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.New Small-Diameter Forceps for Thoracoscopic Surgery: Technical Adaptations and Initial Experiences
In this report, we describe the use of new small-diameter forceps (Endo Relief forceps) for port-reduced thoracoscopic surgery. Forceps were designed with end that were the same size and shape as conventional 5-mm forceps, except that the diameter of the shaft was decreased to 2.4 mm. Endo Relief forceps were used for thoracoscopic surgery in 18 patients. We retrospectively compared the frequency of grasping error between conventional small-diameter forceps and Endo Relief group. The mean surgical time was 57.5 minutes (range, 45–75 minutes). There were no complications, no recurrences of pneumothorax and lung cancer, an...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research
Aspergilloma of the Lung: Strategy to Prevent Endobronchial Spillage
Abstract: Aspergilloma of the lung eroding into the airway may lead to perioperative endobronchial spillage and contamination of the normal lung. Our aim in this group of patients who are undergoing robotic- or video-assisted thoracoscopic lobectomy is to protect the contralateral lung and, if possible, uninvolved lobes of ipsilateral lung. Double-lumen endobronchial tubes do provide lung protection to the contralateral lung intraoperatively, but there is no protection to the ipsilateral lung lobes not involved by the disease process. Moreover, there is no lung protection against endobronchial spillage during the period of...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research
Onyx Embolization as Single Rescue Treatment for Ruptured Abdominal Aortic Aneurysm After EVAR
Abstract: A 76-year-old man who had undergone endovascular repair for an infrarenal aortic aneurysm, presented with a late type Ia endoleak 3 years after his operation. Deployment of an aortic cuff did not achieve a better seal at the proximal neck, and the aneurysm developed a rupture. We successfully treated the ruptured aneurysm using transcatheter Onyx embolization only. At 6-month and 1-year follow-ups with contrast-enhanced duplex scanning, no endoleak was seen and sac shrinkage was observed. Onyx is a relatively new liquid embolic agent that is slowly transformed into a solid state by contact with blood. Owing to th...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Type IIIb Endoleak Associated With an Infected Thoracoabdominal Endograft
We present a 63-year-old male patient who presented with vague abdominal pain after an endoluminal thoracoabdominal aneurysm repair. He was found to have an infected endograft and an associated type IIIb endoleak. We believe that the infection contributed to the fabric degradation along the endograft and resulted in an expanding endoleak. Graft explantation was not performed because of the patient's multiple comorbidities, and the endoleak was treated with an additional stent graft and suppressive antibiotics. Endograft infection may lead to endograft degradation and associated leak. Therefore, an infectious etiology, alth...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Transaortic Transcatheter Aortic Valve Implantation and Concomitant Off Pump Revascularization
We present 4 successfully combined off-pump procedures consisting of a transcatheter aortic valve implantation (Edwards SAPIEN XT) via the transaortic approach and an off-pump coronary artery bypass grafting. All patients were discharged free from stroke, myocardial infarction, or access site complications either to rehabilitation facility or to the referring hospital with none or trace aortic regurgitation and patent grafts. These cases confirm the feasibility of those combined operations and should be considered as realistic alternative for surgical treatment in high-risk patients who are clearly identified to benefit fr...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Pseudoaneurysm as a Late Complication of Hybrid Aortic Arch Repair
Abstract: Hybrid aortic arch repair is increasingly used for the management of aortic arch aneurysm. Pseudoaneurysm is a newly described late complication of this procedure. A 57-year-old man underwent emergent supra-aortic debranching and aortic arch stent grafting after rupture of an arch aneurysm. Three years later, the patient presented with a pseudoaneurysm at the junction between the stent graft's proximal landing zone and the origin of the debranching graft. At reoperative repair, the proximal stent graft had eroded through the aortic wall at the junction of the endograft proximal landing zone and the proximal anast...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research
Ascending Aortic Endoballoon Occlusion Feasible Despite Moderately Enlarged Aorta to Facilitate Robotic Mitral Valve Surgery
Conclusions: Our experience suggests that it is possible to successfully use endoaortic balloon occlusion in patients with ascending aortic dilation with proper preoperative imaging and planning. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
The Application of Liquid Nitrogen Spray Cryotherapy in Treatment of Bronchial Stenosis
Conclusions: The median change in grade after treatment was 2 grades of improvement for both the benign and malignant groups. These results provide evidence that the use of SCT is equally efficacious for both types of stenosis with an expectation of overall improvement in luminal patency, offering a safe and effective method of achieving airway patency in a minimally invasive fashion. This study contributes to the small but growing body of literature supporting the use of SCT in benign and malignant disease. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Early Results of the Modified Right Atrial Lesion Set for the Cox-CryoMaze Procedure
Conclusions: These results suggest the modified RAL set to be an effective alternative to the traditional RALs of Cox-Maze III. By substituting this lateral RAA lesion for the more technically difficult medial lesion, the procedure becomes easier to perform and favorably impacts operative time while achieving comparable results in reducing AF burden. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Proof of Concept of an Endoscopic Sutureless Valve Sizer
Conclusions: The use of the endoscopic expandable sizer is technically possible. In this early-stage test in the flaccid heart, selection of the valve size was satisfactory during thoracoscopic sutureless aortic bioprosthesis implantation. Further laboratory evaluation with fluid dynamics (aortic root pressurization) will be performed before a clinical study is started. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Prosthetic Aortic Valve Fixation Study: 48 Replacement Valves Analyzed Using Digital Pressure Mapping
Objective: Prostheses attachment is critical in aortic valve replacement surgery, yet reliable prosthetic security remains a challenge. Accurate techniques to analyze prosthetic fixation pressures may enable the use of fewer sutures while reducing the risk of paravalvular leaks (PVL).
Methods: Customized digital thin film pressure transducers were sutured between aortic annulus models and 21-mm bioprosthetic valves with 15 × 4-mm, 12 × 4-mm, or 9 × 6-mm-wide pledgeted mattress sutures. Simulating open and minimally invasive access, 4 surgeons, blinded to data acquisition, each secured 12 valves using manual knot-tying ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Robotic Resection of 3 cm and Larger Thymomas Is Associated With Low Perioperative Morbidity and Mortality
Objective: The approach to thymoma resection has usually been determined by tumor size, although established guidelines do not exist. Minimally invasive approaches have been limited to tumors smaller than 5 cm, although 3 cm has been the suggested cutoff for performing an adequate oncologic procedure. No study has compared the perioperative outcomes of patients with 3 cm or larger tumors resected robotically versus sternotomy.
Methods: We reviewed patients who underwent resection of 3 cm or larger thymomas from 2004 to 2014. Patients were divided based on approach: robotic and open thymectomy/thymomectomy.
Results: Forty...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Predictors and Outcomes of Sternotomy Conversion and Cardiopulmonary Bypass Assistance in Minimally Invasive Coronary Artery Bypass Grafting
Objective: This work's objective was to identify the determinants of conversion of minimally invasive coronary artery bypass grafting to sternotomy, with and without cardiopulmonary bypass assistance, and to compare clinical outcomes in patients who needed conversion.
Methods: This is a prospectively collected data on patients who underwent minimally invasive coronary bypass done by a single surgeon from February 2005 to September 2014. Statistical analyses were expressed as mean values ± standard deviation or proportions.
Results: The total number of patients was 266, with an average age of 62 years. The median number ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research
Mechanical Circulatory Support: Heart Failure Therapy “in Motion”
Abstract: Because the first generation of pulsatile-flow devices was primarily used to bridge the sickest patients to transplantation (bridge-to-transplant therapy), the current generation of continuous-flow ventricular assist devices qualifies for destination therapy for patients with advanced heart failure who are ineligible for transplantation. The first-generation devices were associated with frequent adverse events, limited mechanical durability, and patient discomfort due device size. In contrast, second-generation continuous-flow devices are smaller, more quiet, and durable, thus resulting in less complications and ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Review Article Source Type: research
Right Minithoracotomy Approach for Replacement of the Ascending Aorta, Hemiarch, and Aortic Valve
Abstract: A minimally invasive right anterior thoracotomy approach is the preferred technique used at our institution for isolated aortic valve pathology. We have recently introduced more complex concomitant minimally invasive procedures through this access site. Here, we describe how we perform a replacement of the ascending aorta and aortic valve with and without the use of circulatory arrest through a 6-cm right minimally invasive thoracotomy incision. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Article Source Type: research
