Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Assistive Techniques for Proximal Anastomosis in Minimally Invasive Coronary Artery Bypass Grafting
Abstract: We introduce assistive techniques for proximal anastomosis in off-pump minimally invasive coronary artery bypass grafting (MICS CABG) to overcome difficult access to the ascending aorta in MICS CABG. An 8-cm left thoracotomy is made in the fifth intercostal space. ThoraTrak retractor (Medtronic Inc, Minneapolis, MN USA) is used to open the thoracotomy and is pulled to the cephalad and rightward direction toward to the ascending aorta. The pericardium is opened from the ascending aorta to the left ventricular apex and to the inferior vena cava. Two retraction sutures on the pericardial edge are used to laterally d...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research
Off-Pump Transapical Removal of an Embolized Transcatheter Aortic Valve
We report the successful off-pump retrieval of an embolized valve after transfemoral transcatheter aortic valve replacement through a left anterior thoracotomy. We maintained the embolized valve on the guidewire and snared it using a transapical approach. We then deployed a valve in an adequate position to ensure hemodynamic stability before transapical removal of the embolized valve. Transapical exteriorization of the femoral guidewire offers additional support, particularly in patients with a horizontal aortic annulus. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Transareolar Video-Assisted Approach to the Atrial Septal Defect and Tricuspid Valve
Abstract: Minimally invasive atrial septal defect closure and tricuspid annuloplasty in female patients are normally performed through a right submammary anterior minithoracotomy approach. However, when the aortic root is located higher, the direction of aortic cannulation becomes not ideal through the submammary incision. In such cases, transareolar approach is useful. Through this approach, aortic cannulation and tricuspid operation can be performed with endoscopic assistance, and ASD closure can be performed under direct vision. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Pulmonary Transplant Salvage Using Ultrasound-Assisted Thrombolysis of Subacute Occlusive Main Pulmonary Artery Embolus
Abstract: A 53-year-old woman who underwent bilateral lung transplantation 14 months before presented with 2 to 3 weeks of severe exertional dyspnea. Workup revealed a complete embolic occlusion of her left main pulmonary artery related to a femoral deep venous thrombosis. The occlusion did not respond to systemic anticoagulation, and a trial of catheter-directed thrombolysis was pursued. Flow to the left lower lobe was restored after 2 days of thromobolytic therapy. The patient is alive and well at more than 1 year of follow-up. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Comparative Analysis of Perioperative and Mid-Term Results of TECAB and MIDCAB for Revascularization of Anterior Wall
Objective: Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results.
Methods: Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53–76) years and a median (range) EuroSCORE I of 2 (0–3). Minimally invasive direct coronary artery bypass was performed in 60 patients with a median (range) age of 66 (54–75...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
The Use of Rapid Deployment Valves in Combined Aortic and Mitral Valve Surgery: One-Year Clinical and Echocardiographic Outcomes
Conclusions: Rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in combined aortic and mitral valve surgery can be performed safely with reproducible results. One-year follow-up data of this small series shows encouraging results potentially justifying the extension of the indication for rapid deployment valves to patients with concomitant mitral disease. Especially elderly patients undergoing multiple valve surgery may benefit from a reduction of cardiopulmonary bypass and myocardial ischemic times. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
A Contemporary Approach to Reoperative Aortic Valve Surgery: When is Less, More?
Conclusions: With appropriate preoperative evaluation and careful surgical planning, a minimally invasive approach to reoperative aortic valve surgery can be performed in a safe and effective manner. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Consequences of Hybrid Procedure Addition to Robotic-Assisted Direct Coronary Artery Bypass
Conclusions: Despite similar preoperative demographics in the two groups, we have observed a significant difference in the blood transfusion rate in group 1. However, this did not lead into a statistically significant re-exploration rate for bleeding. Hence, we assume that dual antiplatelet therapy usage in the hybrid group might be the cause of the increase in blood transfusion rate. Nevertheless, it did not affect postoperative morbidity and length of hospital stay. A randomized multicenter clinical trial is needed. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
A Minimally Invasive Stand-alone Cox-Maze Procedure Is as Effective as Median Sternotomy Approach
Conclusions: Stand-alone Cox-Maze IV via minithoracotomy was as effective as via sternotomy with a shorter hospital stay. A minimally invasive approach is our procedure of choice. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Endoscopic Fundoplication: Effectiveness for Controlling Symptoms of Gastroesophageal Reflux Disease
Objective: Transoral incisionless fundoplication (TIF) is a completely endoscopic approach to treat gastroesophageal reflux disease (GERD). We previously reported our initial results demonstrating safety and early effectiveness. We now present an updated experience describing outcomes with longer follow-up.
Methods: For a three-year period, TIF procedures were performed on 80 patients. Preoperative workup routinely consisted of contrast esophagram and manometry. PH testing was reserved for patients with either atypical symptoms or typical symptoms unresponsive to proton-pump inhibitors (PPIs). Heartburn severity was longi...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Hybrid Coronary Revascularization has Improved Short-term Outcomes but Worse Mid-term Reintervention Rates Compared to CABG: A Propensity Matched Analysis
Objective: We evaluated short-term outcomes and mid-term survival and reintervention of hybrid coronary revascularization versus conventional coronary artery bypass grafting using a propensity score matched cohort.
Methods: We conducted a retrospective review of patients undergoing surgery for multivessel coronary artery disease from 2007 to 2015 at a single institution. Patients were propensity matched 1:1 to receiving hybrid coronary revascularization or conventional bypass grafting by multivariate logistic regression on preoperative characteristics. Short-term outcomes were compared. Freedom from reintervention and dea...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
The Perceval Sutureless Aortic Valve: Review of Outcomes, Complications, and Future Direction
Abstract: Surgical aortic valve replacement with a stented prosthesis has been the standard of care procedure for aortic stenosis. The Perceval (LivaNova, London, United Kingdom) is a sutureless aortic valve bioprosthesis currently implanted in more than 20,000 patients. The purpose of this article was to review the literature available after 9 years of clinical experience of the Perceval aortic valve. PubMED, Embase, and the Cochrane Library databases were searched. A meta-analysis of summary statistics from individual studies was conducted. A total of 333 studies were identified and 84 studies were included. Thirty-day m...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Review Article Source Type: research
Figure 4 Knot: Simple Tying Technique for Robotic and Endoscopic Sutures
Abstract: Various endoscopic suturing and tying methods have been reported, but these methods remain imperfect because knots are sometimes not tied completely and additional stitches are needed. To address this problem, we developed the “Figure 4” technique in which the knot can be easily slid to the suture point and tied by pulling suture tail—these knots will never come untied. This technique requires very simple technique and can be used in other surgical procedures such as conventional laparoscopic surgery. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research
Antegrade Cardioplegia Decannulation Using the COR-KNOT System in Minimally Invasive Mitral Valve Surgery
Abstract: A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding. (Source: Innovation...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research
Concomitant Valve-in-Valve Transcatheter Aortic Valve Replacement and Left Ventricular Assist Device Implantation
Abstract: Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation. Transthoracic echocardiography results showed severe aortic pros...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
