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Intraoperative Management of Hypercapnia With an Extracorporeal Carbon Dioxide Removal Device During Giant Bullectomy
This report describes a case of giant bullectomy for vanishing lung syndrome in which intraoperative hypercapnia secondary to protective ventilation was managed with a CO2-removal device (Decap-Hemodec s.r.l., Salerno, Italy). To the best of our knowledge, this is the first report in the literature of the intraoperative use of the Decap system for giant bullectomy. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

The Descending Thoracic Aorta: Forgotten Vascular Access for Endovascular Device Delivery
We describe direct descending thoracic aortic access during endovascular aneurysm repair, transcatheter aortic valve replacement, and redo mesenteric revascularization in three patients who did not have traditional access options. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Robotic Endoscopic Off-Pump Total Pericardiectomy in Constrictive Pericarditis
Conclusions: Total pericardiectomy for constrictive pericarditis can be performed using a robotic approach. In contrast to thoracoscopy, it offers better visualization of both phrenic nerves, avoids injury, and allows a thorough pericardial dissection. In our experience, the robotic left chest approach has proven more efficacious in removing the posterior pericardium than is allowed with median sternotomy. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Health-Related Quality of Life After Minimally Invasive Cardiac Surgery
Conclusions: Health-related quality of life improved significantly after minimally invasive cardiac surgery. These improvements were influenced by age, operative risk, symptoms, and rhythm status. Even patients with HRQL in a normal range before surgery can experience improved HRQL after surgery. Minimally invasive cardiac surgery can offer decreased postoperative complications and also improved HRQL. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Nicorandil Infusion During Off-Pump Coronary Artery Bypass Grafting Reduces Incidence of Intra-aortic Balloon Pump Insertion
Conclusions: Nicorandil infusion significantly (P = 0.007) reduced the incidence of intra-aortic balloon pump insertion in our series. In patients with left ventricular dysfunction (ejection fraction ≤ 30%), this difference (P = 0.008) assumes a special significance as off-pump bypass surgery is considered high risk in this subset. Nicorandil is an inexpensive drug, and the reduction in cost of surgery by avoiding intra-aortic balloon pump insertion is an added advantage. The use of nicorandil infusion during off-pump coronary artery bypass may result in favorable patient outcomes by reducing invasive intra-aortic balloo...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

A Laser-Assisted Anastomotic Technique: Feasibility on Human Diseased Coronary Arteries
Conclusions: This study demonstrates the feasibility of an anastomotic connector on human diseased coronary arteries and shows that lasering does not induce coronary wall damage. However, careful selection of the coronary, regarding the target inner diameter and disease status, will prevent construction failures. This connector could facilitate less invasive coronary artery bypass grafting. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

The Impact of Robotic Versus Conventional Coronary Artery Bypass Grafting on In-Hospital Narcotic Use: A Propensity-Matched Analysis
Conclusions: Patients undergoing robotic CABG use fewer narcotics over the first three hospital days than patients undergoing conventional CABG. The surrogate of narcotics use for postoperative pain shows that the minithoracotomy of robotic CABG may result in either less or equivalent pain than the sternotomy of conventional CABG. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Transaortic Aortic Valve Implantation in 100 Patients: Follow-up to 3 Years
Conclusions: Our results show that TAo-AVI is a promising alternative to transapical implantation for treating severe inoperable aortic valve stenosis. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Thoracoscopic Ablation With Appendage Ligation Versus Medical Therapy for Stroke Prevention: A Proof-of-Concept Randomized Trial
Conclusions: This small proof-of-concept study showed that TPVIAL improved QOL on two subscores and restored normal sinus rhythm in all but one patient, and it showed the potential to prevent secondary stroke. A larger study will be needed. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

SPECT-CT–Guided Thoracoscopic Biopsy of Sentinel Lymph Nodes in the Internal Mammary Chain in Patients With Breast Cancer: A Pilot Study
Conclusions: Compared with lymphoscintigraphy alone, the use of SPECT-CT improves localization of the SLN in the internal mammary chain, allowing more accurate planning of each individual’s treatment. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

First-in-Man Transcervical Surgical Aortic Valve Replacement Using the CoreVista System
Conclusions: Transcervical SAVR with sutureless valve is feasible using this novel access system. The new approach has potential to offer patients substantially shorter stay and fewer, less serious complications, as has been observed in transcervical thymectomy. Further studies are merited. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

The Evolution of Modern Cardiac Surgery and the Necessity to Change
This article depicts the Kit V. Arom Lecture, which was held at the 15th Annual Congress of the International Society for Minimally Invasive Cardiothoracic Surgery in Berlin, Germany. It describes the evolution of modern cardiac surgery and the necessity for cardiac surgeons to change. The article is dedicated to a pioneer in minimally invasive cardiac surgery and a good friend, Kit V. Arom, MD. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Kit V. Arom Lecture Source Type: research

A Simple Porcine Model of Inducible Sustained Atrial Fibrillation
Abstract: The surgical management of atrial fibrillation (AF) is an evolving field with a history of testing various lesion sets and ablation technologies. Previous animal models of AF require a chronic intervention to make AF reliably inducible. Our objective was to create an acute, reliable, and reproducible porcine model of sustained AF. To accomplish this, 21 adult domestic pigs underwent median sternotomy. Methods to induce AF were then performed sequentially: manual stimulation, rapid pacing (200 beats per minute), and then rapid pacing of 8 beats with a cycle length of 300 milliseconds, followed by an extra stimulus...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Article Source Type: research

Transapical Mitral Valve-in-Valve Implantation Using an Edwards SAPIEN 3 Prosthesis
We report a case of transapical mitral valve-in-valve implantation for a deteriorated bioprosthesis using the SAPIEN 3. Our patient, a 79-year-old man, with a history of mitral valve replacement 10 years before, presented with acute dyspnea due to mitral valve dysfunction. He was successfully treated with transapical implantation and had an uneventful recovery. Our case demonstrates the feasibility of using SAPIEN 3 in treating degenerated bioprosthetic mitral valves. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

External Saphenous Vein Support Mesh Does Not Interfere With Transit-Time Flow Measurement on Venous Coronary Bypass Conduit: Clinical Confirmation
Abstract: A 65-year-old patient underwent double coronary artery bypass grafting using the left internal thoracic artery on the left anterior descending coronary artery and nitinol alloy mesh [external Saphenous Vein Support (eSVS)]–covered saphenous vein graft to the right posterior descending coronary artery. Transit-time flow measurements (TTFMs) were obtained on meshed and bare parts of the vein graft. There was no difference in TTFM parameters (flow, pulsatility index, and diastolic fraction values) obtained from the eSVS mesh–covered and the uncovered parts of the venous graft. This observation confirms that eSVS...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research