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Median sternotomy

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https://www.readbyqxmd.com/read/28549027/a-minimally-invasive-stand-alone-cox-maze-procedure-is-as-effective-as-median-sternotomy-approach
#1
Matthew R Schill, Laurie A Sinn, Jason W Greenberg, Matthew C Henn, Timothy S Lancaster, Richard B Schuessler, Hersh S Maniar, Ralph J Damiano
OBJECTIVE: The Cox-Maze IV procedure has been shown to be an effective treatment for atrial fibrillation when performed concomitantly with other operations either via median sternotomy or right minithoracotomy. Few studies have compared these approaches in patients with lone atrial fibrillation. This study examined outcomes with sternotomy versus minithoracotomy in stand-alone Cox-Maze IV procedures at our institution. METHODS: Between 2002 and 2015, 195 patients underwent stand-alone biatrial Cox-Maze IV...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28539936/pregabalin-effect-on-acute-and-chronic-pain-after-cardiac-surgery
#2
Aik Bouzia, Vassilios Tassoudis, Menelaos Karanikolas, George Vretzakis, Argyro Petsiti, Nikolaos Tsilimingas, Elena Arnaoutoglou
Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75 mg, and Group 3 received oral pregabalin 150 mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/28539132/an-aneurysmal-right-coronary-artery-fistula-draining-into-the-left-ventricle
#3
Dongxu Li, Yabo Wang, Qi An
We describe a rare case of aneurysmal right coronary artery drainage into left ventricle in a 38-year old male with entailed coronary CT images. After median sternotomy surgery, the patient recovered well.
May 25, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28528237/skin-deformation-during-shoulder-movements-and-upper-extremity-activities
#4
Weiqing Ge, Alison Sfara, Brittany Hians
BACKGROUND: The necessity of sternal precautions for patients following cardiac surgery with median sternotomy has been questioned by clinicians, researchers, and even patients. The primary purpose was to determine if sternal skin deformation during shoulder movements and upper extremity activities is compressive or distractive and if there are any significant differences between the skin deformation at different positions during shoulder movements and upper extremity activities. The secondary purpose was to determine if sternal skin deformation is correlated with scapular stabilizer muscle strength...
May 12, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28523134/cardiac-surgery-using-a-single-thoracic-port-current-status-and-future-directions
#5
REVIEW
Javier Gallego-Poveda, Nuno Carvalho Guerra, Diego Gonzalez-Rivas, Catarina Carvalheiro, Hugo Ferreira, André Sena, Nádia Junqueira, Tiago Rodrigues Velho, Ângelo Nobre
Cardiac surgery is almost universally performed through a median sternotomy, an approach which is painful, unestethical, and prone to life-threatening infections. Minimally invasive cardiac surgery has tried to avoid problems associated with full sternotomy for many years. Recently, uniportal thoracic surgery was shown to be very advantageous when compared to standard thoracotomy and classical video assisted thoracic surgery (VATS). Despite very good results in lung surgery, cardiac surgery through a single thoracic port has rarely been attempted and successfully conducted...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#6
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28498910/extra-anatomical-bypass-in-complex-and-recurrent-aortic-coarctation-and-hypoplastic-arch%C3%A2
#7
Eva Maria Delmo Walter, Mariano Francisco Del Maria Javier, Roland Hetzer
OBJECTIVES: Our goal was to report the selection schemes, technical variations and long-term outcome of extra-anatomical bypass to correct complex, recurrent aortic coarctation and hypoplastic aortic arch. METHODS: Between 1989 and 2012, 53 patients (mean age 13.2 ± 4.3, median 11.6, range 9-23 years) with complex aortic coarctation ( n  = 33; long-segment hypoplastic aortic arch in 15), recurrent coarctation ( n  = 20; anastomosic pseudoaneurysm in 10), underwent correction using extra-anatomical bypass, either with ( n  = 18: femoral bypass = 13, left heart bypass = 5) or without ( n  = 35) extracorporeal circulation via a left lateral thoracotomy ( n = 48) and combined median sternotomy and median laparotomy ( n  = 5)...
May 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28496090/-mediastinal-thyroid-carcinoma-report-of-a-case
#8
Yusuke Kita, Ryo Kobayashi, Hiroshi Nogimura, Kumiko Hongo, Hideyo Miyato, Yukio Ishihara, Naoki Takabayashi, Takeyuki Hiramatsu
71-year-old woman was pointed out to have an asymptomatic mediastinal tumor. Chest computed tomography(CT) showed a well-demarcated mass measuring 7 cm in diameter in the anterior mediastinum. We resected the mass through a median sternotomy. The tumor had a clear margin without invasion to the surrounding tissue and did not show continuity with the cervical thyroid gland. Histopathologically, the tumor was diagnosed as follicular thyroid carcinoma with capsular invasion. This is an exceptionally rare case.
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28484651/surgical-repair-of-subacute-right-ventricular-perforation-after-pacemaker-implantation
#9
Takeshi Oda, Takanori Kono, Keiichi Akaiwa, Yasushi Takahara, Chie Yasuoka, Katsuhiko Nakamura
We report an 84-year-old woman who presented with right ventricular perforation 4 days after pacemaker implantation for syncope due to sick sinus syndrome. Median sternotomy revealed no pericardial effusion, but the pacing lead had penetrated the right ventricle and pericardium. When the pleura was opened, the tip of the lead was seen in the visceral pleura. The lead was cut in the pericardial cavity and extracted from the left subclavian wound together with the generator. The right ventricular perforation was sutured and a temporary pacing lead was placed on the right ventricular wall intraoperatively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28476113/simple-technique-of-subxiphoid-hernia-correction-carries-a-low-rate-of-early-recurrence-a-retrospective-study
#10
Gustavo Heluani Antunes de Mesquita, Leandro Ryuchi Iuamoto, Fabio Yuji Suguita, Felipe Futema Essu, Lucas Torres Oliveira, Matheus Belloni Torsani, Alberto Meyer, Wellington Andraus
BACKGROUND: Subxiphoid incisional hernia occurs as a complication following median sternotomy and are difficult to repair. We present recent data of a standardized technique for correction of subxiphoid incisional hernias, and discuss possible anatomical and surgical factors related to recurrence of the hernia. METHODS: A retrospective study with medical records analysis of patients submitted to surgical correction of subxiphoid incisional hernias through standardized treatment between July 2014 and September 2016...
May 5, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28467129/heartware-hvad-for-end-stage-heart-failure-a-review-of-clinical-experiences-with-%C3%A2-50-patients
#11
Luca Botta, Benedetta De Chiara, Francesca Macera, Aldo Cannata, Alessandro Costetti, Alessandra Voltolini, Antonella Moreo, Manlio Cipriani, Maria Frigerio, Claudio Francesco Russo
Despite the improvements in medical and surgical treatments, the incidence of end-stage heart failure (ESHF) continues to increase. Different mechanical systems have been adopted to support failing left ventricles. Among continuous-flow devices, the HeartWare-HVAD was the first to use a centrifugal pump rather than an axial one. Areas covered: In this review article, we provide an overview of the HeartWare-HVAD as a ventricular assist device for ESHF, discussing indications, echocardiographic assessment, surgical techniques, outcomes, concerns and controversies...
May 3, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28461805/repair-of-intrapericardial-diaphragmatic-hernia-during-aortic-surgery-in-a-78-year-old-woman
#12
Konstantinos Spiliotopoulos, Kim I de la Cruz, Georgios Gkotsis, Ourania Preventza, Joseph S Coselli
Intrapericardial diaphragmatic hernias are reported very rarely. Those of congenital origin are most often diagnosed in neonates, and those caused by indirect blunt trauma occur chiefly in adults. The latter type can be asymptomatic; however, the results of a computed tomographic scan can yield a definitive diagnosis. Once discovered, these hernias should be corrected to avoid severe sequelae such as bowel strangulation and necrosis, peritonitis, mediastinitis, and cardiac tamponade. We report the case of a 78-year-old woman who presented for elective ascending aortic aneurysm repair...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28460201/deep-sternal-wound-infections-a-severe-complication-after-cardiac-surgery
#13
A Morgante, F Romeo
Sternal Wound Infections (SWI) represent a dangerous complication after cardiac surgery entailing significantly longer hospital stays and worse short-term survival, especially in case of deep infections (DSWI) with the onset of osteomielitis or mediastinitis. The real incidence of SWI can be estimated between 0.25% and 10%; among the risk factors for sternal dehiscences after a longitudinal median sternotomy, several experiences underline the role of diabetes as an independent risk factor for post-operative infections, especially in patients affected by COPD with higher BMI...
January 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28453792/triple-valve-surgery-through-a-less-invasive-approach-early-and-mid-term-results
#14
Petar Risteski, Nadejda Monsefi, Aleksandra Miskovic, Tanja Josic, Sherife Bala, Razan Salem, Andreas Zierer, Anton Moritz
OBJECTIVES: A partial upper sternotomy has become established as a less invasive approach mainly for single and double valve surgery. This report evaluates the clinical outcomes of triple valve surgery performed through a partial upper sternotomy. METHODS: We reviewed the medical records of 37 consecutive patients (28 men, 76%) who underwent triple valve surgery through a partial upper sternotomy between 2005 and 2015. The patients' mean age was 67 ± 17 years; 27 (73%) were in New York Heart Association Class III or IV...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28451038/-myxoma-involving-posterolateral-leaflet-about-a-case
#15
Fouad Nya, Abdessamad Abdou, Mehdi Bamous, Younes Moutakiallah, Noureddine Atmani, Aniss Seghrouchni, Mahdi Aithoussa, Abdellatif Boulahya
Cardiac myxomas are the most common type of primary cardiac tumors. They mainly affect the interatrial septum and exceptionally the heart valves. Surgical excision remains the only therapeutic alternative. We here report the case of a 69-year old patient with no significant pathological history suffering from NYHA class II-III dyspnea associated with lipothymia. Transthoracic echocardiography showed a tight calcified aortic narrowing with aortic valve gradient of 58 mmHg. A sessile mass of 15mm diameter inserted into the posterolateral leaflet, without stenosis or mitral regurgitation evoking an atypical localization of myxomaor or fibroelastoma was detected at the level of the mitral valve...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28433220/comparison-of-two-minimally-invasive-techniques-and-median-sternotomy-in-aortic-valve-replacement
#16
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
#17
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
#18
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
#19
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
#20
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
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