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Sternotomy

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https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#1
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29136152/concomitant-thoracoscopic-surgery-for-solitary-pulmonary-nodule-and-atrial-fibrillation
#2
Rongxin Lu, Ju Mei, Dongfang Zhao, Zhaolei Jiang, Haibo Xiao, Mingsong Wang, Nan Ma
OBJECTIVES: The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection. METHODS: Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation...
November 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29128572/mitral-valve-repair-robotic-and-other-minimally-invasive-approaches
#3
REVIEW
Mateo Marin Cuartas, Hoda Javadikasgari, Bettina Pfannmueller, Joerg Seeburger, A Marc Gillinov, Rakesh M Suri, Michael A Borger
Robotic and minimally invasive mitral valve (MV) procedures have been performed with increasing frequency over time. These alternatives offer similar efficacy to that achieved via standard median sternotomy, particularly in large volume centers, along with low perioperative morbidity and mortality rates. Moreover, patient acceptance is oftentimes increased due to less postoperative pain and shorter recovery times, as well as superior cosmetic results. However, these techniques are technically complex and associated with a significant learning curve...
November 8, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29125632/median-sternotomy-versus-intercostal-thoracotomy-for-lung-lobectomy-a-comparison-of-short-term-outcome-in-134-dogs
#4
Seth Bleakley, Kevin Phipps, Brian Petrovsky, Eric Monnet
OBJECTIVE: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT). STUDY DESIGN: Retrospective case control study. METHODS: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded...
November 10, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29125270/alternative-incision-sutureless-aortic-valve-replacement-propensity-matched-comparison-between-partial-sternotomy-and-right-anterior-minithoracotomy
#5
Daniyar Gilmanov, Marco Solinas, Giuseppe Santarpino, Pier A Farneti, Michele Murzi, Theodor Fischlein, Steffen Pfeiffer
BACKGROUND: Sutureless aortic valve prostheses have the potential to augment the adoption of alternative incision approaches for aortic valve replacement (AVR). Still, we lack the evidence on which surgical approach is best associated with sutureless AVR. METHODS: Data on 483 patients undergoing sutureless small incision AVR between 2010-2014 in two European institutions (207 with partial sternotomy (MS) and 276 via right anterior minithoracotomy (RAMT)) have been retrospectively analyzed...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29118301/two-incision-totally-thoracoscopic-approach-for-mitral-valve-replacement
#6
Guochang Zhao, Jie Gao, Yan Liu, Song Gu, Yulin Guo, Bin Xie, Pi Xiong Su
Totally thoracosopic mitral valve replacement (MVR) has been applied to mitral stenosis for many years. Three working ports are usually necessary, among which the longest port ranges from 6 to 8 cm. This study aimed to determine the safety and feasibility of the two-incision totally thoracoscopic approach for MVR, with the longest incision of 3 cm.From January 2014 to February 2016, 90 patients with mitral valve stenosis were retrospectively analyzed. Thirty-six (40%) patients were included in the two-incision group and 54 patients were operated on using the sternotomy approach...
November 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29117042/impact-of-patient-distance-from-ventricular-assist-device-implanting-center-on-short-and-long-term-outcomes
#7
Ashwin K Ravichandran, Palak Shah, Ramesh Singh, Keith D Aaronson, Francis D Pagani, John Stulak, Shannon M Dunlay, Todd F Dardas, Nahush A Mokadam, Christopher T Salerno, Jennifer A Cowger
Highly specialized left ventricular assist device care is not readily available in many areas, potentially limiting access to therapy. This retrospective analysis examines the relationship of outcomes by patient distance from implanting left ventricular assist device center within the Mechanical Circulatory Support Research Network. Zip codes were used to calculate patient distance, with the primary outcome of interest being 3-year survival by distance from the surgical center. Secondary outcomes included 90-day survival and incident event rates for the following: gastrointestinal bleeding, infection, cerebral event, and pump thrombosis...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29108083/-pedicled-omentum-flaps-in-the-management-of-deep-sternal-wound-infections
#8
Nick Spindler, Christian Etz, Martin Misfeld, Christoph Josten, Michael Borger, Friedrich Wilhelm Mohr, Stefan Langer
Aim Coverage of a deep sternal wound infection with a greater omentum flap. Due to a persistent infection caused by an infected aortic prosthesis, the primarily performed reconstruction with a latissimus dorsi flap had to be revised, and an alternative solution had to be found. Indication A deep sternal wound infection is a rare but devastating complication following median sternotomy. If the commonly used muscle flap is not sufficient and artificial material is still present in the wound, for instant drivelines or a vascular prosthesis, the greater omentum flap is a useful option due to its immunologic capacity...
November 6, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29104198/-feasibility-of-super-bioabsorbable-plate-insertion-into-the-sternum-manubrium-for-sternal-closure
#9
Yumi Kando, Mutsumu Fukata, Naoko Sakagami, Hitoshi Terada
We evaluated the efficacy of our sternum closure technique. Out of the 101 patients who underwent cardiovascular surgery at our department, 36 patients underwent sternum closure using ultra-high molecular weight polyethylene tape (NT) with Super FIXSORB MX40 (SF40) insertion into the sternum manubrium (group A) and 19 patients used NT with Sterna Lock Blu (group B). None of the patients had sternum disruption. Postoperative computed tomography scan revealed comparable effect in preventing transverse and anterior-posterior sternal displacement between the 2 groups...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29104016/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#10
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
OBJECTIVE: Del Nido cardioplegia (DC) offers prolonged cardiac protection with single dose administration and has been shown to be safe in adult CABG surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of del Nido cardioplegia versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: From 8/2011 to 5/2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n=101) or DC (n= 77)...
November 2, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29102209/minimally-invasive-coronary-artery-bypass-grafting-with-bilateral-internal-thoracic-arteries-will-this-be-the-future
#11
Pradeep Nambiar, Sanjay Kumar, Chander Mohan Mittal, Kailash Saksena
OBJECTIVE: The aim was to show that total arterial revascularization via a left minithoracotomy using bilateral internal thoracic arteries was not only feasible but also a safe and reproducible procedure with excellent midterm outcomes. METHODS: From August 2011 to August 2016, 819 patients underwent off-pump minimally invasive multivessel coronary artery bypass grafting using bilateral internal thoracic arteries harvested through a 2-inch left minithoracotomy incision, and complete revascularization of the myocardium was performed using the left internal thoracic artery-right internal thoracic artery Y composite conduit...
September 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29101953/catheterization-laboratory-structural-heart-disease-devices-and-transcatheter-aortic-valve-replacement
#12
REVIEW
Paul N Fiorilli, Saif Anwaruddin, Elizabeth Zhou, Ronak Shah
The cardiac catheterization laboratory is advancing medicine by performing procedures on patients who would usually require sternotomy and cardiopulmonary bypass. These procedures are done percutaneously, allowing them to be performed on patients considered inoperable. Patients have compromised cardiovascular function or advanced age. An anesthesiologist is essential for these procedures in case of hemodynamic compromise. Interventionalists are becoming more familiar with transcatheter aortic valve replacement and the device has become smaller, both contributing to less complications...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29097107/echocardiographic-imaging-options-in-ovine-research-subjects
#13
M Colpitts, M Malinowski, R Phillion, R Coleman, L Mitchell, A Malone, L Eberhart, R Sanders, D Langholz
OBJECTIVES: To determine the feasibility of acquiring quality transesophageal (TEE), epicardial (EE), and intracardiac (ICE) echocardiographic images in ovine subjects and to discuss the merits of each technique with a focus on ICE image acquisition. ANIMALS: Eleven male castrated Dorset adult sheep. METHODS: Transesophageal echocardiography was performed under general anesthesia. Epicardial echocardiography was performed as part of an open chest (thoracotomy or sternotomy) experiment...
October 30, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29096673/sternal-reconstruction-after-post-sternotomy-mediastinitis
#14
REVIEW
Pankaj Kaul
BACKGROUND: Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text. METHODOLOGY AND REVIEW: This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and management of deep sternal wound infections and mediastinitis after cardiac surgery...
November 2, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29095733/left-lateral-thoracotomy-for-centrifugal-continuous-flow-left-ventricular-assist-device-placement-an-analysis-from-the-mechanical-circulatory-support-research-network
#15
Simon Maltais, Lucman A Anwer, Vakhtang Tchantchaleishvili, Nicholas A Haglund, Shannon M Dunlay, Keith D Aaronson, Francis D Pagani, Jennifer Cowger, Christopher T Salerno, Palak Shah, Zain Khalpey, Jan Schmitto, John M Stulak
Continuous-flow left ventricular assist devices (CF-LVADs) have revolutionized the management of patients with advanced heart failure. Alternative implant strategies are increasingly used for device placement. We reviewed our experience from the Mechanical Circulatory Support Research Network registry with the HeartWare centrifugal CF-LVAD (HVAD). From May 2004 to August 2015, 1,150 patients underwent primary CF-LVAD implantation at our institutions. Within this group, a total of 283 patients (25%) were implanted with the HVAD...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29092117/a-staged-approach-of-proximal-left-anterior-descending-coronary-artery-percutaneous-intervention-followed-by-minimally-invasive-valve-surgery
#16
Andrés M Pineda, Christos G Mihos, Juan P Rodriguez-Escudero, Joseph Lamelas, Nirat Beohar, Orlando Santana
BACKGROUND: A subset of patients requiring coronary revascularization of the proximal left anterior descending coronary artery (LAD) and valve surgery may benefit from a staged approach, rather than combined median sternotomy coronary artery bypass graft (CABG) and valve surgery. METHODS: A retrospective evaluation was made of the outcomes of patients with significant proximal LAD and valvular heart disease undergoing a staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) at the authors' institution between February 2009 and April 2014...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29092038/results-of-the-first-investigator-initiated-randomized-clinical-trial-of-nmarqtm-pvactm-and-thoracoscopic-ablation-for-paroxysmal-atrial-fibrillation
#17
Conn Sugihara, Steve Furniss, Jonathan Hyde, Michael Lewis, Neil Sulke
Aims: To investigate the effect of minimally invasive thoracoscopic surgical ablation and nMARQ irrigated multi-electrode phased radiofrequency (RF) ablation to treat paroxysmal atrial fibrillation (AF) compared with PVAC multi-electrode phased RF ablation, with beat-to-beat device-derived Holter monitoring throughout the study duration. Methods and results: An investigator-initiated prospective trial of patients with paroxysmal AF randomized (1:1:1) to initial surgical, nMARQ or PVAC ablation...
October 30, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29078661/definitions-and-standard-indications-of-minimally-invasive-techniques-in-thymic-surgery
#18
Marcin Zieliński
BACKGROUND: The minimally invasive thoracic procedures are those performed through the intercostal, subxiphoid, subcostal or transcervical incisions. In most of these procedures (with exception of some transcervical procedures) the video-assisted thoracic surgery (VATS) technique is used for performance of an operation under guidance of a video monitor. METHODS: According to the definition the minimally invasive procedures do not include the sternal manubriotomy (upper sternal split), transverse sternotomy and subcutaneous longitudinal sternotomy...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078638/subxiphoid-thymectomy-single-port-dual-port-and-robot-assisted
#19
Takashi Suda
Currently, surgical techniques that are less invasive than conventional median sternotomy are used for thymectomy in the treatment of myasthenia gravis and anterior mediastinal tumors as no sternal incision is required. We reported on a subxiphoid single-port thymectomy using CO2 insufflation, which has the following advantages: (I) the field of view offered by the camera scope inserted from the midline of the body helps confirm the location of the superior pole of the thymus and bilateral phrenic nerves; (II) there is minimal pain and no intercostal neuropathy occurs as intercostal spaces are not traversed; and (III) cosmetic outcomes are excellent...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078632/uniportal-bilateral-video-assisted-sequential-thoracoscopic-extended-thymectomy
#20
REVIEW
Francesco Paolo Caronia, Ettore Arrigo, Sebastiano Trovato, Attilio Ignazio Lo Monte, Salvatore Cottone, Francesco Sgalambro, Mario Guglielmo, Antonio Volpicelli, Alfonso Fiorelli
Standard video-assisted thoracoscopic surgery has been reported as a minimally invasive approach alternative to sternotomy for management of myasthenia gravis (MG) associated with thymoma or thymic hyperplasia. Uniportal video-thoracoscopy is an evolution of standard multi-portal video-thoracoscopy for management of several thoracic diseases but its role for resecting mediastinal tumor remains under-evaluated. Herein, we describe our experience with bilateral uniportal thoracoscopic sequential extended thymectomy with case and video illustrations...
2017: J Vis Surg
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