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Median sternotomy

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https://www.readbyqxmd.com/read/28433220/comparison-of-two-minimally-invasive-techniques-and-median-sternotomy-in-aortic-valve-replacement
#1
Severin Semsroth, Raffaela Matteucci Gothe, Yvonne Rodríguez Raith, Kristof de Brabandere, Esther Hanspeter, Juliane Kilo, Markus Kofler, Ludwig Müller, Elfriede Ruttman-Ulmer, Michael Grimm
BACKGROUND: Propensity score-matched analysis of the anterolateral minithoracotomy and the partial upper hemisternotomy vs the median sternotomy approach has not been reported to date for isolated aortic valve replacement. METHODS: From 2005 to 2013, isolated aortic valve replacement was performed through a partial upper hemisternotomy in 315 patients (38.9%), through a median sternotomy in 328 patients (40.5%), and through an anterolateral minithoracotomy in 167 patients (20...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431721/intra-aortic-missile-after-gunshot-wound-to-chest-an-interesting-case-of-traumatic-cardiac-injury
#2
Charles D Fraser, Lee Goeddel, Nishant D Patel, Said C Azoury, Joshua C Grimm, Rosanne B Sheinberg, Christopher M Sciortino
Missile embolus to the heart, although uncommon, is one of the most challenging scenarios in trauma. We describe a 36-year-old man who presented with a gunshot wound to the left chest and a chest x-ray revealing a foreign body in the mediastinum. A median sternotomy was performed and an injury to the left ventricle was identified. After intraoperative echocardiography and fluoroscopy confirmed a foreign body in the aortic root, cardiopulmonary bypass was implemented. A bullet was retrieved from the noncoronary sinus of the aortic valve...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28427001/emergency-room-thoracotomy-for-acute-traumatic-cardiac-tamponade-caused-by-a-blunt-cardiac-injury-a-case-report
#3
Kenichiro Ishida, Yoshihiro Kinoshita, Nobutaka Iwasa, Masaro Nakae, Masayuki Sakaki, Yohei Ieki, Kyosuke Takahashi, Yumiko Shimahara, Taku Sogabe, Keiichiro Shimono, Mitsuhiro Noborio, Daikai Sadamitsu
INTRODUCTION: Traumatic blunt cardiac injuries have a high mortality rate, and prompt diagnosis and treatment can be lifesaving in cardiac tamponade. PRESENTATION OF CASE: A 62-year-old man was transferred to the emergency department after a motor vehicle accident. He was hemodynamically unstable. A focused assessment with sonography in trauma (FAST) showed pericardial fluid with right ventricular collapse consistent with cardiac tamponade in the subxiphoid view...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28414995/case-report-of-an-intracaval-leiomyomatosis-10-months-after-complete-hysterectomy
#4
Hannah Maria Schäfer, Andrej Isaak, Lorenz Gürke
INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor, usually found in women with tumors of the reproductive organs, such as uterus myomatosous. Surgically, this case belies the call for sternotomy and two-stage surgery in caval IVL extending to the right atrium: we suggest one-stage median laparotomy as a minimal procedure with maximal benefit. PRESENTATION OF CASE: We present the case of a 60-year-old postmenopausal woman with suspected intravenous leiomyomatosis of the right internal iliac vein...
March 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28412961/perventricular-double-device-closure-of-wide-spaced-multi-hole-perimembranous-ventricular-septal-defect
#5
Fei Liang, Li Hongxin, Hai-Zhou Zhang, Guo Wenbin, Cheng-Wei Zou, Zeeshan Farhaj
BACKGROUND: Device closure of a wide-spaced multi-hole PmVSD is difficult to succeed in percutaneous approach. This study is to evaluate the feasibility, safety and efficacy of perventricular device closure of wide-spaced multi-hole PmVSD using a double-device implanting technique. METHODS: Sixteen patients with wide-spaced multi-hole PmVSD underwent perventricular closure with two devices through an inferior median sternotomy approach under transesophageal echocardiographic guidance...
April 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28412038/surgical-treatment-of-postintubation-tracheal-stenosis-a-retrospective-22-patient-series-from-a-single-center
#6
Ahmet Ulusan, Maruf Sanli, Ahmet Feridun Isik, İlknur Aytekin Celik, Bulent Tuncozgur, Levent Elbeyli
BACKGROUND/OBJECTIVE: We aimed to present cases of postintubation tracheal stenosis (PITS), all due to long-term intubation and treated surgically in a university hospital, and to discuss them in light of the literature. METHODS: In this retrospective study, 22 patients who were treated with tracheal resection and reconstruction due to PITS were included. Demographics, intubation characteristics, localization of stenosis, surgical technique and material, postoperative complications, and survival of patients were recorded...
April 12, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28407104/minimally-invasive-or-conventional-edge-to-edge-repair-for-severe-mitral-regurgitation-due-to-bileaflet-prolapse-in-barlow-s-disease-does-the-surgical-approach-have-an-impact-on-the-long-term-results-%C3%A2
#7
Michele De Bonis, Elisabetta Lapenna, Benedetto Del Forno, Stefania Di Sanzo, Andrea Giacomini, Davide Schiavi, Luca Vicentini, Azeem Latib, Alberto Pozzoli, Federico Pappalardo, Giovanni La Canna, Ottavio Alfieri
OBJECTIVES: To evaluate whether the adoption of a right minithoracotomy operative approach had an impact on the long-term results of edge-to-edge (EE) repair compared to conventional sternotomy in patients with Barlow's disease and bileaflet prolapse. METHODS: We assessed the long-term results of 104 patients with Barlow's disease treated with a minimally invasive EE technique. An equal number of patients had a conventional median sternotomy EE repair for the same disease and were used as a control group...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28400498/effect-of-thoracic-epidural-anesthesia-on-heart-rate-variability-in-a-porcine-model
#8
Arjun Mahajan, Tatsuo Takamiya, Peyman Benharash, Wei Zhou
Heart rate variability (HRV) is increasingly recognized as a means of evaluating autonomic tone. Thoracic epidural anesthesia (TEA) has been previously demonstrated to suppress the electrical storms in patients. However, the effect of TEA on HRV during sympathoexcitation remains unknown. In this study, we aimed to determine the effects of TEA on HRV response to left stellate ganglion stimulation (LSS) in a porcine model. In 12 anesthetized pigs after insertion of an epidural catheter to T1 level, a median sternotomy was performed to expose the heart and the left stellate ganglion...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#9
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/28393776/serial-semi-invasive-hemodynamic-assessment-following-pericardiectomy-for-chronic-constrictive-pericarditis
#10
Ujjwal Kumar Chowdhury, Poonam Malhotra Kapoor, Adil Rizvi, Vishwas Malik, Sandeep Seth, Rajiv Narang, Mani Kalaivani, Sarvesh Pal Singh, Sathiya Selvam
OBJECTIVES: This study was designed to prospectively investigate the effects of pericardiectomy via median sternotomy on intra- and postoperative hemodynamics by a new semi-invasive device (Flotrac/VigileoTM monitor) using arterial pressure waveform analysis. PATIENTS AND METHODS: Thirty consecutive patients aged 15 to 55 years (mean+SD, 31.73 + 13.53 years), who had undergone total pericardiectomy via median sternotomy underwent serial hemodynamic evaluation. FlotracTM Sensor - derived stroke volume, stroke volume variation, systemic vascular resistance index (SVRI), cardiac index and right atrial pressure were measured just before and after pericardiectomy, at 12 hours, 24 hours, 48 hours, 72 hours and at discharge postoperatively...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393738/surgical-management-of-postoperative-ductal-aneurysm-a-case-report
#11
Alaae Boutayeb, Loubna Mahfoudi, Said Moughil
We report the case of 24-year-old woman who presented with ductal aneurysm 7 years after a triple ligation of a patent ductus arteriosus. She underwent successful repair through median sternotomy and under moderate hypothermic circulatory arrest and selective cerebral perfusion.
April 10, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28391520/neonatal-repair-of-left-atrial-diverticulum-with-gigantic-thrombus-without-cardiopulmonary-bypass
#12
Akihiko Higashida, Takaya Hoashi, Heima Sakaguchi, Hajime Ichikawa
A 5-day-old neonate with coarctation of the aorta, hypoplastic aortic arch, large apical muscular ventricular septal defect, and patent ductus arteriosus developed pulmonary over-circulation and systemic hypoperfusion underwent bilateral pulmonary artery banding through median sternotomy as a part of hybrid stage I palliation. At operation, left atrial diverticulum with gigantic thrombus formation at the base of the left atrial appendage was incidentally detected by intraoperative direct echocardiography, and therefore, was successfully resected with the whole thrombus inside it without use of cardiopulmonary bypass...
April 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28370059/congenital-lobar-emphysema-in-a-kitten
#13
M Blonk, I Van de Maele, A Combes, B Stablay, H De Cock, I Polis, G Rybachuk, H de Rooster
A five-month-old ragdoll cat presented with severe respiratory signs, unresponsive to medical therapy. Hyperinflation of the right middle lung lobe was diagnosed with radiography and computed tomography. Lung lobectomy following a median sternotomy led to full recovery. Histopathological analysis revealed lobar emphysema and, based on the animal's age, congenital lobar emphysema was considered the most likely diagnosis.
March 28, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28359506/single-stage-hybrid-repair-of-right-aortic-arch-with-kommerell-s-diverticulum
#14
Cristian Rosu, Jean-François Dorval, Cherrie Zack Abraham, Raymond Cartier, Philippe Demers
Kommerell diverticulum is uncommon, and it carries risks of dissection or rupture. Hybrid aortic arch repair is being used increasingly for this pathology. We report the hybrid arch repair of Kommerell diverticulum in a 72-year-old woman known for muscular dystrophy and right aortic arch with aberrant left subclavian artery. Head-vessel debranching was performed through median sternotomy using a handmade, bifurcated, Dacron graft. Stent-grafting was performed from the ascending aorta to the proximal descending aorta...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28350561/reducing-pediatric-sternal-wound-infections-a-quality-improvement-project
#15
Claudia Delgado-Corcoran, Charlotte S Van Dorn, Charles Pribble, Emily A Thorell, Andrew T Pavia, Camille Ward, Randall Smout, Susan L Bratton, Phillip T Burch
OBJECTIVES: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery. DESIGN: This is a pre- and postintervention quality improvement study. SETTING: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital. PATIENTS: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included...
March 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28346261/advantages-of-minimal-access-versus-conventional-aortic-valve-replacement-in-elderly-or-severely-obese-patients
#16
Calogera Pisano, Pasquale Totaro, Oreste Fabio Triolo, Vincenzo Argano
OBJECTIVE: The aim of our study was to investigate potential clinical advantages of minimal access versus conventional surgical approach in older and severely obese patients undergoing isolated aortic valve replacement (AVR). METHODS: One hundred thirty-five patients undergoing isolated primary AVR were enrolled. Propensity score matching was used to compare 42 selected patients operated on ministernotomy (MS, group B) with 42 selected patients operated on full sternotomy (FS, group A)...
March 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28344425/surgical-treatment-of-an-invasive-thymoma-with-intracaval-and-intracardiac-extension
#17
Kun-Eng Lim, Ta-Chung Shen
A 53-year-old male with an invasive thymoma extending to the superior vena and right atrium, presenting as superior vena cava syndrome is herein reported. However invasive thymoma with this growth pattern is extremely rare. In this case, the tumor was successfully resected via median sternotomy with cardiopulmonary bypass. After 17 months of follow-up, the patient was still free from any signs and symptoms indicative of superior vena cava syndrome, but recurrent tumor in the right pleura was observed on the follow-up chest computed tomography...
March 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28331446/lung-transplantation-and-the-routine-use-of-cardiopulmonary-bypass-and-median-sternotomy-experience-at-the-ochsner-multi-organ-transplant-institute
#18
Michael Bates, Matthew Factor, P Eugene Parrino, Aditya Bansal, Reinaldo Rampolla, Leonardo Seoane, Jose Mena, Matthew Gaudet, William Smith, P Michael McFadden
BACKGROUND: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28329118/comparison-of-surgical-approach-and-extent-of-resection-for-masaoka-koga-stage-i-and-ii-thymic-tumours-in-europe-north-america-and-asia-an-international-thymic-malignancy-interest-group-retrospective-database-analysis%C3%A2
#19
Wentao Fang, Xiaopan Yao, Alberto Antonicelli, Zhitao Gu, Frank Detterbeck, Eric Vallières, Ralph W Aye, Alexander S Farivar, James Huang, Yue Shang, Brian E Louie
OBJECTIVES: Surgeons at different institutions worldwide choose different types of operations for thymic tumours. It is not known whether these differences affect the outcomes of the patients. METHODS: A total of 1430 patients with Masaoka-Koga pathological Stage I-II thymic tumours without myasthenia gravis or pre-treatment were identified from the International Thymic Malignancy Interest Group retrospective database. Outcomes of patients from 3 major continents (Europe, North America and Asia) were compared...
February 28, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#20
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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