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Median sternotomy

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https://www.readbyqxmd.com/read/29156016/pectus-excavatum-repair-after-sternotomy-the-chest-wall-international-group-experience-with-substernal-nuss-bars
#1
Dawn E Jaroszewski, Paul J Gustin, Frank-Martin Haecker, Hans Pilegaard, Hyung Joo Park, Shao-Tao Tang, Shuai Li, Li Yang, Sadashige Uemura, Jose Ribas Milanez De Campos, Robert Obermeyer, Frazier W Frantz, Michele Torre, Lisa McMahon, Andre Hebra, Chih-Chun Chu, J Duncan Phillips, David M Notrica, Antonio Messineo, Robert Kelly, Mustafa Yüksel
OBJECTIVES: Patients with pectus excavatum (PE) after prior sternotomy for cardiac surgery present unique challenges for repair of PE. Open repairs have been recommended because of concerns about sternal adhesions and cardiac injury. We report a multi-institutional experience with repair utilizing substernal Nuss bars in this patient population. METHODS: Surgeons from the Chest Wall International Group were queried for experience and retrospective data on PE repair using sub-sternal Nuss bars in patients with a history of median sternotomy for cardiac surgery (November 2000 to August 2015)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29153964/evaluation-of-different-minimally-invasive-techniques-in-surgical-treatment-for-ventricular-septal-defect
#2
Huagang Liu, Zhiwei Wang, Jun Xia, Rui Hu, Zhiyong Wu, Xiaoping Hu, Wei Ren
BACKGROUND: Minimally invasive cardiac surgery is becoming a safe and cosmetic alternative to standard median sternotomy (SMS). This retrospective study reviews our results and experience with the lower mini-sternotomy (LMS) technique and the right lateral thoracotomy (RLT) technique for ventricular septal defect (VSD) closure compared with SMS. METHODS: Between January 2013 and Dec 2015, 198 patients underwent repair VSD through lower mini-sternotomy (LMS Group, n=66), right lateral thoracotomy (RLT Group, n=59), standard median sternotomy (SMS Group, n=73)...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#3
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29128572/mitral-valve-repair-robotic-and-other-minimally-invasive-approaches
#4
REVIEW
Mateo Marin Cuartas, Hoda Javadikasgari, Bettina Pfannmueller, Joerg Seeburger, A Marc Gillinov, Rakesh M Suri, Michael A Borger
Robotic and minimally invasive mitral valve (MV) procedures have been performed with increasing frequency over time. These alternatives offer similar efficacy to that achieved via standard median sternotomy, particularly in large volume centers, along with low perioperative morbidity and mortality rates. Moreover, patient acceptance is oftentimes increased due to less postoperative pain and shorter recovery times, as well as superior cosmetic results. However, these techniques are technically complex and associated with a significant learning curve...
November 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29125632/median-sternotomy-versus-intercostal-thoracotomy-for-lung-lobectomy-a-comparison-of-short-term-outcome-in-134-dogs
#5
Seth Bleakley, Kevin Phipps, Brian Petrovsky, Eric Monnet
OBJECTIVE: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT). STUDY DESIGN: Retrospective case control study. METHODS: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded...
November 10, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29117042/impact-of-patient-distance-from-ventricular-assist-device-implanting-center-on-short-and-long-term-outcomes
#6
Ashwin K Ravichandran, Palak Shah, Ramesh Singh, Keith D Aaronson, Francis D Pagani, John Stulak, Shannon M Dunlay, Todd F Dardas, Nahush A Mokadam, Christopher T Salerno, Jennifer A Cowger
Highly specialized left ventricular assist device care is not readily available in many areas, potentially limiting access to therapy. This retrospective analysis examines the relationship of outcomes by patient distance from implanting left ventricular assist device center within the Mechanical Circulatory Support Research Network. Zip codes were used to calculate patient distance, with the primary outcome of interest being 3-year survival by distance from the surgical center. Secondary outcomes included 90-day survival and incident event rates for the following: gastrointestinal bleeding, infection, cerebral event, and pump thrombosis...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29108083/-pedicled-omentum-flaps-in-the-management-of-deep-sternal-wound-infections
#7
Nick Spindler, Christian Etz, Martin Misfeld, Christoph Josten, Michael Borger, Friedrich Wilhelm Mohr, Stefan Langer
Aim Coverage of a deep sternal wound infection with a greater omentum flap. Due to a persistent infection caused by an infected aortic prosthesis, the primarily performed reconstruction with a latissimus dorsi flap had to be revised, and an alternative solution had to be found. Indication A deep sternal wound infection is a rare but devastating complication following median sternotomy. If the commonly used muscle flap is not sufficient and artificial material is still present in the wound, for instant drivelines or a vascular prosthesis, the greater omentum flap is a useful option due to its immunologic capacity...
November 6, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29095733/left-lateral-thoracotomy-for-centrifugal-continuous-flow-left-ventricular-assist-device-placement-an-analysis-from-the-mechanical-circulatory-support-research-network
#8
Simon Maltais, Lucman A Anwer, Vakhtang Tchantchaleishvili, Nicholas A Haglund, Shannon M Dunlay, Keith D Aaronson, Francis D Pagani, Jennifer Cowger, Christopher T Salerno, Palak Shah, Zain Khalpey, Jan Schmitto, John M Stulak
Continuous-flow left ventricular assist devices (CF-LVADs) have revolutionized the management of patients with advanced heart failure. Alternative implant strategies are increasingly used for device placement. We reviewed our experience from the Mechanical Circulatory Support Research Network registry with the HeartWare centrifugal CF-LVAD (HVAD). From May 2004 to August 2015, 1,150 patients underwent primary CF-LVAD implantation at our institutions. Within this group, a total of 283 patients (25%) were implanted with the HVAD...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29092117/a-staged-approach-of-proximal-left-anterior-descending-coronary-artery-percutaneous-intervention-followed-by-minimally-invasive-valve-surgery
#9
Andrés M Pineda, Christos G Mihos, Juan P Rodriguez-Escudero, Joseph Lamelas, Nirat Beohar, Orlando Santana
BACKGROUND: A subset of patients requiring coronary revascularization of the proximal left anterior descending coronary artery (LAD) and valve surgery may benefit from a staged approach, rather than combined median sternotomy coronary artery bypass graft (CABG) and valve surgery. METHODS: A retrospective evaluation was made of the outcomes of patients with significant proximal LAD and valvular heart disease undergoing a staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) at the authors' institution between February 2009 and April 2014...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29078638/subxiphoid-thymectomy-single-port-dual-port-and-robot-assisted
#10
Takashi Suda
Currently, surgical techniques that are less invasive than conventional median sternotomy are used for thymectomy in the treatment of myasthenia gravis and anterior mediastinal tumors as no sternal incision is required. We reported on a subxiphoid single-port thymectomy using CO2 insufflation, which has the following advantages: (I) the field of view offered by the camera scope inserted from the midline of the body helps confirm the location of the superior pole of the thymus and bilateral phrenic nerves; (II) there is minimal pain and no intercostal neuropathy occurs as intercostal spaces are not traversed; and (III) cosmetic outcomes are excellent...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078610/left-video-assisted-thoracic-surgery-thymectomy
#11
REVIEW
Anee Sophia Jackson, Chris Devulapalli, Alexa Lowe, Abigael Bragado, Lorenzo De Marchi, M Blair Marshall
Video-assisted thoracic surgery (VATS) for the management of non-thymomatous myasthenia gravis (MG) as well as the management of small thymomas and other benign thymic pathology has been gaining in acceptance and popularity as an alternative to the traditional median sternotomy approach. Although VATS thymectomy has been described in several variations, our current preference is a left sided VATS approach due to the exposure it provides in critical areas of dissection. Here we describe our technique for the left sided VATS thymectomy including patient selection, preoperative preparation, operative steps, and postoperative care...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29075945/use-of-freeze-dried-bone-allografts-in-osteoporotic-patients-undergoing-median-sternotomy
#12
Mei Liang, Jianzhou Liu, Qi Miao, Guotao Ma, Xingrong Liu, Xiaofeng Li, Chaoji Zhang
Osteoporosis is a major risk factor for deep sternal wound infection, which is a rare but serious complication after median sternotomy. We investigated the incidence of deep sternal wound infection and the protective effect of bone allografts in osteoporotic patients after sternal approximation. Data were collected retrospectively from consecutive osteoporotic patients who underwent cardiac surgery via median sternotomy. Sternal approximation in the historical control group was performed with conventional steel wire sutures...
October 26, 2017: Cell and Tissue Banking
https://www.readbyqxmd.com/read/29070772/coexisting-thymic-and-pulmonary-carcinoid-tumors-associated-with-multiple-endocrine-neoplasia-type1
#13
Makoto Motoishi, Kanna Horimoto, Kazuki Hayashi, Satoru Sawai, Koki Moriyoshi
An anterior mediastinal tumor was detected in a 45-year-old female during a medical checkup. Chest computed tomography (CT) showed the anterior mediastinal tumor and a pulmonary tumor in the right lower lobe. Furthermore, tumors of the parathyroid gland, pancreas, and pituitary gland were also detected. She was clinically diagnosed with multiple endocrine neoplasia type1 (MEN1). The patient underwent extended thymectomy combined with mediastinal lymph node dissection and wedge resection of the lung including the right pulmonary lesion via a median sternotomy...
October 26, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29066145/intravenous-acetaminophen-does-not-decrease-persistent-surgical-pain-after-cardiac-surgery
#14
Alparslan Turan, Nika Karimi, Nicole M Zimmerman, Stephanie L Mick, Daniel I Sessler, Negmeldeen Mamoun
OBJECTIVE: The authors investigated the hypothesis that perioperative acetaminophen reduces incisional pain at 30 and 90 days. DESIGN: This was a prospective, randomized, double-blind trial. SETTING: Tertiary-care hospital (single center) cardiac surgery unit. PARTICIPANTS: Patients undergoing cardiac surgery via median sternotomy. INTERVENTIONS: Patients were assigned randomly to intravenous (IV) acetaminophen or IV placebo...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29064568/utility-of-preoperative-holter-monitoring-in-children-undergoing-extracardiac-conduit-fontan-operation
#15
Jun Sasaki, Michael M Lopez, Sherrie J Baysa, Ronald J Kanter, Anthony F Rossi
BACKGROUND: In patients undergoing extracardiac conduit Fontan (ECF) who require postoperative pacing, epicardial leads are usually required because of anatomical constraints. If indicated, these could be conveniently placed at the time of ECF. We have routinely performed ambulatory 24-hour Holter monitoring before ECF to determine the presence or absence of preoperative sinus node dysfunction, in attempt to avoid repeat sternotomy at a later time. METHODS: We performed a retrospective study of all patients undergoing ECF from January 2000 to December 2015...
October 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29062745/review-of-minimal-access-versus-transcatheter-aortic-valve-replacement-for-patients-with-severe-aortic-stenosis
#16
Carson T Hoffmann, Jacob A Heiner, Tom C Nguyen
Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (miniAVR) have become alternatives to surgical aortic valve replacement via median sternotomy (SAVR) to treat severe aortic stenosis (AS). Despite increased interest and utilization, few studies have directly compared TAVR and miniAVR. A review of the current literature shows TAVR to be an indispensable tool for inoperable, high-risk, and perhaps intermediate-risk patients with severe AS. However, it is associated with a number of deleterious perioperative outcomes, such as valvular regurgitation and vascular complications...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062740/outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-in-the-octogenarians-surgery-still-the-gold-standard
#17
Sameer A Hirji, Fernando Ramirez-Del Val, Ahmed A Kolkailah, Julius I Ejiofor, Siobhan McGurk, Ritam Chowdhury, Jiyae Lee, Pinak B Shah, Piotr S Sobieszczyk, Sary F Aranki, Marc P Pelletier, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Contemporary options for aortic valve replacement (AVR) include transcatheter and surgical approaches (TAVR and SAVR). As evidence accrues for TAVR in high and intermediate risk patients, some clinicians advocate that all patients aged over 80 years should only receive TAVR. Our aim was to investigate the utility of SAVR and minimally invasive AVR (mAVR) among octogenarians in the current era of TAVR. METHODS: From 2002 to 2015, 1,028 octogenarians underwent isolated AVR; 306 TAVR and 722 SAVR, of which 378 patients underwent mAVR...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062450/perioperative-outcomes-in-minimally-invasive-direct-coronary-artery-bypass-versus-off-pump-coronary-artery-bypass-with-sternotomy
#18
Ali İhsan Tekin, Ümit Arslan
INTRODUCTION: Surgical treatment of isolated left anterior descending coronary artery disease can be performed with either minimally invasive direct coronary artery bypass via a left anterior thoracotomy (MIDCAB) or off-pump coronary artery bypass via a median sternotomy (OPCAB). AIM: To compare the perioperative outcomes of patients undergoing MIDCAB or OPCAB surgery. MATERIAL AND METHODS: Patients who underwent either MIDCAB or OPCAB for isolated left anterior descending (LAD) coronary artery disease between October 2013 and December 2015 were retrospectively evaluated...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29054231/lung-procurement-after-cardiac-death-in-a-donor-with-previous-median-sternotomy
#19
Chitaru Kurihara, Masashi Kawabori, Masahiro Ono, Syed T Hussain, Amit D Parulekar, Jeffrey A Morgan, Gabriel Loor
The shortage of lungs for organ donation is problematic, and meeting the demand by expanding the donor pool in lung transplantation is critical. Donation after cardiac death (DCD) is an under-used approach that could be a valuable source of organs. However, procuring lungs from donors with a previous median sternotomy is technically difficult and is usually avoided. Here, we describe the procurement of lungs from a DCD patient with a previous median sternotomy.
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29053438/tailored-approach-to-surgical-exposure-reduces-surgical-site-complications-after-bilateral-lung-transplantation
#20
Stefan Elde, Stephen Huddleston, Scott Jackson, Rosemary Kelly, Sara Shumway, Gabriel Loor
BACKGROUND: We evaluated the effects of tailoring the operative approach on major surgical site complications and outcomes in lung transplant recipients. PATIENTS AND METHODS: Beginning in July 2013, bilateral lung transplants at a single institution were performed either through sternotomy or clamshell depending on proximity of hilar structures by computed tomography (CT), anticipated complexity, past surgical history, and surgeon experience. Patient demographics and outcomes were collected in the institution's Transplant Information Services (TIS)...
October 20, 2017: Surgical Infections
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