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Median sternotomy

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https://www.readbyqxmd.com/read/28096865/cardiac-hydatid-cyst-without-liver-involvement-a-case-report
#1
Maryam Shojaeifard, Saeid Hosseini, Sarah Hosseini, Hamidreza Pouraliakbar, Hossein Dehghani, Feridoun Noohi
Hydatid disease is a rare parasitic disease, which mainly involves liver then lung tissues. Cardiac involvement is very rare, especially when there is not hepatic involvement. We describe a 47-year-old woman with a history of a lung hydatid cyst who was referred to Rajaei Heart Center, Tehran, Iran in 2012. Her chest computed tomographic scan showed a cardiac mass. Echocardiographic examination illustrated a large, well-defined heterogeneous mass (4.5 × 2.5 cm) in the roof of the right atrium with attachment to the crista terminalis without compressive effect on the inferior and superior venae cavae...
April 2016: Iranian Journal of Parasitology
https://www.readbyqxmd.com/read/28096827/lung-exposure-during-simultaneous-myocardial-revascularization-and-lung-surgery-through-median-sternotomy
#2
Dariusz Jagielak, Radoslaw Kozaryn, Rafal Pawlaczyk, Piotr Siondalski, Witold Rzyman, Jan Rogowski
Coronary artery disease is a frequent comorbidity in patients undergoing major thoracic surgery. Simultaneous operations eliminate the necessity of a second operation and, more importantly, minimize the delay in compulsory postoperative oncological therapy. We describe a relaxing incision in the contralateral pericardium, which allows for simple displacement of the heart. This maneuver improves exposure of the pulmonary hilum and middle mediastinum on the side of resection.
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28095343/patient-tailored-management-of-an-asymptomatic-massive-substernal-goiter-presenting-as-brachiocephalic-vein-occlusion-report-of-a-case-and-review-of-sternotomy-indications
#3
Georgios Sahsamanis, Eleftherios Chouliaras, Konstantinos Katis, Stavros Samaras, Stavros Daliakopoulos, Georgios Dimitrakopoulos
INTRODUCTION: Substernal goiters are characterized by the protrusion of at least 50% of the thyroid mass below the level of the thoracic inlet. Still their definition is controversial. CASE PRESENTATION: The case refers to a 44year old male who presented to our department due to swelling and a feeling of 'heaviness' of his left upper extremity for the past 6 months. CT scan revealed a massive substernal goiter extending to the great vessels. Intraoperatively, a median sternotomy was performed due to the size of the gland and the close adhesion of the isthmus and lower left thyroid lobe to the brachiocephalic vein...
January 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28094119/-safety-of-repeat-median-sternotomy-in-the-palliative-treatment-of-patients-with-univentricular-heart
#4
Héctor Díliz-Nava, Isis Meléndez-Sagaón, Orlando Tamaríz-Cruz, Luis García-Benitez, Aric Araujo-Martínez, Alexis Palacios-Macedo
OBJECTIVE: Establish the morbidity and mortality of patients with univentricular hearts who underwent repeat median sternotomy at the Instituto Nacional de Pediatría METHOD: We retrospectively review the clinical charts of all patient who underwent repeat median sternotomy from 2001 to 2016. RESULTS: Sixty-five patients underwent 76 surgeries through repeat median sternotomy. Fifty-nine patients had a first repeat median sternotomy with a mean age of 36months (range 4-176months) and a mean weight of 12...
January 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28092294/outcomes-of-a-combined-approach-of-percutaneous-coronary-revascularization-and-cardiac-valve-surgery
#5
Orlando Santana, Sandeep Singla, Christos G Mihos, Andrés M Pineda, Gregg W Stone, Paul A Kurlansky, Isaac George, Ajay J Kirtane, Craig R Smith, Nirat Beohar
A subset of patients requiring coronary revascularization and valve surgery may benefit from a combined approach of percutaneous coronary intervention (PCI) and valve surgery, as opposed to the standard median sternotomy approach of combined coronary artery bypass and valve surgery. To evaluate its potential benefits and limitations, a literature search was performed using PubMed, EMBASE, Ovid, and the Cochrane library, through March 2016 to identify all studies involving a combined approach of PCI and valve surgery in patients with coronary artery and valvular disease...
January 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28091832/utility-and-safety-of-the-safesept%C3%A2-transseptal-guidewire-for-electrophysiology-studies-with-catheter-ablation-in-pediatric-and-congenital-heart-disease
#6
Joseph J Knadler, Jeffrey B Anderson, Ahmad S Chaouki, Richard J Czosek, Chad Connor, Timothy K Knilans, David S Spar
PURPOSE: The atrial transseptal procedure is used in catheter ablation of left-sided arrhythmias. Studies in adult patients have shown the SafeSept™ transseptal guidewire (SSTG) to be effective in atrial transseptal procedures. We analyzed our 5-year experience with SSTG use in pediatric and congenital heart disease patients undergoing catheter ablation. METHODS: This is a single-center retrospective analysis of patients undergoing catheter ablation from 2009 to 2014...
January 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28077503/european-association-for-cardio-thoracic-surgery-expert-consensus-statement-on-the-prevention-and-management-of-mediastinitis
#7
Yasir Abu-Omar, Gregor J Kocher, Paolo Bosco, Cristina Barbero, David Waller, Tomas Gudbjartsson, Miguel Sousa-Uva, Peter B Licht, Joel Dunning, Ralph A Schmid, Giuseppe Cardillo
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28076961/total-arch-replacement-through-a-median-sternotomy-for-kommerell-s-diverticulum
#8
Yoshihiro Goto, Yutaka Koyama, Soh Hosoba, Shinji Ogawa, Shunsuke Fukaya, Yasuhide Okawa
Kommerell's diverticulum with a right aortic arch and aberrant left subclavian artery is a rare anomaly, and the optimal operative strategy has not yet been established. In particular, the approach to the diverticulum is controversial, with the greatest concern being whether or not to add a right thoracotomy to the median sternotomy for distal anastomosis. We successfully performed total arch replacement through a median sternotomy only, by referring to preoperative computed tomography. We think that if the aneurysm is in a shallow position from the tracheal bifurcation, total arch replacement is possible with a midline incision only...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28074028/assessment-of-postoperative-pain-control-with-an-elastomeric-pain-pump-following-cardiothoracic-surgery
#9
Anuvrat Chopra, Jeff Hurren, Susan Szpunar, Stephanie B Edwin
OBJECTIVE: To assess the effectiveness of local anesthesia, delivered via elastomeric pump to manage pain in patients undergoing cardiothoracic surgery. METHODS: A retrospective, comparative analysis evaluating adult cardiothoracic surgery patients (by median sternotomy) who received continuous infusion bupivacaine + traditional methods of pain control (N = 100) or traditional pain control alone (N = 100) from July 2011-October 2013. The primary efficacy end point was total postoperative opioid requirements for 96 hours following surgery...
January 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28070876/pulmonary-artery-sarcoma-resected-via-median-sternotomy-with-thoracoscopic-assistance
#10
Hiromichi Katakura, Yojiro Yutaka, Kenichi Takahashi, Tsuyoshi Shoji, Akira Yamanaka, Mitsuru Kitano
Median sternotomy is frequently selected for the resection of pulmonary artery tumor, and pneumonectomy is performed for complete resection. However, it is difficult to see the inferior pulmonary vein and transect it safely via median sternotomy, so additional thoracotomy is often required and this is highly invasive. In the present case, we employed thoracoscopy (which we routinely use for VATS lobectomy) to transect the inferior pulmonary vein via median sternotomy without additional intercostal thoracotomy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28063686/extubation-failure-after-neonatal-cardiac-surgery-a-multicenter-analysis
#11
Christopher W Mastropietro, Katherine Cashen, Lisa M Grimaldi, Keshava Murty Narayana Gowda, Kurt D Piggott, Michael Wilhelm, Eleanor Gradidge, Elizabeth A S Moser, Brian D Benneyworth, John M Costello
OBJECTIVES: To describe the epidemiology of extubation failure and identify risk factors for its occurrence in a multicenter population of neonates undergoing surgery for congenital heart disease. STUDY DESIGN: We conducted a prospective observational study of neonates ≤30 days of age who underwent cardiac surgery at 7 centers within the US in 2015. Extubation failure was defined as reintubation within 72 hours of the first planned extubation. Risk factors were identified with the use of multivariable logistic regression analysis and reported as OR with 95% CIs...
January 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28054283/mediastinal-seminoma-associated-with-multilocular-thymic-cyst
#12
Masato Inui, Jun-Ichi Nitadori, Shogo Tajima, Takahusa Yoshioka, Noriko Hiyama, Takeyuki Watadani, Aya Shinozaki-Ushiku, Kazuhiro Nagayama, Masaki Anraku, Masaaki Sato, Masashi Fukayama, Jun Nakajima
An asymptomatic 26-year-old man received an annual medical check-up, and chest X-ray showed a protrusion of the aortopulmonary window. Chest computed tomography (CT) revealed an anterior mediastinal tumor and cysts with thin wall and septum enhancement. The preoperative diagnosis was cystic thymoma or malignant lymphoma. We performed total resection of the tumor through a median sternotomy. The pathological findings revealed seminoma, positive for c-kit stain, and multilocular thymic cysts. Cysts were lined by normal squamous epithelium and no seminoma cells were located on their surface...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28044001/resection-of-giant-mediastinal-liposarcoma-via-%C3%A2-shape-incision
#13
Wei Huang, Ge Ning Jiang
Primary mediastinal liposarcomas are extremely rare conditions often resected through standard median sternotomy or lateral thoracotomy. However, the management of a very huge mediastinal tumor involving hemithorax through these two common surgical approaches is always challenging. Herein, we report a case of applying median sternotomy with a sternum transection plus a right fourth intercostal thoracotomy ('⊣ shape' incision) to resect a giant primary anterior mediastinal liposarcoma extending into the whole right thorax...
January 2, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28043830/fetal-primary-cardiac-tumors-during-perinatal-period
#14
REVIEW
Shi-Min Yuan
Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas...
October 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28040763/feasibility-and-clinical-outcome-after-minimally-invasive-valve-sparing-aortic-root-replacement
#15
Kristina Wachter, Ulrich F W Franke, Rashmi Yadav, Ragi Nagib, Adrian Ursulescu, Samir Ahad, Hardy Baumbach
OBJECTIVES: This study aims to examine the feasibility and clinical course after minimally invasive David procedure compared with those via a conventional median sternotomy. METHODS: One hundred and ninety-two consecutive patients who underwent elective valve-sparing aortic root replacement (David procedure) with or without additional cusp repair for aortic regurgitation (n = 17, 8.9%), dilatation of the aortic root (n = 95, 49.5%) or a combination of both pathologies (n = 80, 41...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28025311/operative-results-of-the-anterolateral-thoracotomy-with-partial-sternotomy-approach-for-chronic-type-b-aortic-dissection-involving-the-aortic-arch
#16
Gaku Uchino, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Takuya Kawabata, Munehiro Saiki, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida, Osamu Oba
OBJECTIVES: There are various treatment strategies for chronic-type B aortic dissection involving the aortic arch. Our aim was to review our surgical experience in the anterolateral thoracotomy with the partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch. METHODS: From January 2000 to October 2015, 39 patients underwent the single-stage open surgery for chronic-type B aortic dissection involving the aortic arch using the anterolateral thoracotomy with partial sternotomy approach...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28024212/thymoma-in-middle-mediastinum-that-induced-tracheal-compression-case-report-and-literature-review
#17
Teiko Sakurai, Tetsuki Sakamoto, Tomoko Wakasa, Yoshio Ohta, Hiroyuki Shiono
BACKGROUND: A thymoma, an epithelial neoplasm of the thymus, mainly occurs in the anterior mediastinum, while few are seen in the middle mediastinum. CASE PRESENTATION: An 83-year-old male was referred for an incidental mass in the middle mediastinum. He had severe dementia and denied symptoms. Our follow-up computed tomography (CT) examinations had revealed the progress of tracheal compression along with tumor enlargement for 2 years. At 85 years old, we performed a thymomectomy via a median sternotomy to avoid complete trachea obstruction...
December 13, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28018826/hemopericardium-due-to-idiopathic-coronary-artery-rupture-treated-with-saphenous-vein-patch-plasty
#18
Benedikt Mayr, Stefan Buchholz, Christian Hagl, Maximilian Pichlmaier
We report a case of an idiopathic coronary artery rupture in a 41-year-old male patient who was admitted to the hospital with cardiac tamponade. On opening the chest via a median sternotomy and establishing cardiopulmonary bypass the hemopericardium's cause could be identified as a perforation of the right posterior descending coronary artery which was treated with a saphenous vein patch plasty. With idiopathic coronary artery rupture being a rare diagnosis, one should always consider it in a young patient presenting with cardiac tamponade...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28009710/subxiphoid-exchange-of-heartmate-ii-left-ventricular-assist-device
#19
Vakhtang Tchantchaleishvili, Jessica G Y Luc, Joshua Haswell, William Hallian, H Todd Massey
With increasing use of left ventricular assist devices (LVAD) for long-term circulatory support comes a growing need for device exchange. The conventional surgical approach for device exchanges has been a reoperative median resternotomy. Less invasive HeartMate II LVAD exchange via a non-muscle-dividing subxiphoid incision as an alternative to a left subcostal incision may reduce pain burden and facilitate recovery. From November 2006 through June 2015, 292 patients underwent HeartMate II LVAD placement, of which 30 (10...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28007263/thymic-and-mediastinal-lymph-node-metastasis-of-colon-cancer
#20
Yoko Yamamoto, Ken Kodama, Yoshihito Ide, Masashi Takeda
Most anterior mediastinal tumors are thymomas. Thymic metastasis from other primary cancers is extremely rare. We report the case of a 72-year-old man who developed thymic and mediastinal lymph node metastases of cecum cancer. He had undergone laparoscopic ileocecal resection with regional lymph node dissection for primary cecum cancer 15 months previously. Follow-up computed tomography revealed tumors in the anterior mediastinum. Fluorodeoxyglucose positron emission tomography showed positive uptake in the tumors...
January 2017: Annals of Thoracic Surgery
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