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Multimedia Manual of Cardiothoracic Surgery: MMCTS

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https://www.readbyqxmd.com/read/30407760/pleural-packing-revisional-surgeries-and-delayed-chest-closure-a-salvage-strategy-in-lung-transplant
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/30265458/posterior-segmentectomy-right-upper-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 offers direct access to the segmental structures and is straightforward and versatile enough to allow for adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy in the case of positive margins)...
September 3, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30265454/thoracoscopic-lingulectomy
#10
George Rakovich
Minimally invasive pulmonary segmentectomy makes adequate oncologic treatment possible in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. Most lung segments may be resected as segmentectomies or as part of 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 offers direct access to the segmental structures and is straightforward and versatile enough to allow adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy in the case of positive margins)...
September 3, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30192452/thoracoscopic-thymectomy-using-a-left-side-approach
#11
Etienne Abdelnour-Berchtold, Jean Perentes, Thorsten Krueger, Michel Gonzalez
The surgical treatment of myasthenia gravis involves the complete resection of the thymus and the mediastinal fat between the two phrenic nerves. This procedure has been shown to have a positive impact on the rate of remission. In this video tutorial we illustrate the technical aspects of radical thymectomy using a left thoracoscopic approach.
September 3, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30192453/transapical-valve-in-ring-mitral-valve-implantation-through-the-anterior-mitral-valve-leaflet
#12
Luke Rogers, Jaime Villaquiran, Ian Cox, Malcolm Dalrymple-Hay, Clinton Lloyd
Transcatheter mitral valve implantation (TMVI) is a relatively novel intervention used to replace the mitral valve of individuals deemed too high risk or unsuitable for surgery. It is associated with a number of specific risks, including left ventricular outflow tract obstruction (LVOTO).  In this video tutorial we present the case of a 75-year-old man who was unable to undergo redo surgical repair and had a number of risk factors for LVOTO. To minimize these risks, we deployed the TMVI within the anterior mitral valve leaflet...
August 28, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30192451/suturing-map-for-endoscopic-mitral-valve-repair-developed-on-high-fidelity-endoscopic-simulator
#13
Peyman Sardari Nia, Jules Olsthoorn, Samuel Heuts, Jos Maessen
Minimally invasive mitral valve surgery demands a different mind-set from surgeons due to its high complexity and steep learning curve, especially in a fully endoscopic approach. Smaller incisions, working with long-shafted instruments, and a relatively fixed camera position in a limited working space necessitate the development of new surgical routines.  We used a high-fidelity mitral valve simulator to develop a suturing map for placement of the annuloplasty ring with minimal tissue manipulation and maximal visual exposure...
July 26, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070780/subclavicular-arteriovenous-fistula-for-univentricular-heart-palliation
#14
Federica Caldaroni, Timofey Nevvazhay, Sojak Vladimir, Mark Hazekamp
Creation of a subclavicular arteriovenous fistula is a minimally invasive procedure that provides an additional source of arterial blood flow to the pulmonary arteries in patients who have a Glenn shunt but are unsuitable for or at high risk for Fontan completion.
July 26, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070778/aortic-valve-replacement-with-annular-enlargement-via-a-right-anterior-minithoracotomy
#15
Davida Robinson, Fabio Sagebin, Amanda Yap, Carl Johnson, Peter Knight
A minimally invasive approach to aortic valve replacement offers many advantages compared to the conventional median sternotomy. However, minimally invasive approaches are technically challenging. In this video tutorial, we describe an aortic valve replacement performed via a right anterior minithoracotomy, facilitated by the use of videoscopic and automated suturing technologies.  Briefly, a right anterior minithoracotomy incision is made in the 2nd intercostal space and the 3rd rib is disarticulated. A retractor is placed, pericardiotomy performed, and stay sutures placed...
July 26, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070779/intraoperative-identification-and-treatment-of-a-giant-right-coronary-artery-aneurysm
#16
Joel Ramirez, Georg Wieselthaler, Johannes Kratz
Giant coronary artery aneurysms are rare, difficult to diagnose, and have variable clinical presentations and treatment options. We demonstrate a case of a patient presenting with acute onset chest pain and signs of cardiac tamponade who then underwent a computed tomography pulmonary embolus protocol and was found to have hemopericardium with accumulation of contrast adjacent to the aorta. She then underwent emergent sternotomy and was found to have a large hemorrhagic mass on the right ventricle, which upon further dissection was determined to be a giant right coronary artery aneurysm with a site of contained rupture...
July 24, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070786/valve-sparing-aortic-root-replacement-and-beating-heart-aortic-arch-replacement-in-frozen-elephant-trunk-technique
#17
Stoyan Kondov, Bartosz Rylski, Friedhelm Beyersdorf, Martin Czerny, Matthias Siepe
Correction of extensive aortic pathology often requires a combined surgical approach. This video tutorial presents the technical aspects of beating-heart aortic arch replacement in the frozen elephant trunk technique in combination with valve-sparing aortic root replacement.
July 20, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070785/rotation-of-the-outflow-tracts-for-complex-transposition-of-the-great-arteries
#18
Patrick Myers, Tornike Sologashvili, Maurice Beghetti, René Prêtre
Selecting the optimal treatment for transposition of the great arteries with pulmonary stenosis is a challenge. The Rastelli procedure has long been the method of choice, but it carries the risk of subaortic obstruction. The dysplastic pulmonary valve, which cannot function under systemic pressure, can sometimes be recycled in the pulmonary position.  "En bloc" rotation of the outflow tracts has been proposed for treatment of complex transposition of the great arteries and is demonstrated in the following videos...
July 3, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070783/ambidextrous-techniques-in-cardiac-surgery
#19
Shegu Gilbert, Devender Singh, M K Sivakumar
Ambidexterity is the state of being equally adept in the use of both the left and right hands. It is advantageous in surgeons, but the degree of ambidexterity found among them varies greatly. It is a very desirable attribute in laparoscopic surgery. It provides the surgeon with additional options for performing critical surgical steps when positioning and space are constrained, as is often the case in cardiac surgery and even more so in minimally invasive cardiac surgery. Mentoring for ambidexterity training can be initiated as early as during medical school...
June 27, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/30070787/proximal-first-a-beneficial-anastomotic-strategy-for-no-touch-saphenous-vein-graft
#20
Azumi Hamasaki, Tetsuro Uchida, Masahiro Mizumoto, Shuto Hirooka, Ai Ishizawa, Mitsuaki Sadahiro
In the mid-1990s, a novel saphenous vein harvesting technique, in which the vein is harvested with its surrounding tissue without manual distention, was introduced. This no-touch technique provides an excellent long-term patency; however, graft twisting and kinking can be a problem.  In order to fully take advantage of the benefit of the no-touch method while reducing the risk of twisting and kinking we have modified the anastomosis strategy. Our simple modified strategy involves performing a proximal anastomosis prior to the distal anastomosis...
June 26, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
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