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https://www.readbyqxmd.com/read/29327562/development-of-a-porcine-beating-heart-model-of-self-myocardial-retroperfusion-evaluation-of-hemodynamic-and-cardiac-responses-to-ischemia-and-clinical-applications
#1
Daniel Grandmougin, Jean-Mathieu Casse, Antoine Chalon, Yun Luo, Aude Falanga, Vanessa Marie, Fréderique Groubatch-Joineau, Brice Mourer, Marie Grandmougin, David Grandmougin, Guillaume Gauchotte, Juan-Pablo Maureira, Nguyen Tran
BACKGROUND: Retrograde perfusion into the coronary sinus is used to deliver cardioplegia. We developed an in-vivo porcine beating-heart model of self-myocardial retroperfusion (SMR) using the venous route to supply myocardial oxygenation and sought to assess hemodynamic and cardiac responses triggered by SMR before and after a prolonged occlusion of the LAD. METHODS: A bypass-line between the ascending aorta and the coronary sinus was made to perform a selective retrograde perfusion of the great cardiac vein with oxygenated blood (SMR)...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29325064/comparison-of-right-ventricular-function-after-ministernotomy-and-full-sternotomy-aortic-valve-replacement-a-randomized-study
#2
Magnus Dalén, Cristina Oliveira Da Silva, Ulrik Sartipy, Reidar Winter, Anders Franco-Cereceda, Jasmin Barimani, Magnus Bäck, Peter Svenarud
OBJECTIVES: Right ventricular (RV) function is impaired after cardiac surgery, possibly because of the opening of the pericardium. In minimally invasive aortic valve replacement, the pericardium is only partially incised. METHODS: A randomized trial compared RV function after ministernotomy versus full sternotomy in 40 adults undergoing aortic valve replacement at the Karolinska University Hospital. Primary outcomes were tricuspid annular plane systolic excursion, RV pulsed-wave tissue Doppler velocity, RV fractional area change and basal and mid-RV transversal diameters on postoperative Days 4 and 40...
January 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29323630/fatal-innominate-artery-hemorrhage-in-a-patient-with-tetraplegia-case-report-and-literature-review
#3
Ahmad Zaheer Qureshi
Context Hemorrhage is one of the potentially fatal complications of tracheostomy. A rare but lethal cause of tracheostomy related bleeding is hemorrhage from the innominate artery. This occurs following tracheo-innominate artery fistula (TIF) formation, which is associated with a mortality rate of more than 85%. Here, we report the case of an individual with tetraplegia and a tracheostomy who died as a result of innominate artery hemorrhage. This case highlights the possible causes and interventions associated with this complication, and provides insight into tracheostomy related bleeding in patients with spinal cord injury (SCI)...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29319563/mitral-repair-and-the-robot-a-revolutionary-tool-or-marketing-ploy
#4
Aly Ghoneim, Ismail Bouhout, Fahd Makhdom, Michael W A Chu
PURPOSE OF REVIEW: In this review, we discuss the current evidence supporting each minimally invasive mitral repair approach and their associated controversies. RECENT FINDINGS: Current evidence demonstrates that minimally invasive mitral repair techniques yield similar mitral repair results to conventional sternotomy with the benefits of shorter hospital stay, quicker recovery, better cosmesis and improved patient satisfaction. Despite this, broad adoption of minimally invasive mitral repair is still not achieved...
January 9, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29310938/evaluation-of-the-clinical-utility-of-transesophageal-echocardiography-and-invasive-monitoring-to-assess-right-ventricular-function-during-and-after-pulmonary-endarterectomy
#5
Thomas P Sullivan, James E Moore, Andrew A Klein, David P Jenkins, Lynne K Williams, Andrew Roscoe, Wendy Tsang
OBJECTIVE: Patients undergoing pulmonary endarterectomy (PEA) have impaired right ventricular function. The authors sought to assess the clinical utility of commonly used perioperative echocardiographic and right heart catheter measurements in patients undergoing PEA. DESIGN: A single-center prospective observational study. SETTING: The study was conducted in a quaternary care cardiac surgical center in the United Kingdom. PARTICIPANTS: Patients undergoing PEA between April 2015 and January 2016...
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29306337/partial-anomalous-pulmonary-venous-drainage-repair-concomitant-with-bilateral-semilunar-valve-replacements-and-pulmonary-artery-reconstruction-for-an-adult-female-20-years-after-initial-truncus-arteriosus-repair
#6
Toshiyuki Iwaya, Koichi Sughimoto, Kagami Miyaji
We describe the case of a 21-year-old patient who underwent repairs for multiple lesions including aortic and pulmonary valve replacements, right ventricular outflow tract reconstruction, revision of the right pulmonary artery route, and a repair of partial anomalous pulmonary venous drainage, which was diagnosed during this fourth sternotomy. For these patients with adult CHD, it is most important to address all underlying factors as much as possible at the redo surgery.
January 8, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29304201/short-term-outcomes-of-minimally-invasive-mitral-valve-repair-a-propensity-matched-comparison
#7
Qing Wang, Wang Xi, Yang Gao, Hua Shen, Jie Min, Jie Yang, Shiguan Le, Yufeng Zhang, Zhinong Wang
OBJECTIVES: We aimed to investigate the effect of minimally invasive mitral valve repair on early pulmonary function and haemodynamics, as well as its short-term efficacy. METHODS: From March 2012 to July 2015, 78 cases of minimally invasive mitral valve repair and 89 cases of conventional mitral valve repair were included in this study, with 67 well-matched pairs of patients identified by a propensity score matching, who were divided into the conventional sternotomy group and the right minithoracotomy group (the RT group)...
January 3, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29303867/a-new-device-for-securing-sternal-wires-after-median-sternotomy-biomechanical-study-and-retrospective-clinical-assessment
#8
Matthew R Danter, Amy Saari, Min Gao, Anson Cheung, Samuel V Lichtenstein, James G Abel
OBJECTIVE: Morbidity due to sternotomy continues to be a significant clinical problem. Poor approximation of the sternum may lead to complications such as sternal dehiscence, infection, and pain. A device to assist in tensioning and twisting standard steel wires during sternal closure has been developed (TORQ sternal closure device). Manually tightened interrupted wire closures were compared with those tightened and secured with the aid of the device. Performance of the device was assessed clinically...
January 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29302942/pathophysiological-factors-associated-with-left-ventricular-perforation-in-transcatheter-aortic-valve-implantation-by-transfemoral-approach
#9
Tamer Owais, Mohammad El Garhy, Jürgen Fuchs, Kushtrim Disha, Sameh Elkaffas, Martin Breuer, Bernward Lauer, Thomas Kuntze
BACKGROUND: Left ventricular (LV) perforation is one of the rare and most serious complications of transcatheter aortic valve implantation (TAVI). The study aim was to determine the pathophysiological factors associated with this serious complication. METHODS: A retrospective study was conducted of pathophysiological factors shown in echocardiograms and computed tomography angiograms performed preoperatively in patients who developed LV perforation during transfemoral TAVI (study group) with regards to anatomic and functional variables...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29289988/rerouting-the-internal-thoracic-pedicle-a-novel-solution-for-maxillofacial-reconstruction-in-vessel-depleted-situations-a-preliminary-anatomic-study
#10
François Morel, Frédéric Crampon, Jérôme Adnot, Pierre-Yves Litzler, Fabrice Duparc, Olivier Trost
PURPOSE: Microsurgical reconstruction in a vessel-depleted neck is a challenge due to the lack of reliable vessels in or nearby the host site. The use of the internal thoracic pedicle (ITP) by rib section or sparring is a limited option due to the small length of the pedicle of some flaps. However, in cardiac surgery, the internal thoracic artery (ITA) is widely used for myocardial revascularization, providing a long and versatile pedicle. We aimed at determining precise anatomical bases for the use of the ITP, approached by sternotomy and rerouted in the neck, as recipient vessels for free-flap facial reconstructions...
December 30, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29289366/comparison-of-endoaortic-and-transthoracic-aortic-clamping-in-less-invasive-mitral-valve-surgery
#11
Cristina Barbero, Ralph Krakor, Mohamed Bentala, Filip Casselman, Pascal Candolfi, Jacques Goldstein, Mauro Rinaldi
BACKGROUND: Less-invasive mitral valve surgery has become a widespread procedure in recent years, although mode of perfusion and aortic clamping are still debated questions. The aim of this study was to compare the results between transthoracic aortic clamping (TTC) and endoaortic clamping (EAC) in a multicenter, retrospective study. METHODS: Data from 3 centers experienced in both TTC and EAC were retrospectively analyzed. Five hundred consecutive patients undergoing less-invasive mitral valve surgery received either TTC (n = 250) or EAC (n = 250)...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29286413/standardized-technique-of-aortic-valve-re-implantation-for-valve-sparing-aortic-root-replacement
#12
Reza Tavakoli, Guillaume Lebreton, Max Gassmann, Peiman Jamshidi, Pascal Leprince
Despite the obvious advantages of the preservation of a normal aortic valve during aortic root replacement, the complexity of valve sparing procedures prevents a number of cardiac surgeons from incorporating them into their practice. The aim of this protocol is to describe a simplified and user-friendly technique of an aortic valve-sparing root replacement (VSRR) procedure by re-implantation of the aortic valve. Proper selection of patients and limitations of the technique are discussed. In 54 consecutive patients, normal appearing aortic valves were re-implanted in a commercially available polyester prosthesis with pre-shaped sinuses by a simplified and standardized technique...
December 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29281609/improving-the-safety-and-efficacy-of-robotically-assisted-mitral-valve-surgery
#13
REVIEW
Stephanie Mick
To improve outcomes with robotically assisted mitral valve surgery, Cleveland Clinic conducted a study evaluating outcomes in 1,000 consecutive cases. Primary areas of interest were to determine whether increased surgical experience with robotic techniques improved outcomes and to identify opportunities that could improve procedural processes. Results showed that these surgeries were effective and safe in terms of improvements in procedure time, transfusion rates, stroke risk, number of mitral valve replacements, and number of conversions to sternotomy...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29279532/acute-type-a-aortic-dissection-with-iliac-malperfusion-in-a-patient-with-scimitar-syndrome
#14
Jae Hang Lee, Jin-Ho Choi, Eung-Joong Kim
We encountered a 35-year-old male patient with scimitar syndrome, acute type A aortic dissection, and severe iliac malperfusion. He presented with pain and weakness of the left lower extremity and underwent ascending aorta replacement through sternotomy and right anterior thoracotomy. Left iliac artery flow was recovered after the operation and the patient was discharged on the tenth day without any complication. The purpose of this report is to discuss the considerations in aortic surgery in patients with scimitar syndrome, and the surgical principles for treatment of aortic dissection with critical limb ischemia...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29273336/self-appraised-readiness-of-senior-and-graduating-general-surgery-residents-to-perform-thoracic-surgery
#15
Zachary M DeBoard, Michael Paisley, Donald D Thomas
OBJECTIVE: General surgeons perform up to 50% of noncardiac thoracic surgery (TS). Although data show consistent TS case volume during general surgery (GS) residency it is unknown whether this operative trend will persist given potentially limited subspecialty exposure. We sought to determine if certain aspects of residency programs and resident characteristics were associated with trainees' perceived comfort in performing certain basic TS procedures. DESIGN: An anonymous survey was distributed to GS residents regarding program characteristics, presence of a TS residency, and intent to pursue thoracic surgical training, and estimated case volumes of individual procedures...
December 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29258620/refractory-ventricular-fibrillations-after-surgical-repair-of-atrial-septal-defects-in-a-patient-with-cacna1c-gene-mutation-case-report
#16
Ai Kojima, Fumiaki Shikata, Toru Okamura, Takashi Higaki, Seiko Ohno, Minoru Horie, Shunji Uchita, Yujiro Kawanishi, Kenji Namiguchi, Takumi Yasugi, Hironori Izutani
BACKGROUND: Congenital long QT syndrome (LQTS) can cause ventricular arrhythmic events with syncope and sudden death resulting from malignant torsades de pointes (TdP) followed by ventricular fibrillations (VFs). However, the syndrome is often overlooked prior to the development of arrhythmic events in patients with congenital heart diseases demonstrating right bundle branch block on electrocardiogram (ECG). We present a case of an adult patient with congenital heart disease who developed VFs postoperatively, potentially due to his mutation in a LQTS related gene, which was not identified on preoperative assessment due to incomplete evaluation of his family history...
December 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29250321/recent-advances-in-managing-septal-defects-atrial-septal-defects
#17
REVIEW
P Syamasundar Rao, Andrea D Harris
The purpose of this review is to discuss the management of atrial septal defects (ASD), paying particular attention to the most recent developments. There are four types of ASDs: ostium secundum, ostium primum, sinus venosus, and coronary sinus defects. The fifth type, patent foramen ovale-which is present in 25 to 30% of normal individuals and considered a normal variant, although it may be the seat of paradoxical embolism, particularly in adults-is not addressed in this review. The indication for closure of the ASDs, by and large, is the presence of right ventricular volume overload...
2017: F1000Research
https://www.readbyqxmd.com/read/29247968/an-alternative-approach-for-addressing-mediastinal-tumours-through-mini-invasive-surgery
#18
Nadia Junqueira, Ricardo Ferreira, André Sena, Ângelo Nobre
INTRODUCTION: The treatment of choice for mediastinal tumours is surgical, with the standard approach being sternotomy. Because of the invasive nature of this procedure, the management of these masses through mini-invasive surgery has become an alternative method. PRESENTATION OF CASE: We report the case of a woman with a mediastinum tumour and a new technique used for resection, through an inframammary left incision, using a Thoratrak rib spreader and Rultract Skyhook retractor assisted by a video...
December 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29229038/the-opportunities-and-limitations-of-minimally-invasive-cardiac-surgery
#19
Torsten Doenst, Mahmoud Diab, Christoph Sponholz, Michael Bauer, Gloria Färber
BACKGROUND: Over the past two decades, minimally invasive techniques for classic heart valve surgery and isolated bypass surgery have been developed that enable access to the heart via partial sternotomy for most aortic valve procedures and via sternotomy-free mini-thoracotomy for other procedures. METHODS: We review the current evidence on minimally invasive cardiac surgery on the basis of pertinent randomized studies and database studies retrieved by a selective search in the MEDLINE and PubMed Central databases, as well as by the Google Scholar search engine...
November 17, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29224761/direct-tracheobronchopexy-via-left-lateral-thoracotomy-for-severe-tracheobronchomalacia
#20
Evan J Propst, Faisal Zawawi, Roxanne E Kirsch, Osami Honjo
An infant with pulmonary atresia/ventricular septal defect/major aortopulmonary collateral arteries underwent unifocalization, ventriculoseptal defect closure and placement of a right ventricle to pulmonary artery conduit via median sternotomy. Aortopexy and pulmonary arteriopexy via redo sternotomy were insufficient to allow weaning of continuous positive airway pressure and he required direct tracheobronchopexy via left lateral thoracotomy to alleviate posterior trachealis intrusion along the length of the trachea and left main bronchus...
December 2017: International Journal of Pediatric Otorhinolaryngology
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