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Seminars in Thoracic and Cardiovascular Surgery

Yaron D Barac, David Harold Harpole, Kamrouz Ghadimi, Carmelo A Milano
No abstract text is available yet for this article.
January 16, 2019: Seminars in Thoracic and Cardiovascular Surgery
Aurélien Hostalrich, Ludovic Canaud, Baris Ata Ozdemir, Xavier Chaufour
10 month after thoracic endovascular treatment of blunt thoracic aortic injury, a 15 year old woman was admitted for chest pain, headache and lower limbs weakness. Emergent computed tomography showed almost occlusive stenosis at the distal junction between the thoracic stent graft and the native thoracic due to clot formation inside the graft. She subsequently presented a pulmonary edema with concurrent anuria. Emergent angioplasty and stenting using nitinol bare stent was successfully performed. Blood pressure gradient between radial and femoral arteries decreased from 100mmHg to 25mmHg...
January 15, 2019: Seminars in Thoracic and Cardiovascular Surgery
Ken-Ichi Imasaka, Takuya Nishijima, Eiki Tayama, Shigeki Morita, Ryohei Toriya, Yukihiro Tomita
OBJECTIVES: To investigate postoperative pectoral atrophy in 141 patients undergoing aortic arch surgery involving bilateral axillary artery cannulations with side grafts. METHODS: The depth from the skin to the axillary artery surrounding the thoracoacromial artery (zone 1), and the thicknesses of pectoralis major (zone 2) and pectoralis minor (zone 3) were measured by computed tomography before surgery, at 1 and 6 months after surgery, and at the most recent follow-up assessment (PostT2) (mean = 41 months, range 11-75 months)...
January 14, 2019: Seminars in Thoracic and Cardiovascular Surgery
Alexander Bogachev-Prokophiev, Alexander Afanasyev, Sergei Zheleznev, Alexey Pivkin, Ravil Sharifulin, Dmitriy Kozmin, Alexander Karaskov
OBJECTIVE: Surgical septal myectomy is a standard treatment option for patients with hypertrophic obstructive cardiomyopathy. Subvalvular abnormalities of the mitral valve might play an important role in residual left ventricular outflow tract obstruction. This randomized study aimed to compare the surgical outcomes of septal myectomy with versus without subvalvular interventions. METHODS: Between July 2015 and December 2016, 80 eligible patients were randomly assigned to undergo septal myectomy with versus without subvalvular intervention...
January 11, 2019: Seminars in Thoracic and Cardiovascular Surgery
Seiki Hasegawa, Nobuyuki Kondo, Seiji Matsumoto, Teruhisa Takuwa, Masaki Hashimoto, Ayumi Kuroda, Toru Nakamichi, Norihiko Kamikonya, Tohru Tsujimura, Takashi Nakano
OBJECTIVES: We compared less invasive surgery with conventional surgery for malignant pleural mesothelioma (MPM). METHODS: We retrospectively reviewed consecutive patients with MPM who received surgery at Hyogo College of Medicine between July 2004 and April 2016. Patients underwent multimodal treatment comprising chemotherapy (neoadjuvant and/or adjuvant) and surgery with or without 54 Gy hemithoracic radiotherapy. Patients were grouped into 3 groups according to the surgery intended: Conventional extrapleural pneumonectomy was intended in Group 1(until August 2009); Less invasive extrapleural pneumonectomy was intended in Group 2 (after September 2009); Pleurectomy/decortication was intended in Group 3 (after September 2012)...
January 10, 2019: Seminars in Thoracic and Cardiovascular Surgery
Anthony Zaki, Edward G Soltesz, Faisal G Bakaeen
No abstract text is available yet for this article.
January 9, 2019: Seminars in Thoracic and Cardiovascular Surgery
Xiaoying Lou, Edward P Chen
Cerebral protection strategies in aortic surgery have undergone significant evolution over the years, but its tenets remain rooted in maintenance of hypothermia and cerebral perfusion to limit adverse neurologic outcomes. While deep hypothermic circulatory arrest (DHCA) alone remains a viable approach in many instances, the need for prolonged duration of circulatory arrest and increasing case complexity have driven the utilization of adjunctive cerebral perfusion strategies. In this review, we present the most recent studies published on this topic over the last few years investigating the efficacy of DHCA, retrograde cerebral perfusion (RCP), and unilateral and bilateral antegrade cerebral perfusion (ACP), as well as the emerging trend towards mild and moderate HCA temperatures...
January 8, 2019: Seminars in Thoracic and Cardiovascular Surgery
Jiheum Park, Arnar Geirsson, Pramod N Bonde
OBJECTIVE: Mathematical modeling tries to simplify understanding and proposes a fundamental mechanism that governs the motion and function of a complex biological system such as a mitral valve (MV) motion which represents a dynamic interplay between papillary muscle (PM) position in the context of left ventricular (LV) shape dynamics. Current therapeutic strategies to intervene on the MV may not have exploited these relationships due to lack of understanding of the interactions. We present a MV 3D mathematical model characterized by LV shape dynamics to understand fundamental working principles of ventriculo-papillary-mitral complex...
January 8, 2019: Seminars in Thoracic and Cardiovascular Surgery
Ahmed A Kolkailah, Sameer A Hirji, Julius I Ejiofor, Fernando Ramirez Del Val, Ritam Chowdhury, Siobhan McGurk, Jiyae Lee, Tsuyoshi Kaneko
OBJECTIVES: The effects of patient-prosthesis mismatch (PPM) after surgical aortic valve replacement (SAVR) suggest worse outcomes with smaller valves. We assessed clinical outcomes of younger females undergoing SAVR, using small and large prostheses, and the incremental risk of PPM. METHODS: Between January 2002 and June 2015, 451 younger (age ≤65 years) female patients underwent SAVR. Patients were stratified into small prostheses (SP)≤21-mm (n=256) and large prostheses (LP) ≥23-mm (n=195) groups...
January 7, 2019: Seminars in Thoracic and Cardiovascular Surgery
Yasuo Sekine, Takamasa Itoh, Takahide Toyoda, Taisuke Kaiho, Eitetsu Koh, Toshiko Kamata, Hidehisa Hoshino, Atsushi Hata
OBJECTIVE: We developed a novel approach combined with 3D Image Analyzer and infrared thoracoscopy for pulmonary sublobar resection. The purpose of this study was to investigate the feasibility of this procedure. METHODS: From October 2014 to April 2018, 65 cases were enrolled, and 58 cases were evaluated. For each case, several virtual sublobar resections were created by 3D Image Analyzer preoperatively. The surgical margin was measured in each simulated sublobar resection and the most appropriate procedure was selected...
January 4, 2019: Seminars in Thoracic and Cardiovascular Surgery
Desiree Bonadonna, Yaron D Barac, David N Ranney, Craig R Rackley, Kevin Mumma, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
Utilization of extracorporeal membrane oxygenation (ECMO) has increased dramatically over the last decade. Despite this trend, many medical centers have limited, if any, access to this technology or the resources necessary to manage these complex patients. In an effort to improve the current infrastructure of regional ECMO care, ECMO centers of excellence have an obligation to partner with facilities within their communities and regions to increase access to this potentially life-saving technology. While the need for this infrastructure is widely acknowledged in the ECMO community, few reports describe the actual mechanisms by which a successful interfacility transport program can operate...
January 4, 2019: Seminars in Thoracic and Cardiovascular Surgery
James D St Louis, Nick Timkovich, Susanna Lenderman, Richard A Jonas, Kristine J Guleserian, Christo I Tchervenkov, Jeffery P Jacobs, Erle H Austin, Mark D Plunkett, John L Myers, Viktor Hraska, Pranava Sinha, James E O'Brien, Marshall L Jacobs, James K Kirklin
The World Society for Pediatric and Congenital Heart Surgery has endorsed the establishment of an international platform for the exchange of knowledge and experience for those that treat patients with a congenital heart defect. On January 1st , 2017, the release of the World Database for Pediatric and Congenital Heart Surgery opens a new era in evaluation of treatment with congenital heart defects. The contribution of data from countries with established congenital surgical databases will greatly enhance the efforts to provide the most accurate measure of overall surgical outcomes across the globe...
January 4, 2019: Seminars in Thoracic and Cardiovascular Surgery
Bartholomew V Simon, Subhashini Subramanian, Michael F Swartz, Hongyue Wang, Nader Atallah-Yunes, George M Alfieris
OBJECTIVE: Adverse events following tetralogy of Fallot repair include arrhythmia, reoperation and death. While limiting the right ventriculotomy mitigates these events over the short- and intermediate-term, the impact over the long-term is unknown. METHODS: Children requiring tetralogy of Fallot repair were divided into two groups: extended right ventriculotomy vs limited right ventriculotomy with transatrial ventricular septal defect closure. Follow-up office ECGs and Holter monitoring, exercise stress tests, and echocardiograms were obtained in the first, second, and third postoperative decades...
January 4, 2019: Seminars in Thoracic and Cardiovascular Surgery
Claudio Andreetti, Camilla Poggi, Erino Angelo Rendina, Alfonso Fiorelli
No abstract text is available yet for this article.
January 4, 2019: Seminars in Thoracic and Cardiovascular Surgery
Marco A Zenati, Kay Leissner, Suzana Zorca, Lauren Kennedy-Metz, Steven J Yule, Roger D Dias
Cognitive workload data of members of the cardiac surgery team can be measured intraoperatively and stored for later analysis. We present a case of a near-miss (medication error) that underwent root cause analysis using workload data. Heart rate variability data, representing workload levels, were collected from the attending surgeon, attending anesthesiologist, and lead perfusionist using wireless heart rate monitors. An episode of cognitive overload of the anesthesiologist due to a distractor was associated with the preventable error...
December 19, 2018: Seminars in Thoracic and Cardiovascular Surgery
Pouya Hemmati, Joseph A Dearani, Richard C Daly, Katherine S King, Naser M Ammash, Frank Cetta, Hartzell V Schaff
OBJECTIVE: There is a paucity of cardiac surgery outcomes data for patients with Noonan syndrome (NS). Our objective was to evaluate early results in these patients. METHODS: Between January 1999-December 2015, 29 patients (18 males, 62%) with NS underwent cardiac surgery at our institution. Mean age was 23±17.9 years; 12 (41%) were under 18 years of age. Fourteen patients (48%) had prior sternotomies. RESULTS: The primary operations for the main diagnosis were pulmonary valve/conduit replacement/repair (n=14, 48%), septal myectomy for obstructive hypertrophic cardiomyopathy (n=7, 24%), aortic valve replacement/repair (n=4, 14%), atrial septal defect (ASD) repair (n=2, 7%), and cardiac transplantation (n=2, 7%)...
December 18, 2018: Seminars in Thoracic and Cardiovascular Surgery
Robert A F de Lind van Wijngaarden, Sabrina Siregar, Juno Legué, Aafke Fraaije, Araz Abbas, Jenny Dankelman, Robert J M Klautz
OBJECTIVE: Verbal communication during coronary artery bypass graft (CABG) procedures is essential for safe and efficient cardiac surgery, yet sensitive to failure due to a current lack of standardization. The goal of this study was to improve communication during CABG by identifying critical items in verbal interaction between surgeons, anesthetists and perfusionists. METHODS: Based on 6 video recordings, a list was assembled containing items of communication in CABG procedures...
December 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
Yuki Shiina, Takahiro Nakajima, Hidemi Suzuki, Ichiro Yoshino
No abstract text is available yet for this article.
December 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Konstantinos Tsagakis, Rolf A Jánosi, Ulrich H Frey, Thomas Schlosser, Roberto Chiesa, Tienush Rassaf, Heinz Jakob
OBJECTIVES: Acute type I aortic dissection (AD) complicated from true lumen (TL) collapse and malperfusion downstream is associated with devastating prognosis. The study reports an institutional mid-term experience with TL stabilization by uncovered stents to restore perfusion as a supplement to proximal thoracic aortic surgery. METHODS: Between 01.2007-05.2017 181 out of 270 acute type A AD patients were operated on type I AD. In 18 (10%) uncovered stents were used to expand the aortic TL in presence of visceral/peripheral malperfusion...
December 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Elham Bidar, Sara C Arrigoni, Ryan E Accord
No abstract text is available yet for this article.
December 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
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