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https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#1
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28547835/application-of-omentum-as-an-in-vivo-bioreactor-for-regeneration-of-decellularized-human-internal-mammary-artery
#2
Reza Khorramirouz, Maryam Kameli, Sahar Eftekharzadeh, Abdol-Mohammad Kajbafzadeh
This study investigates the extent of cell seeding as well as lumen patency in acellular Internal mammary artery (IMA) scaffolds that have been re-cellularized by omentum as a natural bioreactor. Sixteen Virgin female Wistar rats were selected for implantation of acellular scaffold in omentum. Following laparotomy omentum was retracted to the outside of the abdomen and the more vascularized portion of it was selected for the experiment. The scaffold was wrapped by omentum and placed between two layers of rectus muscles that have been previously dissected...
May 25, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28542076/comparative-analysis-of-perioperative-and-mid-term-results-of-tecab-and-midcab-for-revascularization-of-anterior-wall
#3
Markus Kofler, Thomas Schachner, Sebastian J Reinstadler, Lukas Stastny, Julia Dumfarth, Dominik Wiedemann, Gudrun Feuchtner, Guy Friedrich, Johannes Bonatti, Nikolaos Bonaros
OBJECTIVE: Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results. METHODS: Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53-76) years and a median (range) EuroSCORE I of 2 (0-3)...
May 24, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#4
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28527195/changes-in-sternal-perfusion-following-internal-mammary-artery-bypass-surgery
#5
Christian D Taeger, Konstantin Klein, Raymund E Horch, Michael Weyand, Justus P Beier
BACKROUND: Coronary bypass surgery using the internal mammary artery (IMA) is among the most commonly performed procedures in treatment of advanced coronary vessel disease. Further, bilateral harvesting of the IMA is associated with increased rates of sternal wound infections. OBJECTIVE: This study aimed to explore changes in sternal perfusion, following left internal mammary artery (LIMA) harvesting. METHODS: 60 patients were divided equally into intervention- and control cohorts and underwent assessment of oxygen saturation (sO2) and relative blood flow (RBF) by laser doppler flowmetry remission spectroscopy preoperatively, 24 h and 72 h postoperatively...
May 18, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28520861/influence-of-practice-patterns-on-outcome-among-countries-enrolled-in-the-syntax-trial-5-year-results-between-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting%C3%A2
#6
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, Arie Pieter Kappetein
OBJECTIVES: To examine differences among participating countries in baseline characteristics, clinical practice, medication strategies and outcomes of patients randomized to coronary artery bypass grafting and percutaneous coronary intervention in the SYNTAX trial. METHODS: In SYNTAX, centres in 18 different countries enrolled 1800 patients, of which 8 countries enrolled ≥80 patients, what was projected to be a large enough sample size to be included in the analysis...
May 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28515852/bilateral-vs-unilateral-internal-mammary-revascularization-in-patients-with-left-ventricular-dysfunction
#7
Batric Popovic, Pablo Maureira, Yves Juilliere, Nicolas Danchin, Damien Voilliot, Fabrice Vanhuyse, Jean Pierre Villemot
AIM: To investigate the survival benefit of bilateral internal mammary artery (BIMA) grafts in patients with left ventricular dysfunction. METHODS: Between 1996 and 2009, we performed elective, isolated, primary, multiple cardiac arterial bypass grafting in 430 consecutive patients with left ventricular ejection fraction ≤ 40%. The early and long-term results were compared between 167 patients undergoing BIMA grafting and 263 patients using left internal mammary artery (LIMA)-saphenous venous grafting (SVG)...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28515581/castleman-s-disease-a-rare-indication-for-endovascular-therapy-for-hemoptysis
#8
Mohammad A Husainy, Farhina Sayyed, Simon J McPherson
Castleman's disease (CD) is a rare lympho-proliferative disorder due to faulty immune regulation resulting in proliferation of lymphatic tissue. The vascular supply to these lesions have been reported to arise from the bronchial, internal mammary and the intercostal arteries. We report a case of hemoptysis secondary to intrathoracic CD with vascular supply arising from the left inferior phrenic artery which was successfully embolised with polyvinyl alcohol (PVA) particles.
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28498546/the-use-of-inverted-l-posteromedial-thigh-l-pmt-flap-for-autologous-breast-reconstruction-a-case-report
#9
Mario F Scaglioni, Maximilian Eder, Pietro Giovanoli
The posteromedial thigh (PMT) flap has been described for breast reconstruction in vertical fashion (vPMT). However, it might not incorporate enough soft tissue for reconstruction of a medium size breast. Here, we present a case utilizing the free inverted-L posteromedial thigh (L-PMT) flap for autologous reconstruction of the breast. A 65-year-old woman with a body max index (BMI) of 24.5 kg/m(2) underwent nipple sparring mastectomy and received immediate unilateral breast reconstruction. The flap was raised based on the first medial perforator of the profunda femoris artery (PFA)...
May 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28497019/anatomical-basis-of-pedicles-in-breast-reduction
#10
REVIEW
Marcelo Irigo, Leonardo Coscarelli, Alberto Rancati
The mammary gland is composed of multiple tubules acinar pockets in which the secretory layer, connective tissue stroma, and fatty tissue all respond to hormonal and systemic influences. These structures are irrigated by three vascular pedicle branches, from the axillary artery, internal mammary artery, and intercostal artery. This vascular anastomotic arrangement forms the anatomical basis of the flaps used in breast reduction techniques. The veins form a strong subdermal network, latticed with the arterial network...
April 2017: Gland Surgery
https://www.readbyqxmd.com/read/28492795/anterior-spinal-artery-syndrome-following-coronary-artery-bypass-grafting-a-case-report
#11
Seyed Mohsen Mirhosseini, Soheil Meghdadi, Ali Sanjari Moghaddam
We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered...
March 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28483590/giant-coronary-aneurysm-management-with-viabahn-covered-stent
#12
Tae-Hoon Kim, Ravi Marfatia, Juyong Lee, Michael Azrin
A 68year old female patient underwent coronary artery bypass surgery (CABG) 1year previously. At that time she had a giant coronary artery aneurysm (CAA) of the proximal right coronary artery and severe 3 vessel disease including a severe ostial right coronary artery stenosis, severe stenosis of the proximal and mid left anterior descending artery (LAD) and a totally occluded left circumflex artery. She underwent CABG including left internal mammary artery to LAD, aorto-saphenous venous graft (ASVG) to posterior descending artery and ASVG sequential to the first diagonal and obtuse marginal branch...
March 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28481987/does-the-use-of-a-free-internal-mammary-artery-graft-on-the-left-anterior-descending-artery-compromise-long-term-survival-%C3%A2
#13
Nicola Vistarini, Dimitri Kalavrouziotis, François Dagenais, Eric Dumont, Pierre Voisine, Siamak Mohammadi
OBJECTIVES: The aim of the study was to determine if there is a long-term outcomes disadvantage associated with using the internal mammary artery (IMA) as a free graft to the left anterior descending artery (LAD) during coronary artery bypass graft surgery. METHODS: Between 1991 and 2014, 21 876 consecutive patients underwent isolated primary coronary artery bypass graft surgery at our institution. Among these, 238 underwent a free IMA (f-IMA) graft to bypass the LAD...
May 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28460760/alterations-in-echocardiographic-left-ventricular-function-after-percutaneous-coronary-stenting-in-diabetic-patients-with-isolated-severe-proximal-left-anterior-descending-artery-stenosis
#14
Maryam Nabati, Morteza Taghavi, Naser Saffar, Jamshid Yazdani, Babak Bagheri
BACKGROUND: There are conflicting theories regarding the use of percutaneous coronary intervention (PCI) of isolated severe proximal left anterior descending (LAD) artery stenosis in place of left internal mammary artery grafting in diabetic patients. The aim of this study was to investigate the effect of PCI on left ventricular function and determine difference between diabetics and non-diabetics. METHODS: A prospective study was conducted on 50 patients with isolated severe proximal LAD stenosis: 23 diabetic and 27 non-diabetic patients...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28456599/robotically-assisted-minimally-invasive-off-pump-coronary-artery-bypass-surgery-in-a-patient-with-permanent-tracheostomy
#15
Fabio Ramponi, Campbell D Flynn, Michael K Wilson
BACKGROUND: Patients with a permanent tracheostomy requiring coronary surgery represent a unique challenge, being at increased risk of sternal wound complications, mediastinitis and stoma necrosis. Several techniques have been described including manubrium sparing sternotomy, thoracoscopic internal mammary harvest and hybrid revascularization. HOW TO DO IT: We report a case of robotic assisted (daVinci(®)Xi™ Surgical System) total arterial off-pump revascularization in a patient with previous laryngectomy and permanent tracheostomy...
April 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28450552/one-year-costs-of-bilateral-or-single-internal-mammary-grafts-in-the-arterial-revascularisation-trial
#16
Alastair M Gray, Jacqueline Murphy, Douglas G Altman, Umberto Benedetto, Helen Campbell, Marcus Flather, Stephen Gerry, Belinda Lees, David P Taggart
OBJECTIVE: Coronary artery bypass grafting (CABG) using bilateral internal mammary arteries (BIMA) may improve survival over CABG using single internal mammary arteries (SIMA), but may be surgically more complex (and therefore costly) and associated with impaired sternal wound healing. We report, for the first time, a detailed comparison of healthcare resource use and costs over 12 months, as part of the Arterial Revascularisation (ART) Trial. METHODS: 3102 patients in 28 hospitals in seven countries were randomised to CABG surgery using BIMA (n=1548) or SIMA (n=1554)...
April 27, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28444175/predictive-value-of-telomere-length-on-outcome-following-acute-myocardial-infarction-evidence-for-contrasting-effects-of-vascular-vs-blood-oxidative-stress
#17
Marios Margaritis, Fabio Sanna, George Lazaros, Ioannis Akoumianakis, Sheena Patel, Alexios S Antonopoulos, Chloe Duke, Laura Herdman, Costas Psarros, Evangelos K Oikonomou, Cheerag Shirodaria, Mario Petrou, Rana Sayeed, George Krasopoulos, Regent Lee, Dimitris Tousoulis, Keith M Channon, Charalambos Antoniades
Aims: Experimental evidence suggests that telomere length (TL) is shortened by oxidative DNA damage, reflecting biological aging. We explore the value of blood (BTL) and vascular TL (VTL) as biomarkers of systemic/vascular oxidative stress in humans and test the clinical predictive value of BTL in acute myocardial infarction (AMI). Methods and results: In a prospective cohort of 290 patients surviving recent AMI, BTL measured on admission was a strong predictor of all-cause [hazard ratio (HR) [95% confidence interval (CI)]: 3...
April 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28434735/effects-of-graded-removal-of-lysine-from-an-intravenously-infused-amino-acid-mixture-on-lactation-performance-and-mammary-amino-acid-metabolism-in-lactating-goats
#18
C L Guo, Y T Li, X Y Lin, M D Hanigan, Z G Yan, Z Y Hu, Q L Hou, F G Jiang, Z H Wang
To investigate responses of milk protein synthesis and mammary AA metabolism to a graded decrease of postruminal Lys supply, 4 lactating goats fitted with jugular vein, mammary vein, and carotid artery catheters and transonic blood flow detectors on the external pudic artery were used in a 4 × 4 Latin square experiment. Goats were fasted for 24 h and then received a 9-h intravenous infusion of an AA mixture plus glucose. Milk yield was recorded and samples were taken in h 2 to 8 of the infusion period; a mammary biopsy was performed in the last hour...
April 20, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28422830/management-of-the-extensive-thoracic-defects-after-deep-sternal-wound-infection-with-the-rectus-abdominis-myocutaneous-flap-a-retrospective-case-series
#19
Yue-Hua Li, Zhao Zheng, Jiaomei Yang, Lin-Lin Su, Yang Liu, Fu Han, Jia-Qi Liu, Da-Hai Hu
Deep sternal wound infection is a severe complication after open heart surgery. According to the different severity and dimensions of the deep sternal wound infection, the treatment method is different. In this study, we aimed to describe our experience with the rectus abdominis myocutaneous flap for large sternal wound management, especially when 1 or 2 internal mammary arteries were absent.Between October 2010 and January 2016, a retrospective review of 9 patients who suffered from the extensive thoracic defects after deep sternal wound infection was conducted...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28416323/review-of-coronary-subclavian-steal-syndrome
#20
REVIEW
Bennett Cua, Natasha Mamdani, David Halpin, Sunny Jhamnani, Sasanka Jayasuriya, Carlos Mena-Hurtado
The clinical benefits of using the left internal mammary artery (LIMA) to bypass the left anterior descending artery are well established making it the most frequently used conduit for coronary artery bypass surgery (CABG). Coronary subclavian steal syndrome (CSSS) occurs during left arm exertion when (1) the LIMA is used during bypass surgery and (2) there is a high grade (≥75%) left subclavian artery stenosis or occlusion proximal to the ostia of the LIMA resulting in "stealing" of the myocardial blood supply via retrograde flow up the LIMA graft to maintain left upper extremity perfusion...
April 14, 2017: Journal of Cardiology
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