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Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery

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https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#1
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28106618/right-internal-mammary-artery-use-in-140-robotic-totally-endoscopic-coronary-bypass-cases-toward-multiarterial-grafting
#2
Husam H Balkhy, Sandeep Nathan, Susan E Arnsdorf, Dorothy J Krienbring
OBJECTIVE: Benefits of adding a second arterial graft in coronary bypass are well documented. In patients requiring mulitvessel grafting robotic totally endoscopic coronary bypass (TECAB) has allowed for routine harvesting and use of the right internal mammary artery (RIMA). We retrospectively reviewed the technical considerations and target choice in 140 cases of beating heart TECAB where a RIMA graft was used. METHODS: In 2008, we introduced beating heart TECAB with anastomotic connectors into our practice, first with single IMA and then with bilateral internal mammary artery...
January 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#3
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28092294/outcomes-of-a-combined-approach-of-percutaneous-coronary-revascularization-and-cardiac-valve-surgery
#4
Orlando Santana, Sandeep Singla, Christos G Mihos, Andrés M Pineda, Gregg W Stone, Paul A Kurlansky, Isaac George, Ajay J Kirtane, Craig R Smith, Nirat Beohar
A subset of patients requiring coronary revascularization and valve surgery may benefit from a combined approach of percutaneous coronary intervention (PCI) and valve surgery, as opposed to the standard median sternotomy approach of combined coronary artery bypass and valve surgery. To evaluate its potential benefits and limitations, a literature search was performed using PubMed, EMBASE, Ovid, and the Cochrane library, through March 2016 to identify all studies involving a combined approach of PCI and valve surgery in patients with coronary artery and valvular disease...
January 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28085691/robot-assisted-mitral-valve-repair-with-posterior-leaflet-extension-for-rheumatic-disease
#5
Burak Onan, Unal Aydin, Zeynep Kahraman, Korhan Erkanli, Ihsan Bakir
Mitral valve repair has been one of the widely used applications of robotic surgery. Patients with rheumatic mitral disease usually present at an early age with thickening, retraction, or fusion of the leaflets and subvalvular apparatus. Robotic mitral repair can be feasible among this group of patients, rather than replacement. Herein, we describe a young woman who presented with rheumatic mitral valve insufficiency. A complex mitral repair with posterior leaflet extension with an autologous pericardial patch was successfully conducted using robot assistance...
January 12, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28085690/a-novel-robotic-bilateral-internal-mammary-artery-harvest-using-double-docking-technique-for-coronary-artery-bypass-grafting
#6
Tatsuya Tarui, Norihiko Ishikawa, Go Watanabe
da Vinci Surgical System (da Vinci) enabled port access for internal mammary arteries (IMA) harvesting. However, bilateral IMA (BIMA) harvesting is difficult when performed on single side. We developed a novel technique of double docking the da Vinci by transpositioning from the left side to the right and examined the feasibility. Twelve patients underwent BIMA harvesting using the double-docking technique. First, the da Vinci was set on the patient's left side for the right IMA harvesting. Afterward, the da Vinci was undocked and transpositioned from the patient's left side to the right side...
January 12, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28085689/consideration-of-native-coronary-disease-progression-in-the-decision-to-perform-hybrid-coronary-revascularization
#7
Maria L Rodriguez, David Glineur, Marc Ruel
No abstract text is available yet for this article.
January 12, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28085688/schwannoma-of-the-recurrent-laryngeal-nerve-a-rare-entity
#8
Linda M de Heer, Ferdinand Teding van Berkhout, Loudy P Priesterbach-Ackley, Marc P Buijsrogge
Neurogenic tumors are the most common posterior mediastinal tumors in adults. Schwannomas originating from the recurrent laryngeal nerve are rare. The present study describes a 46-year-old man with a tumor in the left superior mediastinum. Because of the narrow relationship with the aorta and the left pulmonary artery, the tumor was excised by left-sided minithoracotomy. The tumor, a schwannoma, originated from and encased the left recurrent laryngeal nerve. Six months after surgery, the patient was free of recurrence without symptoms other than hoarseness...
January 12, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27918317/minimally-invasive-robotically-assisted-repair-of-partial-anomalous-venous-connection
#9
Luigi Pirelli, Chad A Kliger, Nirav C Patel, Marcella Bono, Carlos E Ruiz, Vladimir Jelnin, Gregory P Fontana
We describe a novel robotically assisted minimally invasive surgical technique for repair of partial anomalous pulmonary vein connection (PAPVC). Partial anomalous pulmonary vein connection is a rare congenital anomaly that consists in drainage of one or more pulmonary veins into the systemic venous system. Traditionally, large thoracotomy incision and sometimes establishment of cardiopulmonary bypass are needed to redirect the abnormal pulmonary vein to the left-sided reservoir. We describe a robotically assisted, minimally invasive, off-pump technique for the treatment of the left PAPVC in a 57-year-old patient with signs of progressive right ventricular dilatation...
December 1, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27930604/an-automated-expanded-polytetrafluoroethylene-suturing-and-coaxial-fastener-system-for-mitral-chordae-replacement-strength-feasibility-and-healing
#10
Candice Y Lee, Joshua K Wong, Jude S Sauer, Heather R Gorea, Angelo J Martellaro, Andrew R Sifain, Peter A Knight
OBJECTIVE: Mitral valve (MV) chordae replacements can be technically challenging. Technology that remotely delivers and accurately secures artificial chordae may reduce the learning curve and improve the reliability of MV repairs. METHODS: The technology involved two devices: a remote suturing device for delivery of expanded polytetrafluoroethylene (ePTFE) suture to the papillary muscle and a Coaxial titanium suture fastener (TF) device with integrated saline infusion for real-time determination of chordae length during fixation...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27930603/strategies-to-improve-the-efficacy-of-epicardial-linear-ablation-on-the-beating-heart
#11
Yoshiyuki Watanabe, Matthew R Schill, Toshinobu Kazui, Spencer J Melby, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: Creating transmural linear lesions on the beating heart is an important component of minimally invasive surgical ablation for atrial fibrillation. Animal studies have shown poor efficacy for surface bipolar radiofrequency ablation (RFA). Clinicians have developed strategies including multiple device applications and vena caval occlusion (VCO) to improve ablation efficacy. These techniques were evaluated in an acute porcine model. METHODS: In the first experiment, an RFA device was used to perform two 40-second epicardial ablations on the right atrium of six pigs...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27930602/an-early-canadian-experience-with-the-correx-automated-coring-and-apical-connector-device-for-aortic-valve-bypass
#12
Hussein A Al-Amodi, Christopher L Tarola, Hamad F Alhabib, Corey Adams, Linrui Ray Guo, Bob B Kiaii
OBJECTIVE: Aortic valve replacement is the standard of care for severe, symptomatic aortic valve stenosis (AS); however, anatomy or pre-existing comorbidities may preclude conventional or alternative transcatheter approaches. Aortic valve bypass (AVB) may be performed as a salvage procedure for the relief of symptomatic aortic stenosis in patients who are not suitable candidates for aortic valve replacement. METHODS: At our institution, seven patients underwent AVB using the Correx automated coring and apical connector system...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27926627/extrapleural-pneumonectomy-for-malignant-pleural-mesothelioma-a-novel-mini-invasive-technique
#13
Francesco Paolo Caronia, Alfonso Fiorelli, Mario Santini, Ettore Arrigo
We report a novel less-invasive extrapleural pneumonectomy for early-stage malignant pleural mesothelioma without rib spreading. Our approach is unique and differed from the previously reported cases, because we used one skin incision and two small intercostal incisions with videothoracoscopic viewing without rib spreading. The pleural dissection and approach to the hilum for pneumonectomy were performed through a 4- to 5-cm port incision in the sixth intercostal space. Another 4- to 5-cm port was made in the eight intercostal space through the same skin incision and was used for diaphragm resection and reconstruction...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27926626/frailty-assessed-by-the-forecast-is-a-valid-tool-to-predict-short-term-outcome-after-transcatheter-aortic-valve-replacement
#14
Adrian R Kobe, Alexander Meyer, Hassan Elmubarak, Jörg Kempfert, Jovana Pavicevic, Francesco Maisano, Thomas Walther, Volkmar Falk, Simon H Sündermann
OBJECTIVE: The term frailty is frequently used during decision-making in transcatheter heart valve procedures. Nevertheless, frailty is still measured by eyeballing rather than by using standardized frailty assessments. In a previous study, we developed a frailty score in a cardiac surgical patient population including patients, who underwent transcatheter aortic valve replacement (TAVR). Here, we present the results from the subsequent validation study focusing on the TAVR cohort. METHODS: One hundred thirty patients underwent TAVR...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922991/2015-best-manuscript-awards
#15
Ralph J Damiano
No abstract text is available yet for this article.
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922990/robotically-assisted-thoracic-surgery-proposed-guidelines-for-privileging-and-credentialing
#16
Faiz Y Bhora, Adnan M Al-Ayoubi, Sadiq S Rehmani, Craig M Forleiter, Wissam N Raad, Scott G Belsley
OBJECTIVE: Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage. METHODS: We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922989/totally-endoscopic-robotic-correction-of-cor-triatriatum-sinister-coexisting-with-atrial-septal-defect
#17
Changqing Gao, Ming Yang, Cangsong Xiao, Huajun Zhang, Gang Wang
Cor triatriatum sinister (CTS) is a rare congenital cardiac anomaly and is mainly corrected through conventional surgery through sternotomy. We described our successful novel surgical technique of totally robotic correction of CTS in one case of CTS with concomitant repair of atrial septal defect using da Vinci SI Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA USA) with excellent surgical outcome. We conclude that robotic correction of CTS is a feasible and safe alternative to conventional surgical technique...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922988/minimally-invasive-fundoplication-is-safe-and-effective-in-patients-with-severe-esophageal-hypomotility
#18
Michael B Goldberg, Abbas El-Sayed Abbas, Michael S Smith, Henry P Parkman, Ron Schey, Daniel T Dempsey
OBJECTIVE: Fundoplication is used to treat refractory gastroesophageal reflux disease (GERD). A subset of patients has coexisting esophageal dysmotility, including aperistalsis or hypoperistalsis. These patients may be at increased risk of dysphagia after fundoplication. To evaluate the outcomes of minimally invasive fundoplication (MIF) in patients with GERD and esophageal hypomotility. METHODS: Retrospective review of all patients who underwent MIF and had severe esophageal hypomotility from January 2003 to June 2013...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922524/resolution-of-intractable-ventricular-tachycardia-after-surgical-repositioning-of-a-heartmate-ii-inflow-cannula
#19
Andre Y Son, Alex Reyentovich, Stephen Pan, Abe DeAnda, Leora B Balsam
Ventricular arrhythmias are common after left ventricular assist device implantation. Malposition of the inflow cannula is one of the few etiologies with a mechanically correctable defect. We present a case of intractable ventricular tachycardia that resolved after surgical repositioning of a HeartMate II inflow cannula. The diagnosis and management of this case demonstrate the utility of imaging studies for detecting inflow cannula malposition and the efficacy of inflow cannula repositioning for treatment.
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922523/a-simple-and-effective-technique-for-anatomical-approximation-of-the-upper-pericardium-using-hemostatic-clips
#20
Mubassher Husain, Metesh Nalin Acharya, Ian Cummings, Shahzad Gull Raja
Closure of the pericardium is important to protect bypass grafts, the great vessels, and the heart from injury due to sternal dehiscence. Furthermore, it is reported to reduce the formation of pericardial adhesions and thus facilitate entry into the chest at resternotomy. We here describe a simple, reproducible, and effective technique for tension-free approximation of the upper pericardium by applying small hemostatic clips to the preserved thymic fascia overlying the pericardium.
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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