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Median sternotomy

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https://www.readbyqxmd.com/read/28901717/preliminary-result-with-incisional-negative-pressure-wound-therapy-and-pectoralis-major-muscle-flap-for-median-sternotomy-wound-infection-in-a-high-risk-patient-population
#1
Federico Lo Torto, Ambra Monfrecola, Juste Kaciulyte, Pedro Ciudad, Donato Casella, Diego Ribuffo, Bruno Carlesimo
Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open-heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications. Prevena(TM) represents one of these incision management systems and we aimed to evaluate its benefits. A total of 78 patients with major risk factors that presented post-sternotomy DSWI following cardiac surgery was selected...
September 13, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28901231/single-stage-repair-of-coarctation-of-the-aorta-and-ventricular-septal-defect-a-comparison-of-surgical-strategies-and-resource-utilization
#2
Connor Callahan, David Saudek, Amanda Shillingford, Sara Creighton, Garick Hill, William Johnson, James S Tweddell, Michael E Mitchell, Ronald K Woods
BACKGROUND: We sought to compare clinical outcomes and resource utilization for two surgical approaches for single-stage repair of coarctation of the aorta and ventricular septal defect (VSD). METHODS: This was a retrospective chart review of 21 consecutive neonates and infants undergoing single-stage repair of coarctation of the aorta and VSD. Group 1 included 13 patients with both arch repair and VSD repair completed via sternotomy. Group 2 included eight patients with off-pump arch repair via left thoracotomy followed by repositioning and VSD repair via sternotomy...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28894066/-thymoma-with-pure-red-cell-aplasia-report-of-a-case
#3
Masanobu Hayakawa, Kazuyuki Oda
A thymoma with pure red cell aplasia (PRCA) is relatively rare. A 71-year-old woman complainted of dizziness and her blood cell count showed a severe anemia. She was diagnosed as PRCA by bone marrow aspiration biopsy, which showed marked decrease in number of erythroblasts. In addition, the chest computed tomography revealed a solid tumor in the anterior mediastinum. She underwent extended thymothymectomy through median sternotomy. The resected specimen was 10.5×9.7 cm in diameter. The pathological diagnosis was type AB thymoma of the World Health Organization classification, and Masaoka stage I...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28883736/omentum-flap-as-a-salvage-procedure-in-deep-sternal-wound-infection
#4
Nick Spindler, Christian D Etz, Martin Misfeld, Christoph Josten, Friedrich-Wilhelm Mohr, Stefan Langer
INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28882138/a-dual-therapy-of-off-pump-temporary-left-ventricular-extracorporeal-device-and-amniotic-stem-cell-for-cardiogenic-shock
#5
Toshinobu Kazui, Phat L Tran, Tia R Pilikian, Katie M Marsh, Raymond Runyan, John Konhilas, Richard Smith, Zain I Khalpey
BACKGROUND: Temporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy. CASE PRESENTATION: This case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient...
September 7, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28859368/surgical-strategy-of-esophageal-resection-and-reconstruction-for-aortoesophageal-fistula
#6
T Nakamura, M Yamamoto, T Yamazato, S Kanaji, H Takahashi, T Inoue, T Oshikiri, H Tanaka, S Suzuki, Y Okita, Y Kakeji
Aortoesophageal fistula is a critical and life-threatening disease. The cardiovascular strategy for graft replacement has been widely discussed. However, the surgical strategy of esophageal resection and reconstruction for aortoesophageal fistula has rarely been discussed. The objective of this study is to establish a surgical strategy and procedure of esophageal resection and reconstruction for aortoesophageal fistula. Eleven patients with aortoesophageal fistula who underwent aortic graft replacement and esophagectomy between 2008 and 2015 at Kobe University Hospital were enrolled in this study...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28854949/pulmonary-tumor-embolism-secondary-to-soft-tissue-and-bone-sarcomas-a-case-report-and-literature-review
#7
Nicholas Latchana, Vincent C Daniel, Robert W Gould, Raphael E Pollock
BACKGROUND: Tumor embolisms (TE) are an underappreciated source of pulmonary embolisms in sarcoma. Most evidence in the literature is limited to case reports and none have described the presence of TE secondary to myxofibrosarcoma. We report the first case of myxofibrosarcoma TE and perform a review of the literature for TE secondary to bone and soft tissue sarcomas (STS). CASE PRESENTATION: A 36-year-old female presented with debilitating pain of the right upper extremity secondary to a recurrent soft tissue sarcoma...
August 30, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28839999/a-comparison-of-three-approaches-for-the-treatment-of-early-stage-thymomas-robot-assisted-thoracic-surgery-video-assisted-thoracic-surgery-and-median-sternotomy
#8
Liqiang Qian, Xiaoke Chen, Jia Huang, Hao Lin, Feng Mao, Xiaojing Zhao, Qingquan Luo, Zhengping Ding
BACKGROUND: This aim of this study was to compare three approaches of extended thymectomy for the treatment of early-stage thymomas, which included robot-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS), and median sternotomy (MS) perioperative parameters. METHODS: A retrospective study was conducted on 123 patients with early stage thymomas at Shanghai Chest Hospital who underwent extended thymectomy between February 2009 and August 2014...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28838507/magnetic-twin-stent-for-short-term-palliation-of-acquired-nonmalignant-tracheoesophageal-fistula
#9
Áron Altorjay, Miklós Rüll, Ágnes Sárkány
Through a tracheostomy with a rigid esophagoscope in the esophagus, the authors simultaneously placed self-made magnetic twin stents in a critically ill patient with high tracheoesophageal fistula. The operation took 17 minutes. Oral nutrition was started immediately. The stents were checked and changed after the months 3, 7, and 14. At 18 months, a tracheal resection and esophageal reconstruction through a partial median sternotomy was completed successfully. The magnetic twin stent technique can temporize critically ill patients with an acquired nonmalignant tracheoesophageal fistula until they become operable...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28833633/staged-open-repair-for-a-complex-adult-aortic-coarctation
#10
Yusuke Misumi, Takafumi Masai, Satoshi Kainuma, Yoshiki Sawa
We describe a two-stage open repair for a complex aortic coarctation in an adult. A total arch replacement with an elephant trunk was performed via a median sternotomy followed in 10 days by a replacement of the descending aorta through a left thoracotomy.
August 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28832796/transverse-sternal-split-a-safe-mini-invasive-approach-for-perventricular-device-closure-of-ventricular-septal-defect
#11
Pankaj Garg, Arvind Kumar Bishnoi, Ketav Lakhia, Jigar Surti, Sumbul Siddiqui, Parth Solanki, Himani Pandya
Objective: Perventricular device closure of ventricular septal defect through midline sternotomy avoids the cardiopulmonary bypass, however, lacks the cosmetic advantage. Perventricular device closure of ventricular septal defect with transverse split sternotomy was performed to add the cosmetic advantage of mini-invasive technique. Methods: Thirty-six pediatric patients with mean age 7.14±3.24 months and weight 5.00±0.88 kg were operated for perventricular device closure of ventricular septal defect through transverse split sternotomy in 4th intercostal space under transesophageal echocardiography guidance...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28832090/successful-combined-surgical-approach-of-a-rare-retrotracheal-goiter-in-a-patient-with-anatomical-impediments
#12
Eleftherios Spartalis, Christos Damaskos, Demetrios Moris, Antonios Athanasiou, Michael Spartalis, Grigorios Karagkiouzis, Dimitrios Schizas, Dimitrios Dimitroulis, Periklis Tomos
Diving goiters can descend the cervical region expanding directly into the thoracic cavity. In most cases, diving goiters extend into the anterosuperior compartment, but they may also extend behind the trachea. We herein present a case of a male patient with retrotracheal goiter and history of left thyroid lobectomy and median sternotomy for thoracic aortic aneurysm repair with graft placement. After detailed preoperative evaluation, the patient underwent surgical resection of the mass through a combined approach; the existing cervical incision and a right posterolateral mini-thoracotomy...
August 23, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28826681/relationship-between-right-ventricular-function-and-atrial-fibrillation-after-cardiac-surgery
#13
Pei-Chi Ting, An-Hsun Chou, Victor Chien-Chia Wu, Feng-Chun Tsai, Jaw-Ji Chu, Chun-Yu Chen, Tzuo-Yun Lan, Shao-Wei Chen
OBJECTIVE: The aim of this study was to explore the relationship between perioperative right ventricular (RV) function and postoperative atrial fibrillation (POAF) in the context of cardiac surgery. DESIGN: Prospective, observational study. SETTING: A single medical center setting. PARTICIPANTS: The study comprised 92 patients undergoing elective cardiac surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Consecutive patients without previous history of atrial fibrillation referred for cardiac surgery were enrolled prospectively...
May 10, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#14
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28790290/-postoperative-intrathoracic-hemorrhage-perioperative-prevention-and-management
#15
Yoshimasa Maniwa
Postoperative intrathoracic hemorrhage is sometimes diagnosed in the thoracic cavity, while the patient is in the recovery room after undergoing thoracic surgery such as lung resection with thoracotomy or mediastinal surgery with a median sternotomy. The information from the chest tube is important to identify this kind of postoperative complication. When the condition becomes severe, the patient may develop hemorrhagic shock due to hemothorax and re-exploration to assess for bleeding and hemostasis may be required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790248/-concomitant-operations-for-thoracic-aortic-aneurysm-and-myasthenia-gravis-report-of-a-case
#16
Hayato Konishi, Takahiro Katsumata, Yoshikazu Motohashi, Hiroaki Uchida, Eiki Woo, Tomoyasu Sasaki, Shigetoshi Mieno, Hideki Ozawa, Masahiro Daimon, Shintaro Nemoto
A 77-year-old man, who had been under medical treatment for myasthenia gravis without thymoma, was diagnosed with aortic arch aneurysm. He underwent total aortic arch replacement and total resection of the thymus through median sternotomy. His symptoms relating to myasthenia gravis dramatically disappeared after the surgery. The serum anti-acetyl chorine receptor antibody decreased from 2.7 to 0.7 nmol/l (N<0.2) with the reduction of oral predonisolone from 12.5 to 5 mg/day at 4 years after the surgery. The concomitant operations significantly improved his quality of life...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790244/-effectiveness-of-the-waffle-procedure-for-constrictive-pericarditis
#17
Naoki Hashiyama, Hiroko Nemoto, Aya Kato, Masanobu Hashimoto, Makoto Mo, Munetaka Masuda
A 66-year-old woman was referred to our hospital with dyspnea. Right-sided congestive pleural effusion of an unknown etiology was detected and she was diagnosed with constrictive pericarditis. Pericardiectomy was performed via median sternotomy under extracorporeal circulation because severe adhesion was observed. However, hemodynamics did not improve after pericardial resection because of thickend epicardium in front of the right ventricle. Hence, the waffle procedure was additionally performed on the anterior surface of the right ventricle after coming-off the extracorporeal circulation...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790237/-prophylactic-effectiveness-of-vacuum-assisted-closure-for-high-risk-patients-undergoing-cardiovascular-surgery-through-median-sternotomy
#18
Ippei Takazawa, Yoshio Misawa, Satoshi Uesugi, Akira Sugaya, Hirohiko Akutsu, Souki Kurumisawa, Hirotaka Satoh, Arata Muraoka, Kei Aizawa, Shinichi Ohki, Koji Kawahito
Vacuum-assisted closure(VAC) therapy is mainly used for tissue defects. VAC therapy can remove exudate that could impair the healing process. We applied VAC therapy in patients considered at high risk of surgical site infection who underwent cardiovascular surgery via standard median sternotomy. Risk factors included advanced heart failure, obesity, diabetes mellitus, steroid administration, immunosuppressant administration, and chronic renal failure, etc. VAC therapy was used in 134 patients. Only 3 of these patients (2...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28780761/microthymoma-and-microscopic-thymomas-associated-with-a-thymic-cyst-without-solid-component
#19
Tatsuo Furuya, Daishiro Kato, Sanae Yamazaki, Naoko Miyata, Hiroaki Tsunezuka, Satoru Okada, Junichi Shimada, Akio Yanagisawa, Masayoshi Inoue
A 75-year-old asymptomatic man presented with an anterior mediastinal cyst without a solid component on computed tomography. Pathologic examination of the specimens obtained by thoracoscopic resection showed a thymic cyst with a 1.6-mm type A microthymoma in the surrounding thymic tissue. In addition, there were multiple hyperplastic nodules smaller than 1 mm histologically corresponded to microscopic thymomas. The patient underwent completion thymectomy through median sternotomy; thereafter, there was no residual thymic neoplasm detected...
August 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28760470/improved-approach-with-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-difference-in-on-and-off-pump
#20
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Emily Phillips, Joyce Wald, Matthew L Williams, David W Low, Michael A Acker, Pavan Atluri
BACKGROUND: The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. METHODS: This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC)...
July 28, 2017: Annals of Thoracic Surgery
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