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Median sternotomy

Gülbanu Zencir, Ismet Eser
The most painful activities during the days following cardiac surgery are coughing and deep breathing exercises. Cold therapy is an effective nonpharmacological method that decreases the pain during coughing and mobilization. In this study, the effects of cold therapy on pain and breathing exercises among patients with median sternotomy following cardiac surgery were investigated in a randomized crossover clinical trial. Data were collected from patients with median sternotomy (N = 34) in the first two postoperative days...
October 13, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Yu Inaba, Tsutomu Ito, Sachiko Hayashi, Yasunori Iida, Takahiko Misumi, Hideyuki Shimizu
A thoracic aortic pseudoaneurysm is a life-threatening complication following thoracic aortic surgery. We describe a surgical strategy for this pseudoaneurysm with a high risk for rupture during median sternotomy. The pseudoaneurysm was distended and widely adherent to the posterior sternum. Elective cardiopulmonary bypass and moderate hypothermia were established, and sternotomy was performed without left ventricle distention or brain ischemia. Total arch replacement was successful and the patient was discharged on post operative day (POD) 18...
2016: Annals of Vascular Diseases
Han Pil Lee, Won Chul Cho, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
BACKGROUND: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. METHODS: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Mineto Ohta, Chikashi Nakanishi, Naoki Kawagishi, Yasuyuki Hara, Kai Maida, Toshiaki Kashiwadate, Koji Miyazawa, Satoru Yoshida, Shigehito Miyagi, Yukihiro Hayatsu, Shunsuke Kawamoto, Yasushi Matsuda, Yoshinori Okada, Yoshikatsu Saiki, Noriaki Ohuchi
BACKGROUND: Recurrent hepatocellular carcinoma accompanied by a right atrial tumor thrombus is rare. No standard treatment modality has been established. Surgical treatment may be the only curative treatment; however, surgery has been considered high risk. We herein describe a patient who underwent resection of a recurrent right atrial tumor thrombus under normothermic cardiopulmonary bypass on a beating heart. CASE PRESENTATION: A 60-year-old man underwent a right hepatectomy for hepatocellular carcinoma with diaphragm invasion...
December 2016: Surgical Case Reports
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux, Andreza L Bezerra, Maria C M B Duarte
Objective: To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV) on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method: A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26), which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24), which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD)...
September 29, 2016: Brazilian Journal of Physical Therapy
Hakan Akbayrak, Serkan Yildirim, Murat Simsek, Mehmet Oc
Pericardial cysts are rare benign lesions of the thoracic cavity and are mostly congenital anomalies. They are induced by an incomplete coalescence of foetal lacunae during the development of the pericardium. Pericardial cysts are usually unilocular, well marginated spherical or teardrop shaped and may be attached to the pericardium directly or by a pedicle. Of all pericardial cysts, 70 to 75% are located at the right cardiophrenic angle. We report a case that was incidentally diagnosed with only chest magnetic resonance imaging because of a paracardiac mass...
July 12, 2016: Cardiovascular Journal of Africa
Sharon L Cheatham, Grace M Deyo
Hybrid stage I palliation combines cardiothoracic surgery and interventional transcatheter procedures for treatment of hypoplastic left heart syndrome. The approach is an alternative to the Norwood procedure, the traditional first stage of surgical palliation. Hybrid stage I palliation involves placing bilateral branch pulmonary artery bands and a patent ductus arteriosus stent through a median sternotomy, performed without cardiopulmonary bypass. The purpose of the bands is to control blood flow to the lungs and protect the pulmonary bed while the stent sustains systemic cardiac output...
October 2016: Critical Care Nurse
Andreas Tulzer, Rudolf Mair, Michaela Kreuzer, Gerald Tulzer
OBJECTIVES: Coarctation with hypoplastic aortic arch can be treated with resection and extended end-to-end anastomosis (REEEA) as well as end-to-side anastomosis (ESA). The aim of the study was to review our experience with these techniques in newborns and infants and to assess mid-term outcome with regards to morbidity, mortality, and reintervention rate in relation to operative access and technique. PATIENTS AND METHODS: Retrospective review of hospital charts and surgical reports from 183 consecutive newborns and infants with coarctation and hypoplastic aortic arch with or without ventricular septal defect between 1996 and 2013...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Kevin Phan, Joshua M Haswell, Joshua Xu, Yusuf Assem, Stephanie L Mick, Samir R Kapadia, Anson Cheung, Frederick S Ling, Tristan D Yan, Vakhtang Tchantchaleishvili
De novo progressive aortic insufficiency (AI) is a side effect frequently related to prolonged support with continuous-flow left ventricular assist devices (CF-LVAD). Its progression can result in recurrent clinical heart failure symptoms and significantly increased mortality. Recently, percutaneous intervention methods such as transcatheter aortic valve replacement (TAVR) and percutaneous occluder devices have emerged, However, given the very scarce global experience with these approaches, evidence in the literature is lacking...
September 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
C Y Xu, D G Feng, J X Wang, Z Y Cheng, F Wang, B Lin, Z L Xie, L N Suo, P Du
Objective: To explore the application of new chest holder in the median sternotomy for open heart surgery in adults. Methods: Two hundred adult patients in Henan Provincial People's Hospital from May 2013 to May 2015 were enrolled in the study and randomly divided into two groups. Experimental group included 100 cases who accepted the new type of chest holder in the open heart surgery. Control group were also composed of 100 cases whose sternums were fixed with the pure steel wire cerclage. Sternal closure time was recorded since the sternum closing...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Zubair Ashraf Hakeem, Shyam Singh Rathore, Abdul Wahid
Leiomyoma of the mediastinum is rare. They are thought to arise from the smooth muscle cells of the media of mediastinal vascular structures and structure containing smooth muscle. Most mediastinal leiomyomas are seen in association with oesophagus in the posterior mediastinum. We present a case of huge leiomyoma in a 1.5 years old male child arising in the lower anterior mediastinum with compression of heart, liver and deformity of rib cage. Median sternotomy and a separate concomitant right mini-thoracotomy was done and tumor excised...
September 17, 2016: General Thoracic and Cardiovascular Surgery
Christian Liebsch, Nicolas Graf, Hans-Joachim Wilke
PURPOSE: The influence of the anterior rib cage on the stability of the human thoracic spine is not completely known. One of the most common surgical interventions on the anterior rib cage is the longitudinal median sternotomy and its fixation by wire cerclage. Therefore, the purpose of this in vitro study was to examine, if wire cerclage can restore the stability of the human thoracic spine after longitudinal median sternotomy. METHODS: Six fresh frozen human thoracic spine specimens (C7-L1, 56 years in average, range 50-65), including the intact rib cage without intercostal muscles, were tested in a spinal loading simulator and monitored with an optical motion tracking system...
September 17, 2016: European Spine Journal
Mahmoud Abu Abeeleh, Amjad Bani Hani, Ata Ghaith, Tareq Alodwan, Zuhair Bani Ismail, Musa Alshehabat
Ectopic parathyroid adenomas are considered the main cause of primary hyperparathyroidism. However, concurrent parathyroid and thymic pathologies are rarely diagnosed in the same patient. A 47-year-old man with history of diabetes mellitus, hypertension, and myasthenia gravis presented with persistent hypercalcemia. Laboratory investigations, computed tomography, and technetium-99 m sestamibi scintigraphy revealed ectopic parathyroid glands, a mediastinal mass, and an enlarged thymus. The patient underwent thymectomy and mass excision via a median sternotomy...
September 15, 2016: Asian Cardiovascular & Thoracic Annals
Candice L Wilshire, Eric Vallières, Dale Shultz, Ralph W Aye, Alexander S Farivar, Brian E Louie
OBJECTIVE: The approach to thymoma resection has usually been determined by tumor size, although established guidelines do not exist. Minimally invasive approaches have been limited to tumors smaller than 5 cm, although 3 cm has been the suggested cutoff for performing an adequate oncologic procedure. No study has compared the perioperative outcomes of patients with 3 cm or larger tumors resected robotically versus sternotomy. METHODS: We reviewed patients who underwent resection of 3 cm or larger thymomas from 2004 to 2014...
September 14, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Zhao-Lei Jiang, Xiao-Yuan Feng, Nan Ma, Jia-Quan Zhu, Li Zhang, Fang-Bao Ding, Chun-Rong Bao, Ju Mei
BACKGROUND: Right minithoracotomy (RM) has been proven to be a safe and effective approach for mitral valve surgery, but the differences of artificial chordae technique between RM and median sternotomy (MS) were seldom reported. Here, we compared the outcomes of modified artificial chordae technique for mitral regurgitation (MR) through RM or MS approaches. METHODS: One hundred and eighteen consecutive adult patients who received mitral valve repair with artificial chordae and annuloplasty for MR through RM (n = 58) or MS (n = 60) from January 2006 to January 2015 were analyzed...
2016: Chinese Medical Journal
Thomas M Kelley, Mohammed Kashem, He Wang, James McCarthy, Nels D Carroll, G William Moser, T Sloane Guy
BACKGROUND: This study reported on the treatment of Carpentier type IIIa and type IIIb mitral regurgitation (MR) with a large patch anterior mitral valve leaflet augmentation technique using CorMatrix (CorMatrix Cardiovascular Inc, Alpharetta, GA) extracellular matrix (ECM). METHODS: A single-site chart review was conducted on patients who underwent anterior leaflet augmentation performed with the Da Vinci surgical robot (Intuitive Surgical, Sunnyvale, CA) or through a median sternotomy...
September 9, 2016: Annals of Thoracic Surgery
Rüdiger Lange, Bernhard Voss, Victoria Kehl, Domenico Mazzitelli, Peter Tassani-Prell, Thomas Günther
BACKGROUND: Mitral valve (MV) repair through a right minithoracotomy (RT) is technically more demanding than through a median sternotomy (MS) and has been cited for a higher rate of reoperation, increased postoperative bleeding, thromboembolic events, poor visualization, and longer operative times. Randomized studies are not available, however, and specific characteristics of patients who undergo operation with either technique are usually highly different. Therefore, a propensity matching study was performed to reduce selection bias...
September 9, 2016: Annals of Thoracic Surgery
Christian E Rex, Johan Heiberg, Kaj-Erik Klaaborg, Vibeke E Hjortdal
PURPOSE: Transcatheter aortic valve implantation (TA-TAVI) is a well-established treatment for aortic valve stenosis in high-risk patients and indications have been continuously expanding to include also intermediate-risk patients. However, in low-risk patients, experiences are still sparse and although clinical outcomes have been shown favorable, HRQoL has remained unexplored. The aim of this report was to describe the long-term health-related quality-of-life (HRQoL) in low-risk patients randomized to TA-TAVI or surgical aortic valve replacement (SAVR)...
September 10, 2016: Scandinavian Cardiovascular Journal: SCJ
Tomohiro Haruki, Makoto Wakahara, Yuji Taniguchi, Yoshinobu Nakamura, Motonobu Nishimura, Hiroshige Nakamura
Although the optimal treatment strategy for locally advanced thymic carcinomas has yet to be determined, complete resection of the tumor after induction chemoradiotherapy (CRT) can sometimes provide a good chance of being cured. A 61-year-old woman was diagnosed with locally advanced primary thymic carcinoma, which invaded bilateral brachiocephalic veins and superior vena cava with intraluminal tumor thrombus. Induction CRT was performed, and a partial response to the treatment was achieved. Subsequent radical surgery was successfully performed by the median full sternotomy with a right transmanubrial osteomuscular sparing approach (TMA)...
2016: Journal of Surgical Case Reports
Javier Castrodeza, Ignacio J Amat-Santos, Vicenç Serra, Luis Nombela-Franco, Derek Ralph Brinster, Enrique Gutiérrez-Ibanes, Paol Rojas, Pilar Tornos, Manuel Carnero, Carlos Cortes, Javier Tobar, Salvatore Di Stefano, Itziar Gomez, José A San Román
BACKGROUND: We aimed to analyze causes, management, and outcomes of the unexpected need to abort sternotomy in aortic stenosis (AS) patients accepted for surgical aortic valve replacement (SAVR) in the transcatheter aortic valve implantation (TAVI) era. METHODS: Cases of aborted sternotomy (AbS) were gathered from 5 centers between 2009 and 2014. A systematic review of all published cases in the same period was performed. RESULTS: A total of 31 patients (71% males, 74±8years, LogEuroSCORE 11...
November 15, 2016: International Journal of Cardiology
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