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https://www.readbyqxmd.com/read/28323663/percutaneous-single-site-cannulation-for-acute-right-sided-support
#1
Mahim Malik, Ahmet Kilic, Bryan A Whitson
Right ventricular failure (RVF) is a challenging problem after left ventricular device implantation, leading to considerable morbidity and mortality. When inotropic support is no longer adequate, a temporary right ventricular assist device is needed which often mandates reopening of the sternotomy for implant and explant. We describe our technique to percutaneously place a right-internal jugular cannula for extra-corporeal support.
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#2
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28299227/resection-of-the-gastric-tube-reconstructed-through-the-retrosternal-route-without-sternotomy
#3
Masahiro Kimura, Yasuyuki Shibata, Kotaro Mizuno, Hironori Tanaka, Motoki Hato, Satoshi Taniwaki, Yoichiro Mori, Nobuo Ochi, Takaya Nagasaki, Shuhei Ueno, Yuki Eguchi
With advances of combined modality therapy, prognoses in esophageal cancer have been improving. After resection of esophageal cancer, the development of gastric tube cancer is a risk. While such cancer in an early stage can be cured endoscopically, total gastric tube resection is indicated in advanced stages. A 68-year-old man underwent subtotal esophagectomy reconstructed with a gastric tube through the retrosternal route. Gastric cancer was found one and a half years postoperatively. The gastric tube was resected without sternotomy...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28293006/-quadricuspid-aortic-valve-with-atrial-septal-defect-report-of-a-case
#4
Naoki Saito, Takahiro Yoshimura, Katsuyuki Miyatsu, Masahiro Ikeda
The patient was a 69-year-old man who had 1st experienced exertional dyspnea approximately 1 month earlier. He visited our hospital for treatment because his symptoms had gradually worsened and he had developed orthopnea. Echocardiography revealed an atrial septal defect(ASD) and a quadricuspid aortic valve with moderate regurgitation. As patch closure of the ASD alone could pose a risk of exacerbating the untreated aortic regurgitation, we performed both procedures patch closure and aortic valve replacement through median sternotomy concomitantly...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28291141/antegrade-cardioplegia-decannulation-using-the-cor-knot-system-in-minimally-invasive-mitral-valve-surgery
#5
Sabet W Hashim, Philip Y K Pang
A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding...
March 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28289497/interventional-therapy-for-pulmonary-embolism
#6
Alan B Lumsden, Erik Suarez
Patients with pulmonary embolism (PE) present with highly variable clinical symptoms and often have accompanying comorbidities. Timely diagnosis and treatment are critical to help prevent recurrence and increased morbidity/mortality. While open surgical thrombectomy was once reserved only for those with massive PE and hemodynamic compromise, it has been reevaluated with a focus on careful patient selection and early intervention. Lately, there has been increased interest in catheter-based interventions and in combining these with an open surgical component to decrease the magnitude of the intervention-for example, direct placement of large-bore thrombectomy devices directly into the right ventricle via sternotomy or subxiphoid approaches...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28283230/outcomes-after-mitral-valve-repair-a-single-center-16-year-experience
#7
James M Tatum, Michael E Bowdish, Wendy J Mack, Adrienne M Quinn, Robbin G Cohen, Amy E Hackmann, Mark L Barr, Vaughn A Starnes
OBJECTIVE: To evaluate outcomes after mitral valve repair. METHODS: Between May 1999 and June 2015, 446 patients underwent mitral valve repair. Isolated mitral valve annuloplasty was excluded. A total of 398 (89%) had degenerative valve disease. Mean follow-up was 5.5 ± 3.8 years. Postoperative echocardiograms were obtained in 334 patients (75%) at a mean of 24.3 ± 13.7 months. RESULTS: Survival was 97%, 96%, 95%, and 94% at 1, 3, 5, and 10 years...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28279719/surgical-management-of-perforated-ivc-filters
#8
Miguel Manzur, Christian Ochoa, Sung Wan Ham, William Lee, Trevor Simcox, Vincent Rowe, Fred Weaver
OBJECTIVES: Management of complicated indwelling inferior vena cava (IVC) filters has increased due to low retrieval rates. Filter migration and perforation are infrequent complications and require explantation of the filter. We report our recent experience with endovascular retrieval and surgical explantation of IVC filters after caval perforation. METHODS: This is a retrospective review of patients who had IVC filter explantation between 2014-2015. Patient demographics, indication for filter placement, clinical presentation, surgical indication and technique, and outcomes were noted...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28270427/contemporary-cardiac-surgery-for-adults-with-congenital-heart-disease
#9
Sylvain Beurtheret, Oktay Tutarel, Gerhard Paul Diller, Cathy West, Evangelia Ntalarizou, Noémie Resseguier, Vasileios Papaioannou, Richard Jabbour, Victoria Simpkin, Anthony J Bastin, Sonya V Babu-Narayan, Beatrice Bonello, Wei Li, Babulal Sethia, Hideki Uemura, Michael A Gatzoulis, Darryl Shore
OBJECTIVE: Advances in early management of congenital heart disease (CHD) have led to an exponential growth in adults with CHD (ACHD). Many of these patients require cardiac surgery. This study sought to examine outcome and its predictors for ACHD cardiac surgery. METHODS: This is an observational cohort study of prospectively collected data on 1090 consecutive adult patients with CHD, undergoing 1130 cardiac operations for CHD at the Royal Brompton Hospital between 2002 and 2011...
March 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28265218/minimally-invasive-lvad-deactivation-in-a-65-year-old-man-with-recurrent-pump-thrombosis-and-left-ventricular-recovery
#10
Akshay Pendyal, Christopher V Chien, James O Mudd, Jill M Gelow
Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28265217/titanium-plug-closure-after-heartware-ventricular-assist-device-explantation-in-a-15-year-old-girl-first-u-s-experience
#11
Diego A Lara, Aamir Jeewa, Barbara A Elias, Elizabeth O McCullum, Susan W Denfield, William J Dreyer, Iki Adachi
We describe the case of a teenage girl with anthracycline-induced cardiomyopathy who received a HeartWare ventricular assist device and underwent successful device explantation after cardiac recovery. During device support, the patient's cardiac function returned to normal. Twelve months after implantation, we explanted the device via repeat median sternotomy. To close the hole in the left ventricular apex and preserve the sewing ring in case future device support is needed, we used a German-manufactured titanium plug, developed specifically for this purpose...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28262301/effects-of-alcohol-on-postoperative-adhesion-formation-in-ischemic-myocardium-and-pericardium
#12
Nassrene Y Elmadhun, Ashraf A Sabe, Antonio D Lassaletta, Rahul S Dalal, Frank W Sellke
BACKGROUND: Postoperative formation of adhesions increases risk of complications during cardiac reoperations. We previously demonstrated that swine supplemented with vodka had a significant reduction in adhesions at sternotomy after previous thoracotomy. This follow-up study was conducted to determine reproducibility and the mechanism for adhesion reduction in swine supplemented with ethanol. METHODS: An ameroid constrictor was placed in the left circumflex in 14 male Yorkshire swine to induce chronic myocardial ischemia through left minithoracotomy...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28260150/importance-of-multidisciplinary-management-for-pulmonary-atresia-ventricular-septal-defect-major-aorto-pulmonary-collateral-arteries-and-completely-absent-central-pulmonary-arteries
#13
Takaya Hoashi, Satoshi Yazaki, Koji Kagisaki, Masataka Kitano, Masatoshi Shimada, Isao Shiraishi, Hajime Ichikawa
BACKGROUND: To review long-term clinical outcomes for pulmonary atresia, ventricular septal defect (PA/VSD), major aorto-pulmonary collateral arteries (MAPCAs) and completely absent central pulmonary arteries (cPAs). METHODS: Of all 120 surgically treated patients with PA/VSD, MAPCAs between 1981 and 2011, 15 patients (12.5%) with completely absent cPAs were enrolled. The median age at initial surgery was 3.8 ± 4.9 years old (range 0.1-17.6) and 3.5 (2-6)...
March 4, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28258733/-perioperative-gabapentin-and-pregabalin-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#14
Souvik Maitra, Dalim K Baidya, Sulagna Bhattacharjee, Anirban Som
OBJECTIVES: Sternotomy for cardiac surgeries causes significant postoperative pain and when not properly managed may cause significant morbidity. As neuropathic pain is a significant component here, gabapentin and pregabalin may be effective in these patients and may reduce postoperative opioid consumption. The purpose of this systematic review was to find out efficacy of gabapentin and pregabalin in acute postoperative pain after cardiac surgery. METHODS: Published prospective human randomized clinical trials, which compared preoperative and/or postoperative gabapentin/pregabalin with placebo or no treatment for postoperative pain management after cardiac surgery has been included in this review...
March 1, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28258401/respiratory-motion-compensation-for-the-robot-guided-laser-osteotome
#15
Alina Giger, Christoph Jud, Philippe C Cattin
PURPOSE: The use of a robot-guided laser osteotome for median sternotomy is impeded by prohibiting cutting inaccuracies due to respiration-induced motions of the thorax. With this paper, we advance today's methodologies in sternotomy procedures by introducing the concept of novel 3D functional cuts and a respiratory motion compensation algorithm for the computer-assisted and robot-guided laser osteotome, CARLO(®). METHODS: We present a trajectory planning algorithm for performing 3D functional cuts at a constant cutting velocity...
March 3, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28245342/assessment-of-the-extravascular-implantable-defibrillator-feasibility-of-substernal-ventricular-pacing
#16
Tom F Brouwer, Lonneke Smeding, Wouter R Berger, Antoine H G Driessen, Joris R de Groot, Arthur A M Wilde, Reinoud E Knops
INTRODUCTION: The objective of this study was to assess feasibility of ventricular pacing and thresholds from within the substernal space to examine a new extravascular ICD configuration with pacing capabilities. METHODS: In patients undergoing midline sternotomy, a duodecapolar diagnostic pacing catheter was positioned in the substernal space anterior to the pericardium, and a cutaneous patch in left lateral position. Different unipolar and bipolar pacing configurations were assessed...
February 28, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28242076/regional-changes-in-leaflet-coaptation-dynamics-after-total-tricuspid-reconstruction
#17
Diana M Ropcke, Christine Ilkjær, Søren N Skov, Marcell J Tjørnild, Anders Vibaek, Henrik Jensen, Vibeke E Hjortdal, Sten L Nielsen
BACKGROUND: Stentless porcine extracellular matrix tricuspid tube grafts were developed for tricuspid valve reconstruction. The purpose of this study was to conduct an echocardiographic assessment of the performance of native and tube graft leaflets in an acute porcine model. METHODS: Fourteen 65-kg pigs were randomly assigned to tube graft (n = 7) or control with native valve preservation (n = 7). Epicardial echocardiography was performed at baseline after sternotomy, after valve operation, and after hemodynamic stabilization...
February 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28240499/outcomes-for-cervicomediastinal-vascular-trauma-managed-by-a-vascular-subspecialistled-vascular-trauma-service
#18
J Islam, G L Laing, G V Oosthuizen, D L Clarke, J V Robbs
BACKGROUND: The management of cervicomediastinal vascular trauma is challenging. We report on our experience with the condition in a newly established vascular trauma service unit, and compare the outcomes to those reported in our parent vascular surgery department. METHOD: The details of patients with cervicomediastinal vascular injuries from January 2012 to June 2014 were retrieved for analysis from a prospective database. RESULTS: Ninety-three patients were identified, 84 of whom were male (90%), with an average age of 29 years...
June 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28239810/totally-thoracoscopic-surgery-for-atrial-myxomas-resection-and-atrial-septal-defect-repair
#19
L Deng, G-W Zhang, Z-H Liu, W-X Meng, H-Y Liu
OBJECTIVE: The purpose of this study is to compare the effectiveness and safety of thoracoscopic surgery and traditional median sternotomy. PATIENTS AND METHODS: 64 patients with atrial myxoma and 114 patients with atrial septal defect were collected from Mar 2012 to Aug 2015. 40 atrial myxoma and 77 atrial septal defect (ASD) patients underwent totally thoracoscopic surgery technique, while 24 atrial myxoma and 37 ASD patients underwent traditional median sternotomy...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28237371/pain-locations-in-the-postoperative-period-after-cardiac-surgery-chronology-of-pain-and-response-to-treatment
#20
J Roca, R Valero, C Gomar
INTRODUCTION: Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. METHODS: Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables...
February 22, 2017: Revista Española de Anestesiología y Reanimación
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