Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 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.

Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy
This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Hematomas in Tiger Territory: An Endovascular Alternative to Wading In
A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy. Renal artery stenting has been advoc...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Rapid Explantation of Rapid-Deployment Sutureless Valve in Case of Acute Endocarditis: How to Remove Safely Sutureless Perceval S Prostheses
We report a case of infective endocarditis on a Perceval S aortic valve bioprosthesis, and we describe a feasible and useful technique that can help remove the infected valve. These maneuvers consist of an “x-movement” reached with the aid of anatomical forceps. The risk of infective endocarditis in patients with prosthetic valves is a well-known phenomena in cardiac surgery, and it can represent a life-threatening event in many cases. According to guidelines, an emergency surgical intervention is required in case of high risk of embolization, vegetation superior than 1 cm or acute cardiac failure secondary to the acut...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Totally Endoscopic Robotic Management of Failed Percutaneous Atrial Septal Defect Closure With Tricuspid Valve Injury
Totally endoscopic robotic surgery is a safe approach to atrial septal defect closure in adults. Robotic approach can be an alternative to traditional incisions in the management of concomitant tricuspid valve regurgitation with ruptured chordae tendineae. Herein, we describe a woman who presented with atrial septal defect and tricuspid insufficiency after an unsuccessful percutaneous intervention with device removal from the right ventricle. Concomitant closure of septal defect and tricuspid valve repair with artificial chords was successfully performed using robot assistance. (Source: Innovations: Technology and Techniqu...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta. Three patients were transferred from outside facilitie...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Pharmacomechanical Thrombolysis for Deep Vein Thrombosis in May-Thurner Syndrome
Conclusions In patients with May-Thurner syndrome, pharmacomechanical thrombolysis is an effective approach for the management of acute deep vein thrombosis, decreasing thrombus burden, and long-term postthrombotic syndrome when used in conjunction with stenting. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Three-Dimensional Printing of Life-Like Models for Simulation and Training of Minimally Invasive Cardiac Surgery
Conclusions This life-like model can be used as a standard simulator to train younger, less experienced surgeons to practice minimally invasive cardiac surgery procedures and may help develop new operative tools. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Impact of an Ultrasonically Activated Device in Robot-Assisted Distal Gastrectomy
This study therefore assessed the effect of ultrasonically activated device use on procedural times and on other early surgical outcomes. Methods Consecutive patients (N = 42) who underwent robot-assisted distal gastrectomy for gastric cancer were included. Clinicopathological characteristics and early surgical outcomes were compared between robotic-assisted gastrectomy procedures using an ultrasonically activated device (U group, n = 21) and those without it (NU group, n = 21). Results There were no significant differences in patient characteristics between the groups; however, the median operation time was signific...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart Without Robotic Assistance in 25 Patients
Conclusions Totally endoscopic operation for ASD closure on beating heart is safe, with short recovery period, and surgical scars are of high cosmetic value, especially in a woman and girl. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Long-Term Success With Driveline Exit Site Relocation for Deep Driveline Infection in Left Ventricular Assist Device Patients
Conclusions An aggressive surgical strategy, including debridement and formal relocation of the driveline exit site, can result in long-term device salvage after deep driveline infection. This approach is a less invasive alternative to device exchange for refractory driveline infections. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Morbid Obesity Does not Increase Morbidity or Mortality in Robotic Cardiac Surgery
Objective Morbid obesity (body mass index ≥ 35 kg/m2) usually confers a higher perioperative risk in cardiac surgery. Robotic cardiac surgery may have many advantages for these high-risk patients. Methods We retrospectively reviewed patients undergoing robotic cardiac surgery from July 2013 to April 2017 at our institution. We compared the outcomes of morbidly obese patients versus nonobese patients. Results A total of 486 patients underwent robotic cardiac surgery (322 men, median age = 65 years). The robotic procedures were the following: totally endoscopic beating heart coronary artery bypass (n = 263), mitral...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Pressure and Flow Characteristics of a Novel Bidirectional Cannula for Cardiopulmonary Bypass
Objective Femoral arterial cannulation is associated with a significant risk of lower limb ischemia. The aim of the study was to assess the pressure and flow in the femoral artery using a novel bidirectional femoral cannula in a sheep model of peripheral cardiopulmonary bypass. Methods Peripheral cardiopulmonary bypass was established using a multistage venous cannula inserted into the internal jugular vein and the bidirectional or a conventional arterial cannula into the femoral artery in seven adult ewes. Systemic and distal perfusion pressures and flow rates were measured during cardiopulmonary bypass with flow rat...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

The Need for Consistent Predictors of Success for Surgical Ablation of Atrial Fibrillation: A Call to Action
Conclusions The innate heterogeneity of published data precludes a meta-analysis for predictors of surgical ablation success. Of the few published studies that allow comparison, the most consistent predictors of failure were enlarged left atrium and long atrial fibrillation duration. These results underscore the need for consistent and reliable outcome predictors. We strongly recommend the development of a standardized system of measurement for consistent clinical parameters that can be used in outcome analyses for surgical ablation of atrial fibrillation. (Source: Innovations: Technology and Techniques in Cardiothoracic...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Benefits of Electromagnetic Navigational Bronchoscopy for Identifying Pulmonary Nodules for Robotic Resections
Conclusions Pleural dye marking via electromagnetic navigational bronchoscopy can provide an effective method for localizing pulmonary nodules, while maintaining a minimally invasive robotic approach. This tactic allows one to obtain diagnostic tissue more efficiently, while limiting the potential inability to localize a nodule. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Use of a New Expanded Polytetrafluoroethylene Multichordal Mitral Apparatus (MitraPatch) to Repair Complex Mitral Valve Lesions
We report a new expanded polytetrafluoroethylene multichordal mitral apparatus (MitraPatch) to simplify mitral repairs involving multiple cusps and sought to describe the surgical technique and demonstrate the efficacy of the device. Methods MitraPatch was laser cut from a single sheet of expanded polytetrafluoroethylene and mounted on a custom-designed handle. Surgical technique to deploy the apparatus on the native mitral valve was developed in ex vivo porcine hearts. Hemodynamic efficacy of repairing mitral prolapse and regurgitation was assessed in ex vivo hearts and in five 30-day chronic swine, with histopathology...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research