Romina Pantanella,* 

*by Antonio Giovanni Cammardella, Federico Ranocchi, Antonio Lio, Amedeo Pergolini, Francesco Nicolò, Marina Comisso, Vitaliano Buffa* 

*Roberto Scrofani and Francesco Musumeci*

Transcatheter Cardiac Surgery

*and Francesco Musumeci*

**IntechOpen**

**1**

**Chapter 1**

**Abstract**

to patients.

**1. Introduction**

Minimally Invasive Ventricular

*Marina Comisso, Andrea Montalto, Francesca Nicolò,* 

Heart failure is a growing disease that affects millions of people around the world. Heart transplantation is currently the therapy of choice for these patients. However, the lack of donors has forced the physician to evolve another kind of therapy such as ventricular assist device (VAD) as a bridge to transplant to compensate the lack of organs. Ventricular assist devices are today a successful therapy for the treatment of heart failure; the evolution of these devices and their progressive miniaturization have allowed an evolution of their implantation technique. To date, therefore, in addition to the traditional implant through sternotomy, there are more mini-invasive implant techniques. The purpose of the treaty is to describe these techniques, the implantation sites, and the benefits they can bring

**Keywords:** LVAD, minimally invasive, heart failure, ventricular assist device

Heart failure is a chronic progressive disease characterized by decreased pump function. This may lead to venous congestion and also to hypoperfusion due to low cardiac output with severe organ comorbidities. Modern conservative therapies for heart failure have improved outcomes in adult patients [1]. Despite medical advances in treating this condition, the disease itself remains a progressive condition. For treating end-stage heart failure, cardiac transplantation remains the gold standard. Despite this evidence, cardiac transplantation as a therapeutic option is limited by donor organ shortage and is therefore limited to patients younger than 65 years [2]. However a promising alternative to cardiac transplantation is ventricular assist device (VAD) implantation. In consideration of these problems, the number of VAD implantations has exceeded the number of cardiac transplantations [3]. This therapeutic trend, i.e., the increasing number of patients who undergo VAD implantation also as a destination therapy (DT), has led to an obvious longer duration of the assistance period with the cardiovascular assistance system. This has also led to a change in the basal characteristics of patients who (especially DT patients) are increasingly older, are more fragile, have greater comorbidities, and, consequently, may have a higher incidence of surgical complications [4]. For several years the choice approach for VAD implantation was sternotomy. However, destination therapy patients suffered a greater intraoperative risk and increased mortality [5]. Nonetheless, Slaughter showed that treatment

Assist Device Surgery

*Romina Pantanella and Francesco Musumeci*
