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minimal invasive coronary surgery

Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
Dharmesh Radheshyam Agrawal, Sathyaki Purushottam Nambala
Minimally invasive cardiac surgery is establishing itself as the standard of care across the world. MICS CABG is currently performed in only a few centers. Hemodynamics disturbances are peculiar during MICS CABG due to space constraints. We report a 70-year-old man who underwent MICS CABG who developed tension pneumothorax during revascularization that was diagnosed in a novel way.
October 2016: Annals of Cardiac Anaesthesia
Anne H Krog, Mehdi Sahba, Erik M Pettersen, Irene Sandven, Per M Thorsby, Jørgen J Jørgensen, Jon O Sundhagen, Syed Ss Kazmi
PURPOSE: Minimally invasive surgical techniques have been shown to reduce the inflammatory response related to a surgical procedure. The main objective of our study was to measure the inflammatory response in patients undergoing a totally laparoscopic versus open aortobifemoral bypass surgery. This is the first randomized trial on subjects in this population. PATIENTS AND METHODS: This is a substudy of a larger randomized controlled multicenter trial (Norwegian Laparoscopic Aortic Surgery Trial)...
2016: Vascular Health and Risk Management
P Laborda-Vidal, B Pedro, M Baker, A R Gelzer, J Dukes-McEwan, T W Maddox
Pulmonic stenosis (PS) is the most common congenital cardiac disease in dogs. Boxers and English bulldogs are among the most commonly affected breeds and also commonly associated with an aberrant coronary artery (CA). If an aberrant CA is suspected and balloon valvuloplasty indicated, an intra-operative angiography is recommended prior to the procedure. ECG-gated computed tomography (CT) can be used to screen for CA anomalies in a quick and minimally-invasive way (preventing side effects associated with selective catheter angiography) and allowing early planning of the procedure...
September 29, 2016: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Mehmet Ezelsoy, Kerem Oral, Baris Caynak, Zehra Bayramoglu, Belhhan Akpinar
OBJECTIVE: Minimally invasive bypass grafting is a promising surgical treatment in proximal LAD stenosis procedures. The main goal of this study was to make comparisons between robotically assisted minimally invasive coronary bypass surgery and conventional surgery in isolated proximal LAD lesions in terms of pain and quality of life improvement. METHODS: The study contains patients with proximal LAD lesions who were treated with robotically assisted minimally invasive coronary artery bypass surgery and conventional bypass surgery between June 2005 and November 2012...
2016: Heart Surgery Forum
Gudrun Dieberg, Neil A Smart, Nicola King
BACKGROUND: Minimally invasive (MI) cardiac surgery was introduced to reduce problems associated with a full sternotomy. This meta-analysis aimed to investigate the effects of minimally invasive cardiac surgery on a range of clinical outcomes. METHODS: To identify potential studies (randomised/prospective clinical trials) systematic searches were carried out. The search strategy included the concepts of "minimally invasive" OR "MIDCAB" AND "coronary artery bypass grafting" OR "cardiac surgery"...
November 15, 2016: International Journal of Cardiology
Sabin J Bozso, Aaron Grant, Ivan Iglesias, Michael W A Chu
Less invasive techniques are commonly used to treat patients with anatomically suitable secundum atrial septal defects; however, repair of more complex atrial septal defects are still performed through sternotomy. Cosmetically appealing periareolar incisions have been used in breast reconstructive surgery and may provide an esthetically superior alternative to the anterolateral minithoracotomy incision used in minimally invasive cardiac surgery. We describe a patient with an unroofed coronary sinus atrial septal defect who underwent successful minimally invasive, endoscopic repair of this defect with autologous pericardial baffle reconstruction of the coronary sinus roof and closure of the interatrial communication through a periareolar approach...
September 2016: Annals of Thoracic Surgery
Rugmani Padmanabhan Iyer, Lisandra E de Castro Brás, Presley L Cannon, Yonggang Ma, Kristine Y DeLeon-Pennell, Mira Jung, Elizabeth R Flynn, Jeffrey B Henry, Dustin R Bratton, Jared A White, Linda K Fulton, Andrew W Grady, Merry L Lindsey
The purpose of this study was to evaluate the effect of sham surgery in a minimally invasive surgical model of permanent coronary artery occlusion used to generate myocardial infarction (MI) in mice. Adult male C57BL/6J mice (3-6 mo old) were divided into five groups: day (D) 0 (no surgical operation), D1 Sham, D1 MI, D7 Sham, and D7 MI. A refined MI surgery technique was used to approach the coronary artery without the ribs being cut. Both sham and MI mice had the left ventricle (LV) exposed through a small incision...
September 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
X Z Xu, W Yi, H Li, G Y Shi, Y W Chen, N Qiao, M Chen, Z X Jin, R Zhao, Y Jin, S Q Yu
OBJECTIVE: To summarize the experience of totally thoracoscopic cardiac surgical (TTCS) at congenital heart diseases (CHD) treatment. METHODS: From April 2000 to March 2016, 2 543 patients with CHD underwent TTCS in Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, including 957 male and 1 586 female patients. The age ranged from 0.5 to 66.0 years with a mean age of (21±18) years. The body weight ranged from 6 to 118 kg with a mean of (49±30) kg...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
David S Strosberg, Michelle C Nguyen, Peter Muscarella, Vimal K Narula
INTRODUCTION: Robotic-assisted surgery is gaining popularity in general surgery. Our objective was to evaluate and compare operative outcomes and total costs for robotic cholecystectomy (RC) and laparoscopic cholecystectomy (LC). METHODS AND PROCEDURES: A retrospective review was performed for all patients who underwent single-procedure RC and LC from January 2011 to July 2015 by a single surgeon at a large academic medical center. Demographics, diagnosis, perioperative variables, postoperative complications, 30-day readmissions, and operative and hospital costs were collected and analyzed between those patient groups...
August 5, 2016: Surgical Endoscopy
David S Strosberg, Robert E Merritt, Kyle A Perry
BACKGROUND: Laparoscopic gastric devascularization (LGD) is an innovative method to improve gastric conduit perfusion and improve anastomotic healing following esophagectomy. This study reports our early experience with LGD performed two weeks prior to minimally invasive esophagectomy (MIE) with intrathoracic anastomosis. METHODS: We performed a retrospective review of all patients who underwent LGD prior to minimally invasive Ivor Lewis esophagectomy between August 2014 and July 2015 at a large academic medical center...
August 5, 2016: Surgical Endoscopy
John D Puskas, Michael E Halkos, Joseph J DeRose, Emilia Bagiella, Marissa A Miller, Jessica Overbey, Johannes Bonatti, V S Srinivas, Mark Vesely, Francis Sutter, Janine Lynch, Katherine Kirkwood, Timothy A Shapiro, Konstantinos D Boudoulas, Juan Crestanello, Thomas Gehrig, Peter Smith, Michael Ragosta, Steven J Hoff, David Zhao, Annetine C Gelijns, Wilson Y Szeto, Giora Weisz, Michael Argenziano, Thomas Vassiliades, Henry Liberman, William Matthai, Deborah D Ascheim
BACKGROUND: Hybrid coronary revascularization (HCR) combines minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery with percutaneous coronary intervention (PCI) of non-left anterior descending vessels. HCR is increasingly used to treat multivessel coronary artery disease that includes stenoses in the proximal left anterior descending artery and at least 1 other vessel, but its effectiveness has not been rigorously evaluated. OBJECTIVES: This National Institutes of Health-funded, multicenter, observational study was conducted to explore the characteristics and outcomes of patients undergoing clinically indicated HCR and multivessel PCI for hybrid-eligible coronary artery disease, to inform the design of a confirmatory comparative effectiveness trial...
July 26, 2016: Journal of the American College of Cardiology
Julian J Nesbitt, George Mori, Charlotte Mason-Apps, George Asimakopoulos
OBJECTIVE: Minimally invasive coronary artery bypass surgery performed through a left thoracotomy has potential benefits over conventional sternotomy, including reduced surgical trauma, faster recovery and potential improvement in quality of life. This study is a prospective assessment of quality of life in patients undergoing off-pump coronary bypass by median sternotomy and left anterior thoracotomy. METHODS: Quality of life was assessed by the EuroQoL questionnaire, with additional questions on dyspnoea, angina, wound pain and scar aesthetics...
July 20, 2016: Perfusion
Norihiko Ishikawa, Go Watanabe
The application for robot-assisted coronary surgery ranges from internal thoracic artery (ITA) harvesting with hand-sewn anastomoses to totally endoscopic coronary artery bypass grafting (TECAB), either on- or off-pump. The bilateral IMA can be harvested with the aid of a surgical robot and then multivessel bypass grafting can follow. Such robot-assisted minimally invasive direct coronary artery bypass grafting is called "ThoraCAB". Surgical robots cannot only endoscopically harvest the ITA but they can also anastomose the coronary artery in TECAB...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Satoshi Hanada, Hajime Sakamoto, Michael Swerczek, Kenichi Ueda
BACKGROUND: Placement of a percutaneous coronary sinus catheter (CSC) by an anesthesiologist for retrograde cardioplegia in minimally invasive cardiac surgery is relatively safe in experienced hands. However, the popularity of its placement remains limited to a small number of centers due to its perceived complexity and potential complications. METHODS: We retrospectively reviewed all cardiac cases performed by one surgeon between December 2009 and April 2012. The reviewed cases were divided into two groups: cardiac cases with percutaneous CSC placement (CSC group) and cardiac cases without placement (control group)...
2016: BMC Anesthesiology
Dharmesh Radheshyam Agrawal, Sathyaki Nambala, Arul Fartado
Minimally invasive cardiac surgery/coronary artery bypass grafting (MICS CABG) is performed through a small 2 inch left thoracotomy incision. Lung isolation is must during MICS CABG. Oxygenation with one-lung ventilation can be difficult, especially during supine position. We report a case of a 53-year-old male patient who underwent MICS CABG with the selective lobar blockade.
July 2016: Annals of Cardiac Anaesthesia
Murali Chakravarthy, Muralimanohar Veerappa, Vivek Jawali, Nischal Pandya, Jayaprakash Krishnamoorthy, Geetha Muniraju, Antony George, Jitumoni Baishya
BACKGROUND: Minimal invasive surgeries are carried out to benefit the patient with less pain, blood loss, mechanical ventilation and hospital stay; a smaller scar is not the aim. Minimal invasive cardiac surgeries are carried out via small sternotomy, small thoracotomy and via robotic arms. Subxiphoid route is a novel method and avoids sternotomy. AIM: This case series is an attempt to understand the anesthetic modifications required. Secondly, whether it is feasible to carry out subxiphoid coronary artery bypass surgery...
July 2016: Annals of Cardiac Anaesthesia
Gabriele Di Giammarco, Daniele Marinelli, Massimiliano Foschi, Michele Di Mauro
Transit-time flow measurement (TTFM) is a reliable method to check the graft function intraoperatively in coronary surgery. The given parameters are: Mean Graft Flow (MGF); Pulsatility Index (PI) and Insufficiency Ratio (%BF). Some cutoffs of these parameters have been identified as predictors for unfair 1-y clinical outcome: mean graft flow (MGF) less than 20 ml/min and high pulsatility index greater than 5. Other cutoffs have been found as related to postoperative angiography: MGF 15 ml/min or less and pulsatility index at least 3 (sensitivity 94%; specificity 61%); MGF less than 15 ml/min and pulsatility index greater than 3 for left coronary artery or pulsatility index greater than 5 for right coronary artery (sensitivity 96%; specificity 77%); MGF 15 ml/min or less and pulsatility index at least 5...
June 29, 2016: Journal of Cardiovascular Medicine
Kyriakos Anastasiadis, Polychronis Antonitsis, Georgia Kostarellou, Athanassios Kleontas, Apostolos Deliopoulos, Vassilios Grosomanidis, Helena Argiriadou
OBJECTIVES: The effect on postoperative health-related quality of life (HRQoL) after coronary artery bypass grafting (CABG) surgery with conventional cardiopulmonary bypass (cCPB) and off-pump surgery has been investigated extensively; however, there are no studies focusing on HRQoL after surgery with minimally invasive extracorporeal circulation (MiECC). Therefore, we sought to prospectively investigate the effect of MiECC on postoperative HRQoL when compared with cCPB in patients undergoing CABG over a short-term (3-month) follow-up period...
June 14, 2016: European Journal of Cardio-thoracic Surgery
Taichi Sakaguchi
Although a minithoracotomy approach has several advantages over a sternotomy approach in terms of superior cosmesis and faster recovery, coronary artery bypass grafting (CABG) via sternotomy has been the gold standard for revascularization in multivessel coronary artery disease. Recently, nonsternotomy approaches, including the minimally invasive cardiac surgery CABG (MICS-CABG) via small left thoracotomy, have emerged as safe, effective alternatives. Excellent clinical results have been reported including equivalent mid-term graft patency as compared with a sternotomy approach...
March 2016: Nihon Geka Gakkai Zasshi
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