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Multimedia Manual of Cardiothoracic Surgery: MMCTS

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https://www.readbyqxmd.com/read/30549511/hybrid-ablation-under-intraoperative-3d-voltage-mapping-guidance
#1
Malak Elbatarny, Benedict Glover, Jason Baley, Sanoj Chacko, Nasser Alhammad, Gianluigi Bisleri
Long-standing persistent atrial fibrillation remains a significant therapeutic challenge, often proving to be resistant to treatment with antiarrhythmic medications and transcatheter ablation. Hybrid ablation, which combines a minimally invasive surgical and transcatheter approach, is emerging as a promising treatment option. In this video tutorial, we demonstrate our method of hybrid ablation for long-standing persistent atrial fibrillation using advanced 3D electro-anatomical voltage mapping to guide the ablation process and thereby improve the ultimate effectiveness of the procedure...
December 10, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30549515/exercises-in-anatomy-ventricular-septal-defect
#2
Robert Anderson, Diane E Spicer, Jessica Saavedra, Carl L Backer
The phenotypic features of the heart with ventricular septal defects will be shown in this video tutorial. There is still no agreement as to whether it's best to categorize lesions on the basis of their geography or their borders. Both geography and borders are features that are of importance. I hope this video will persuade you that the borders are the most significant because they display the phenotypic variance and give added information about the heart regarding the location of the atrioventricular conduction axis...
December 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30549514/repair-of-tricuspid-papillary-muscle-rupture-after-percutaneous-coronary-intervention
#3
Shinji Kanemitsu
Papillary muscle rupture is a rare complication after myocardial infarction and almost all cases occur in the mitral valve papillary muscle. Tricuspid regurgitation development after right ventricular myocardial infarction caused by papillary muscle rupture is extremely rare.  In this video tutorial we present a 70-year-old man with massive tricuspid regurgitation caused by papillary muscle rupture after percutaneous stenting of the right coronary artery. We performed tricuspid valve repair with reimplanted papillary muscle in situ using neither artificial chordae nor a prosthetic valve...
December 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30549509/thoracoscopic-left-apical-bisegmentectomy
#4
George Rakovich
Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. It may also be ideal for removing benign obstructive lesions. Most lung segments may be resected as segmentectomies or as partial bisegmentectomies (as is the case for the lingula). Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that generally allows direct access to the segmental structures, is usually straightforward, and is versatile enough to allow adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy if positive margins are found)...
December 5, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30549513/minimally-invasive-triple-valve-surgery-the-rome-approach
#5
Francesco Musumeci, Antonio Lio, Marcello Bergonzini, Antonio Cammardella, Francesca Nicolò, Federico Ranocchi
Although the benefits of minimally invasive cardiac surgery are well recognized, most surgeons have little experience in the treatment of triple valve disease through a minithoracotomy approach. In this video tutorial, we present a case of concomitant aortic valve replacement with mitral and tricuspid valve repair through a lateral minithoracotomy.
December 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30549512/one-stage-transmediastinal-surgical-approach-for-extensive-aortic-pathology
#6
Corrado Cavozza, Antonio Campanella, Andrea Audo
"One-stage" transmediastinal replacement of the thoracic aorta provides an alternative treatment to single or multiple stage hybrid procedures for patients with ascending, arch, and descending thoracic aorta aneurysm. The patient is placed on bypass and cooled. During circulatory arrest, after surgical treatment of the aortic valve and root where appropriate, the entire ascending aorta is excised and the transverse arch is opened longitudinally. The heart is retracted cephalad and the left pleural cavity is entered longitudinally...
December 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30549510/heartmate-3-left-ventricular-assist-device-minimally-invasive-off-pump-implantation
#7
Paolo Centofanti
With advancements in mechanical circulatory support technology, and limitations in donor supply for heart transplantation, the use of left ventricular assist devices (LVADs) has increased significantly in recent years. Multiple studies have shown that minimally invasive cardiac surgery can improve outcomes, with shorter hospital stays, decreased morbidity, faster recovery and ambulation, and lower total hospital costs. The current generation of centrifugal continuous-flow pumps is miniaturized and makes minimally invasive approaches increasingly practicable...
December 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30480388/uniportal-vats-approach-for-treatment-of-empyema-challenges-and-recommendations
#8
Hussein Elkhayat
The uniportal VATS approach is now taking the lead in the practice of thoracic surgery and is transforming the way we operate. We describe here how to perform a uniportal VATS debridement and decortication, with a special focus on tips and tricks for getting inside an empyema pouch and identifying the optimal plane of cleavage for decortication.
November 21, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30480386/completely-thoracoscopic-superior-segmentectomy-of-the-right-lower-lobe
#9
George Rakovich
Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay.   Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that allows direct access to the segmental structures, and is straightforward and versatile enough to allow adaptation (such as conversion to lobectomy in the case of positive margins) if there are unexpected intraoperative findings...
November 19, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30480387/beating-heart-porcine-high-fidelity-simulator-for-the-training-of-edge-to-edge-mitral-valve-repair
#10
Can Gollmann-Tepeköylü, Johannes Holfeld, Gerhard Pölzl, Bernhard Metzler, Florian Hintringer, Agne Adukauskaite, Marco Stijnen, Sjoerd van Tuijl, Ludwig Müller, Michael Grimm, Nikolaos Bonaros
Transcatheter treatment of structural heart disease is becoming an everyday reality for an increasing number of surgeons, and effective training modalities for basic guide-wire skills, catheter handling, and periprocedural imaging are of growing relevance. In this video tutorial we present a beating-heart porcine model used as a high-fidelity training simulator for transcatheter cardiac valve procedures.  We demonstrate a complete transcatheter edge-to-edge mitral valve repair procedure, including periprocedural imaging, clip deployment, and quality control...
November 16, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30480385/replacement-of-the-descending-thoracic-aorta-after-stent-graft-failure
#11
Thomas Schachner
Open surgery after failed endovascular aortic repair remains an important therapy. The potential modes of stent-graft failure include: type I endoleaks; progression of the aortic disease at the landing zones or proximal/distal to them persistent false lumen perfusion in post-dissection aneurysms; retrograde aortic dissection; stent-graft infection; and stent-graft collapse, fracture, or dislocation. The mortality associated with those procedures can be up to 20% depending on the complexity of the operation and the comorbidities of the patient, especially the presence of graft infection...
November 9, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30480389/muscle-sparing-extrapleural-repair-of-neonatal-aortic-coarctation
#12
René Prêtre, Tornike Sologashvili, Raymond Pfister, Anna Nowacka, Stéphanie Berset, Patrick Myers
The goal of surgical treatment of aortic coarctation is to relieve the pressure gradient on the aorta and to allow for subsequent growth of the repaired aorta. In this regard, coarctation resection and extended end-to-end anastomosis has become the surgical gold standard. Early and long-term results have been reported to be excellent. In this tutorial, we present our technique for correction of aortic coarctation using a muscle-sparing, extrapleural approach.
November 7, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30407760/pleural-packing-revisional-surgeries-and-delayed-chest-closure-a-salvage-strategy-in-lung-transplant
#13
Geoffrey Brioude, Lucile Gust, Henri De Lesquen, Xavier Benoît D'Journo, Pascal Alexandre Thomas
Coagulopathy during lung transplantation leads to 2 major problems: first, control of diffuse bleeding becomes challenging and second, massive lung edema can cause significant volume expansion. To control these potentially lethal complications, we used a combined technique of pleural packing and delayed chest wall closure with negative pressure wound therapy. We retrospectively reviewed 100 bilateral lung transplants performed in our institute over the past 30 months and identified 7 cases of coagulopathy...
November 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30407759/vagus-nerve-preservation-during-minimally-invasive-esophagectomy-with-2-field-lymphadenectomy-for-esophageal-carcinoma-a-more-physiological-alternative
#14
Yin Li, Ahmed Daoud, Yan Zheng, Zongfei Wang, Jiangjun Qin, Jiangen Li
Vagal-sparing esophagectomy allows for curative tumor resection with better functional outcome and reduced postoperative morbidity, and minimally invasive esophagectomy has the advantage of avoiding the morbidities associated with big thoracoabdominal incisions. The video tutorial demonstrates our technique of preserving both vagus nerves and their celiac and hepatic branches in the abdomen during the thoracoscopic and laparoscopic phases of minimally invasive esophagectomy, with 2-field lymphadenectomy, for esophageal carcinoma...
November 5, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30285323/direct-surgical-transcatheter-heart-valve-implantation-in-a-calcified-mitral-valve
#15
Michele Gallo, Stefanos Demertzis, Tiziano Torre, Enrico Ferrari
Surgical transcatheter stent-valve implantation in severely calcific mitral valves represents a bail-out technique  for avoiding ventricular rupture and calcium embolization in patients with a high surgical risk profile. In this video tutorial, we present the transcatheter implantation of a valve in a severely calcific mitral valve annulus, under direct surgical vision, using an anchoring stitch technique to secure the stent-valve to the mitral annulus.
September 26, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30265460/reconstruction-of-regurgitant-bicuspid-aortic-valve-sievers-type-1-l-r-i-with-raphe-resection-and-concomitant-pericardial-patch-augmentation-a-standardized-approach
#16
Markus Liebrich, Vladimir Voth, Nicolas Doll, Wolfgang Hemmer
A major limitation of the more widespread application of aortic valve reconstruction is the lack of a common framework for valve assessment that could  be used to guide a standardized approach to aortic valve repair, similar to that used in reconstructive mitral valve surgery. Most patients with a regurgitant aortic valve are young and possess a specific subtype of a bicuspid aortic valve according to the Sievers classifications system. This video tutorial presents the technical aspects of a standardized approach for reconstruction of the regurgitant bicuspid aortic valve (Sievers type 1, L/R), which was developed during the past decade...
September 26, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30265455/a-novel-harvesting-technique-for-a-no-touch-saphenous-vein-graft-using-the-thunderbeat-device
#17
Ai Ishizawa, Azumi Hamasaki, Tetsuro Uchida, Mitsuaki Sadahiro
The no-touch technique of saphenous vein harvesting involves harvesting the vein as a pedicled graft, together with its surrounding adipose tissue, while avoiding direct contact and excessive high-pressure expansion. This technique offers the possibility of comparable long-term graft patency to that of an internal mammary artery graft. However, the wound complications using the no-touch technique can be more significant than those using a conventional skeletonized technique. To solve the problem of leg wound trouble and to perform the no-touch saphenous vein harvesting more rapidly and efficiently, we have developed a new harvesting technique using a novel energy device, the THUNDERBEAT...
September 17, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30265459/a-simple-and-safe-removal-method-for-the-heartstring-iii-proximal-seal-system-device
#18
Azumi Hamasaki, Tetsuro Uchida, Masahiro Mizumoto, Shuto Hirooka, Ai Ishizawa, Mitsuaki Sadahiro
The HEARTSTRING III Proximal Seal System is a useful proximal anastomosis assist device, but it has a notable drawback in that the removal process is irreversible. If thread cutting occurs during the tying process, repair without side clamping is difficult. We have developed a simple modified technique for the safer removal of the HEARTSTRING device and we demonstrate it in this video tutorial.
September 11, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30265456/awake-extracorporeal-life-support-ecls-implantation-in-profound-cardiogenic-shock
#19
Thomas Haberl, Arezu Aliabadi-Zuckermann, Georg Goliasch, Dominik Wiedemann
Awake extracorporeal life support (ECLS) implantation is an attractive option for unstable patients for whom avoiding the risk of hemodynamic deterioration during intubation is important. In this video tutorial we show, step by step, a successful awake ECLS implantation, placing special emphasis on safeguards and potential pitfalls.
September 11, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30265457/upper-ministernotomy-for-mitral-valve-replacement-via-superior-approach
#20
Sergey Boldyrev, Vasily Kaleda, Irina Gunko, Kirill Barbukhatty, Vladimir Porhanov
This video tutorial demonstrates the surgical technique for mitral valve replacement through the roof of the left atrium via an upper inverted T-shaped ministernotomy, with central cannulation for cardiopulmonary bypass.
September 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
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