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Median sternotomy

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https://www.readbyqxmd.com/read/29770873/xiphoidectomy-for-intractable-xiphodynia
#1
Patrick Dorn, Michael A Kuhn, Barbara A Schweizer, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Xiphodynia is a rare condition with hardly any data published regarding xiphoidectomy as a valid treatment option for intractable disease. It is necessary to bear this syndrome in mind after having filtered out other differential diagnoses. METHODS: Between 2003 and 2015, 11 patients underwent xiphoidectomy for intractable xiphodynia at our institution. Patients' charts were reviewed including preoperative workup, operative technique, and results. Every patient had routine follow-ups, 4 weeks after the procedure and 1 year after surgery...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29768973/myasthenia-gravis-appearing-after-thymectomy-heralding-recurrent-thymoma
#2
Paul A J Beckers, Rudy Mercelis, Stijn Heyman, Lies Verheuen, Patrick Lauwers, Jeroen M Hendriks, Paul E Van Schil
INTRODUCTION: Thirty to fifty percent of thymoma patients develop myasthenia gravis (MG). In 1.5-28% of cases, MG appears many years after removal of a thymoma. PATIENTS AND METHODS: We present a case report of a 72-year-old female who presented with MG four months after total thymectomy. RESULTS: A 72-year-old female patient presents with MG four months after total thymectomy. Imaging revealed a PET-positive nodule anterior to the superior vena cava...
May 17, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29766749/enhanced-sternal-healing-via-platelet-rich-plasma-and-biodegradable-gelatin-hydrogel
#3
Masafumi Shibata, Gen Takagi, Mitsuhiro Kudo, Jiro Kurita, Yoko Kawamoto, Yasuo Miyagi, Mikimoto Kanazashi, Takashi Sakatani, Zenya Naito, Yasuhiko Tabata, Masaaki Miyamoto, Takashi Nitta
Platelet-rich plasma (PRP) contains numerous growth factors and promotes bone fracture healing. The aim of this study was to evaluate the effectiveness of the controlled release of PRP from biodegradable gelatin hydrogel for promoting healing in a rabbit ischemic sternal model. PRP was prepared from the whole blood of a Japanese white rabbit. Sixteen rabbits were randomized into four groups (each n = 4) and all underwent median sternotomy and bilateral internal thoracic artery removal. Before the sternum was closed, the following solutions were applied between the sternum incisions in three of the groups: 30 mg of gelatin hydrogel incorporating 300 μL of phosphate-buffered saline, 300 μL of a solution form of PRP, or 30 mg of gelatin hydrogel incorporating 300 μL of PRP (PRP+Gel)...
May 16, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29755812/is-bilateral-staged-muscle-sparing-thoracotomy-performed-within-1-week-for-lung-hydatid-cysts-safe-for-pediatric-patients
#4
Ömer Önal, Ömer Faruk Demir
OBJECTIVES: Median sternotomy or staged thoracotomies are generally the preferred surgical treatment options for bilateral lung hydatid cysts. According to literature, it is usually recommended to wait from 3 weeks to 3 months between bilateral staged thoracotomies. The aim of this study is to compare postoperative complications, hospitalization days and morbidity and mortality ratios between unilateral thoracotomy and bilateral staged thoracotomy groups and to evaluate the safety of performing bilateral staged thoracotomy within 1 week for lung hydatid cysts in pediatric patients...
April 2018: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29755625/minimal-invasive-technique-in-atrial-septal-defect-surgery
#5
Feridoun Sabzi, Reza Faraji, Mahmood Kazeminasab
Background: Median sternotomy with minimal skin incision (MSWMSI) and modified anterior mini-thoracotomy (MAMT) approach that both are innovative techniques modified from previous documented techniques are important alternative to conventional median sternotomy in atrial septal defect (ASD) repair. Our aim is to explain the details of two performed techniques in our center and explain the results. Methods: Totally 54 children with ASD (20 female and 34 male) were operated with two different techniques i...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29755093/-concomitant-atrial-septal-defect-closure-and-repair-of-pectus-excavatum-in-a-50-year-old-patient-report-of-a-case
#6
Atsushi Tamura, Hajime Kinoshita, Kei Kazuno, Hiroshige Sato, Seiichiro Murata, Hiroshi Iida
We report a case of atrial septal defect (ASD) with severe pectus excavatum. A 50-year-old female had a stroke due to paradoxical embolism from deep vein thrombosis thorough ASD. Her preoperative computed tomography(CT) revealed a severe pectus excavatum (Haller CT index 28.6). The patient underwent ASD closure and repair of the pectus excavatum concomitantly. Median full sternotomy was performed for ASD closure. And we adopted sterno-costal elevation for pectus excavatum repair. Cartilages of the 3rd to the 7th rib were segmentally resected and the remainders were re-sutured to the sternum...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#7
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750930/a-simplified-technique-for-complex-mitral-valve-regurgitation-via-minimally-invasive-approach
#8
Giuseppe Speziale, Marco Moscarelli, Nicola Di Bari, Raffaele Bonifazi, Massimo Salardino, Teresa De Donatis, Giusepe Nasso
BACKGROUND: Complex mitral valve disease can require surgical repair techniques that are challenging in a minimally invasive context and may expose patients to prolonged cardiopulmonary bypass and cross clamp times. Here, we review our simplified stepwise operative approach for the treatment of complex bileaflet mitral disease, on early outcomes and mid-term follow-up. METHODS: One hundred and forty consecutive patients with bileaflet disease underwent video-assisted right minimally invasive mitral valve repair at our surgical center between 2008 and 2016...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750405/heartmate-3-implantation-via-left-antero-lateral-thoracotomy-to-avoid-resternotomy-in-high-risk-patients
#9
Raymond Pfister, Piergiorgio Tozzi, Roger Hullin, Patrick Yerly, Fritz-Patrick Jahns, René Prêtre, Matthias Kirsch
Left ventricular assist devices (LVADs) are currently the best alternative to cardiac transplantation for patients with end-stage heart failure (HF) as a bridge to transplant or to decision, or as destination therapy. Full median sternotomy or minimally invasive techniques are the more standard approaches used at present.  LVADs are usually implanted between the left ventricle apex and the ascending aorta. An implantation through a left thoracotomy with an outflow graft connected to the descending aorta is much less performed nowadays due to the longer times to extubation, higher incidence of postoperative pain, and poorer hemodynamics in the ascending aorta, which may lead to thrombosis...
April 25, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29748938/an-entire-clinical-course-of-mediastinal-myxofibrosarcoma-treated-by-surgery-and-radiation
#10
Yasoo Sugiura, Hiroyuki Fujimoto, Toshinori Hashizume, Go Ogura, Etsuo Nemoto
A woman in her 70s with an 8.6-cm tumor in the anterior mediastinum underwent tumor excision by median sternotomy, which combined resection of the fifth and sixth ribs. The pathological diagnosis was myxofibrosarcoma, and pathologically curative resection was accomplished. Local recurrence was detected at 10, 19, 23 and 28 months after the initial surgery. After repeated surgical resection, radiation therapy for the fourth unresectable recurrence resulted in failure. She died 34 months after the initial surgery...
May 10, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29733824/preoperative-aortic-arch-size-and-late-outcome-following-coarctation-repair-via-lateral-thoracotomy
#11
Preeti Ramachandran, Philip R Khoury, Robert H Beekman, Erik C Michelfelder, Peter B Manning, James S Tweddell, James F Cnota
BACKGROUND: The approach (lateral thoracotomy vs median sternotomy) to repair coarctation of aorta is frequently based on arch dimensions from the preoperative echocardiogram. Few studies have assessed the relationship between preoperative arch dimensions and late postoperative outcome. This study aims to define how preoperative arch dimensions relate to late outcomes and identify long term predictors of successful surgery. METHODS: We performed a retrospective review of 102 neonates and infants undergoing isolated coarctation repair via lateral thoracotomy between 2003-2012...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29722889/double-arterial-cannulation-a-strategy-for-whole-body-perfusion-during-aortic-arch-reconstruction
#12
Michaela Kreuzer, Eva Sames-Dolzer, Laura Schausberger, Andreas Tulzer, Thomas Ratschiller, Bettina Haizinger, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Double-arterial cannulation enables cerebral perfusion and lower body perfusion during aortic arch reconstruction. The aim of this study was to analyse and report our experience of using this cannulation and perfusion technique on paediatric patients. METHODS: A retrospective single-centre study was carried out on 407 consecutive paediatric patients who underwent an aortic arch reconstruction under double-arterial cannulation between 2003 and 2015. The median age of the patients at surgery was 8 (range 2-5570) days, and body weight was 3...
May 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29721848/pyogenic-granuloma-originating-in-the-pulmonary-artery
#13
Noriaki Kishimoto, Takeshi Ikuta, Hirofumi Fujii, Akihiro Sumiya, Eiji Kimura, Yoshihiro Shimizu
We herein report an unreported case of pyogenic granuloma that originated in the pulmonary artery. A 38-year-old man was urgently hospitalized with dyspnea and back pain. He had been on hemodialysis for 2 years due to chronic renal failure. We performed contrast-enhanced computed tomography and detected a mass occluding the left main pulmonary artery. The maximum standardized uptake value (SUVmax ) of 18 F-fluorodeoxy glucose (FDG) in the mass was 4.1. We made a tentative diagnosis of pulmonary artery tumor, and planned an operation...
May 2, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29707310/right-anterior-mini-thoracotomy-vs-conventional-sternotomy-for-aortic-valve-replacement-a-propensity-matched-comparison
#14
Mauro Del Giglio, Elisa Mikus, Roberto Nerla, Antonio Micari, Simone Calvi, Alberto Tripodi, Gianluca Campo, Elisa Maietti, Fausto Castriota, Alberto Cremonesi
Background: Right anterior mini-thoracotomy (MIAVR) is a promising technique for aortic valve replacement. We aimed at comparing its outcomes with those obtained in a propensity-matched group of patients undergoing sternotomy at our two high-volume centers. Methods: Main clinical and operative data of patients undergoing aortic valve replacement between January 2010 and May 2016 were retrospectively collected. A total of 678 patients were treated with a standard full sternotomy approach, while MIAVR was performed in 502...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29705833/robotic-assisted-thymectomy-for-early-stage-thymoma-a-propensity-score-matched-analysis
#15
Monica Casiraghi, Domenico Galetta, Alessandro Borri, Adele Tessitore, Rosalia Romano, Daniela Brambilla, Patrick Maisonneuve, Lorenzo Spaggiari
The aim of this study was to analyse the feasibility and safety of robotic-assisted thymectomy (RoT) in patients with clinically early stage thymoma, investigating clinical and early oncological results. Between 1998 and 2017, we retrospectively reviewed 76 (42.2%) patients who underwent radical thymectomy for clinically early stage thymoma (Masaoka-Koga I and II), identifying all patients who underwent RoT (n = 28) or open thymectomy (OT) with eligibility criteria for robotic surgery (n = 48). Using a propensity-score matched for tumor size (3...
April 28, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29703578/early-in-vivo-experience-with-the-pediatric-continuous-flow-total-artificial-heart
#16
Jamshid H Karimov, David J Horvath, Nicole Byram, Gengo Sunagawa, Barry D Kuban, Shengqiang Gao, Raymond Dessoffy, Kiyotaka Fukamachi
BACKGROUND: Heart transplantation in infants and children is an accepted therapy for end-stage heart failure, but donor organ availability is low and always uncertain. Mechanical circulatory support is another standard option, but there is a lack of intracorporeal devices due to size and functional range. The purpose of this study was to evaluate the in vivo performance of our initial prototype of a pediatric continuous-flow total artificial heart (P-CFTAH), comprising a dual pump with one motor and one rotating assembly, supported by a hydrodynamic bearing...
March 30, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29699805/minimally-invasive-versus-full-sternotomy-aortic-valve-replacement-in-low-risk-patients-which-will-stand-against-transcatheter-aortic-valve-replacement
#17
Sameer A Hirji, Masaki Funamoto, Jiyae Lee, Fernando Ramirez Del Val, Ahmed A Kolkailah, Siobhan McGurk, Marc P Pelletier, Sary Aranki, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Minimally invasive aortic valve replacement using upper-hemisternotomy has been associated with improved results compared to full sternotomy aortic valve replacement. Given the likely expansion of transcatheter aortic valve replacement to low-risk patients, we examine contemporary outcomes after full sternotomy and minimally invasive aortic valve replacement in low-risk patients using our 15-year experience. METHODS: Two thousand ninety-five low-risk patients (Society of Thoracic Surgeons Predicted Risk of Mortality score <4) underwent elective isolated aortic valve replacement, including 1,029 (49%) minimally invasive and 1,066 (51%) full sternotomy, from 2002 to 2015...
April 23, 2018: Surgery
https://www.readbyqxmd.com/read/29698663/fate-of-the-aortic-arch-following-surgery-on-aortic-root-and-ascending-aorta-in-bicuspid-aortic-valve
#18
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Panagiotis Theodoropoulos, Simon Phillips, Bernard Liban, Anne Child, Maite Tome, Justin Nowell, Rajan Sharma, Mark Edsell, Marjan Jahangiri
BACKGROUND: Recent guidelines support more aggressive surgery for aneurysms of the ascending aorta and root in patients with bicuspid aortic valve. However, the fate of the arch after surgery of the root and ascending aorta is unknown. We set out to assess outcomes following root and ascending aortic surgery and subsequent growth of the arch. METHODS: Between 2005 and 2016, 536 consecutive patients underwent surgery for aneurysm of the root and ascending aorta. 168 had bicuspid aortic valve...
April 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29697519/intraoperative-combination-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-a-median-sternotomy-in-hemodynamically-unstable-patients-with-penetrating-chest-trauma-is-this-feasible
#19
Carlos A Ordoñez, Michael W Parra, Ramiro Manzano-Nunez, Juan P Herrera-Escobar, Jose J Serna, Paola Rodriguez Ossa, David Mejia, Ana M Del Valle, Alexander Salcedo, Juan C Salamea, Fernando Rodriguez
BACKGROUND: Recent evidence suggests that resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective life-saving intervention in patients with severe torso trauma. However, the deployment of REBOA in patients with isolated penetrating intrathoracic injuries remains controversial. We propose that a median sternotomy be performed in conjunction with REBOA as a feasible and effective means of hemorrhage control in patients suffering from penetrating chest trauma who present hemodynamically unstable...
May 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29688301/right-minithoracotomy-versus-median-sternotomy-for-reoperative-mitral-valve-surgery-a-systematic-review-and-meta-analysis-of-observational-studies
#20
Jean H T Daemen, Samuel Heuts, Jules R Olsthoorn, Jos G Maessen, Peyman Sardari Nia
Reoperative mitral valve surgery (MVS) through a median sternotomy (ST-MVS) can be particularly challenging due to dense adhesions and is known to carry a substantial risk of injuries to vascular structures. These injuries occur in 7-9% of cases and are associated with increased mortality rates. A valid alternative that could avoid the risks associated with redo ST-MVS is the right anterolateral minithoracotomy (MT-MVS) approach. The aim of this study was to quantify the effects of MT-MVS compared with those of ST-MVS on morbidity and mortality among patients who underwent prior cardiac surgery through a sternotomy...
April 23, 2018: European Journal of Cardio-thoracic Surgery
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