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Minimally invasive cardiac surgery

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https://www.readbyqxmd.com/read/28396860/aortic-valve-replacement-for-moderate-aortic-stenosis-with-severe-calcification-and-left-ventricualr-dysfunction-a-case-report-and-review-of-the-literature
#1
Nikhil Narang, Roberto M Lang, Vladimir M Liarski, Valluvan Jeevanandam, Marion A Hofmann Bowman
A 55-year-old man with a history of erosive, seropositive rheumatoid arthritis (RA), and interstitial lung disease presented with shortness of breath. Echocardiography showed new-onset severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 15% and moderately increased mean aortic valve gradient of 20 mmHg in a trileaflet aortic valve with severe sclero-calcific degeneration. Coronary angiography revealed no significant obstructive coronary disease. Invasive hemodynamic studies and dobutamine stress echocardiography were consistent with moderate aortic stenosis...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28395387/novel-techniques-and-approaches-to-minimally-invasive-thoracic-surgery
#2
Osita Onugha, Rasheed Ivey, Robert McKenna
Approximately two decades ago, thoracic surgery witnessed the leap from thoracotomy to the first video-assisted thoracic surgery (VATS) lobectomy. Minimally invasive lobectomy and hilar lymphadenectomy is now widely established as a safe and oncological sound technique that is the standard of care for early-stage lung cancer. The move toward less invasive surgery has no doubt driven the innovation of sophisticated instruments and technology to cope with the demanding need of working through a restricted incision...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#3
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28388941/prediction-of-the-optimal-depth-for-superior-vena-cava-cannulae-with-cardiac-computed-tomography-during-minimally-invasive-cardiac-surgery-a-prospective-observational-cohort-study
#4
Ji-Hyun Chin, Eun-Ho Lee, Jong-Il Kim, In-Cheol Choi
BACKGROUND: The determination of the adequate depth of superior vena cava cannulae during minimally invasive cardiac surgery is important for warranting venous drainage and preventing complications during cardiopulmonary bypass. We investigated whether preoperative cardiac computed tomography might be useful for predicting the optimal depth of superior vena cava cannulae. METHODS: The patients who required superior vena cava cannulation and had cardiac tomographic image among those scheduled to undergo a minimally invasive cardiac surgery were evaluated...
April 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28369496/cerebral-circulation-estimated-by-laser-speckle-flowgraphy-in-retrograde-femoral-arterial-perfusion-during-minimally-invasive-cardiac-surgery
#5
Hiroto Kitahara, Hirotsugu Kanda, Fumiaki Kimura, Tomohiro Takeda, Shingo Kunioka, Takayuki Kunisawa, Hiroyuki Kamiya
OBJECTIVES: Laser speckle flowgraphy (LSFG) is a novel modality to assess blood flow of the optic nerve head (ONH), which is reported to be a surrogate marker of cerebral microcirculation. We conducted LSFG measurements during minimally invasive cardiac surgery with retrograde femoral arterial perfusion and evaluated its feasibility and usability as a neuromonitor. METHODS: We prospectively enrolled 7 patients who underwent mitral valve repair through a right minithoracotomy with retrograde femoral arterial perfusion...
March 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28363366/minimal-invasive-repair-of-pectus-excavatum-and-carinatum
#6
REVIEW
Hans Pilegaard, Peter Bjørn Licht
Minimal invasive surgery has become the gold standard for surgical repair of pectus excavatum. The procedure can be performed as fast-track surgery and cosmetic results are excellent. In addition, cardiac performance improves after correction. With increased awareness on the Internet, the number of patients who seek help continues to rise, primarily for cosmetic reasons. Pectus carinatum is much less frequent than pectus excavatum. Over the past decade surgery has largely been replaced by compression techniques that use a brace, and cosmetic results are good...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28358641/intrapericardial-cystic-hematoma-in-a-dog-treated-by-thoracoscopic-subtotal-pericardectomy
#7
Chi-Ya Chen, Boel A Fransson, Adam M Nylund
CASE DESCRIPTION A 2-year-old castrated male mixed-breed dog was evaluated because of a 1-week history of respiratory distress and abdominal distension. Thoracic radiography and echocardiography at that time revealed an enlarged cardiac silhouette and pericardial effusion; abdominal radiography and ultrasonography revealed ascites. CLINICAL FINDINGS At the initial referral examination 5 weeks later, the dog weighed 37.5 kg (82.5 lb) and appeared clinically normal. The only abnormality detected was a grade I/VI systolic murmur on the left side of the thorax...
April 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#8
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28337701/ct-guided-drainage-of-pericardial-effusion-after-open-cardiac-surgery
#9
Nour-Eldin Abdelrehim Nour-Eldin, Mohammed Alsubhi, Tatjana Gruber-Rouh, Thomas J Vogl, Benjamin Kaltenbach, Hazem Hamed Soliman, Wael Eman Hassan, Sherif Maher Abolyazid, Nagy N Naguib
PURPOSE: This study was designed to evaluate the safety and efficacy of CT-guided drainage of the pericardial effusion in patients after cardiac surgery. MATERIALS AND METHODS: The study included 128 consecutive patients (82 males, 46 females; mean age 66.6 years, SD: 4.2) complicated by pericardial effusion or hemopericardium after cardiac surgeries between June 2008 and June 2016. The medical indication for therapeutic pericardiocentesis in all patients was hemodynamic instability caused by pericardial effusion...
March 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28327076/myocardial-protection-during-minimally-invasive-cardiac-surgery-through-right-mini-thoracotomy
#10
Micaela De Palo, Pietro Guida, Florinda Mastro, Daniela Nanna, Teresa A P Quagliara, Ruggiero Rociola, Giosuè Lionetti, Domenico Paparella
BACKGROUND: Myocardial damage is an independent predictor of adverse outcome following cardiac surgery and myocardial protection is one of the key factors to achieve successful outcomes. Cardioplegia with Custodiol is currently the most used cardioplegia during minimally invasive cardiac surgery (MICS). Different randomized controlled trials compared blood and Custodiol cardioplegia in the context of traditional cardiac surgery. No data are available for MICS. AIM: The aim of this study was to compare the efficacy of cold blood versus Custodiol cardioplegia during MICS...
April 2017: Perfusion
https://www.readbyqxmd.com/read/28302745/current-status-and-future-potential-of-transcatheter-interventions-in-congenital-heart-disease
#11
Damien P Kenny, Ziyad M Hijazi
Percutaneous therapies for congenital heart disease have evolved rapidly in the past 3 decades. This has occurred despite limited investment from industry and support from regulatory bodies resulting in a lack of specific device development. Indeed, many devices remain off-label with a best-fit approach often required, spurning an innovative culture within the subspecialty, which had arguably laid the foundation for many of the current and evolving structural heart interventions. Challenges remain, not least encouraging device design focused on smaller infants and the inevitable consequences of somatic growth...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28295456/firth-s-logistic-regression-with-rare-events-accurate-effect-estimates-and-predictions
#12
Rainer Puhr, Georg Heinze, Mariana Nold, Lara Lusa, Angelika Geroldinger
Firth's logistic regression has become a standard approach for the analysis of binary outcomes with small samples. Whereas it reduces the bias in maximum likelihood estimates of coefficients, bias towards one-half is introduced in the predicted probabilities. The stronger the imbalance of the outcome, the more severe is the bias in the predicted probabilities. We propose two simple modifications of Firth's logistic regression resulting in unbiased predicted probabilities. The first corrects the predicted probabilities by a post hoc adjustment of the intercept...
March 12, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28291141/antegrade-cardioplegia-decannulation-using-the-cor-knot-system-in-minimally-invasive-mitral-valve-surgery
#13
Sabet W Hashim, Philip Y K Pang
A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding...
March 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28269441/characteristic-of-a-force-sensing-guide-wire-for-minimally-invasive-cardiac-surgery
#14
N Stefanova, M Hessinger, T Opitz, R Werthschutzky
In minimal invasive cardiac surgery (MICS), the surgeon is missing haptic feedback of the guide wire for navigation through the vessels. A wide range of guide wires with various properties and performance characteristics are available to reduce the risk of complications during the intervention. This paper presents a force sensing guide wire for cardiac catheterization, which provides the surgeon a haptic feedback on the guide wire tip. Three conventional wires for the recanalization of chronic total coronary occlusions (CTO) are investigated and general design requirements for the force sensing guide wire are determined...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28257412/clinical-effect-and-prognosis-of-off-pump-minimally-invasive-direct-coronary-artery-bypass
#15
Ming Yang, Lian-Bo Xiao, Zhi-Sheng Gao, Ji-Wu Zhou
BACKGROUND Coronary artery bypass grafting (CABG) is a common procedure to circumvent the obstruction of coronary arteries when stents are unsuitable. CABG is a very traumatic surgery that requires redirecting blood flow to an external pump. Thus, this procedure has many risks during and after surgery, and minimizing these risks would greatly benefit the patients. MATERIAL AND METHODS We selected 126 patients with coronary artery syndrome and who were unsuitable for stent percutaneous coronary intervention...
March 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28254373/dosing-antibiotic-prophylaxis-during-cardiopulmonary-bypass-a-higher-level-of-complexity-a-structured-review
#16
REVIEW
Fathima Paruk, Fekade B Sime, Jeffrey Lipman, Jason A Roberts
In highly invasive procedures such as open heart surgery, the risk of post-operative infection is particularly high due to exposure of the surgical field to multiple foreign devices. Adequate antibiotic prophylaxis is an essential intervention to minimise post-operative morbidity and mortality. However, there is a lack of clear understanding on the adequacy of traditional prophylactic dosing regimens, which are rarely supported by data. The aim of this structured review is to describe the relevant pharmacokinetic/pharmacodynamic (PK/PD) considerations for optimal antibiotic prophylaxis for major cardiac surgery including cardiopulmonary bypass (CPB)...
April 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28238200/left-cardiac-sympathetic-denervation-case-series-and-technical-report
#17
C McNamara, P Cullen, M Rackauskas, R Kelly, K E O'Sullivan, J Galvin, D Eaton
BACKGROUND: Left cardiac sympathetic denervation (LCSD) is a surgical procedure that has been shown to have an antiarrhythmic and antifibrillatory effect. Evidence indicating its antiarrhythmic effect has been available for over 100 years. It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure. With advancements in thoracic surgery, it can be safely performed via a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach resulting in significantly less morbidity and a shortened inpatient stay...
February 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28227687/characteristic-of-a-force-sensing-guide-wire-for-minimally-invasive-cardiac-surgery
#18
N Stefanova, M Hessinger, T Opitz, R Werthschutzky, N Stefanova, M Hessinger, T Opitz, R Werthschutzky, N Stefanova, M Hessinger, T Opitz
In minimal invasive cardiac surgery (MICS), the surgeon is missing haptic feedback of the guide wire for navigation through the vessels. A wide range of guide wires with various properties and performance characteristics are available to reduce the risk of complications during the intervention. This paper presents a force sensing guide wire for cardiac catheterization, which provides the surgeon a haptic feedback on the guide wire tip. Three conventional wires for the recanalization of chronic total coronary occlusions (CTO) are investigated and general design requirements for the force sensing guide wire are determined...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28203535/the-state-of-robotic-cardiac-surgery-in-europe
#19
Matteo Pettinari, Emiliano Navarra, Philippe Noirhomme, Herbert Gutermann
BACKGROUND: In the past two decades, the introduction of robotic technology has facilitated minimally invasive cardiac surgery, allowing surgeons to operate endoscopically rather than through a median sternotomy. This approach has facilitated procedures for several structural heart conditions, including mitral valve repair, atrial septal defect closure and multivessel minimally invasive coronary artery bypass grafting. In this rapidly evolving field, we review the status of robotic cardiac surgery in Europe with a focus on mitral valve surgery and coronary revascularization...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28154290/comparison-of-clinical-outcomes-after-transcatheter-vs-minimally-invasive-cardiac-surgery-closure-for-atrial-septal-defect
#20
COMPARATIVE STUDY
Masaki Kodaira, Akio Kawamura, Kazuma Okamoto, Hideaki Kanazawa, Yugo Minakata, Mitsushige Murata, Hideyuki Shimizu, Keiichi Fukuda
BACKGROUND: Percutaneous closure has replaced surgery for the majority of cases of secundum atrial septal defect (ASD). However, technological advances have made contemporary minimally invasive cardiac surgery (MICS) less invasive than conventional surgery. The aim of this study was to compare clinical outcomes of percutaneous closure of secundum ASD with those of contemporary MICS.Methods and Results:We conducted a single-center retrospective study of 354 patients with ASD treated either with the Amplatzer Septal Occluder (134 patients) or MICS (220 patients) between 2000 and 2013...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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