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https://www.readbyqxmd.com/read/29785544/heartmate-ii-implantation-technique-that-spares-the-sternum-and-ascending-aorta
#1
Masashi Kawabori, Chitaru Kurihara, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Left ventricular assist devices (LVADs) have become the standard therapy for patients with end-stage heart failure, and the use of LVADs for long-term support has grown exponentially over the past decade. As the number of LVAD implantations has increased, surgeons have faced more challenging cases, such as those in which the patient has previously undergone a sternotomy. The HeartMate II is one of the most widely implanted LVADs. The standard procedure for HeartMate II implantation is median sternotomy and sewing the outflow graft to the ascending aorta...
May 21, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29783998/surgical-repair-via-submammary-thoracotomy-right-axillary-thoracotomy-and-median-sternotomy-for-ventricular-septal-defects
#2
Zhi-Nuan Hong, Qiang Chen, Ze-Wei Lin, Gui-Can Zhang, Liang-Wan Chen, Qi-Liang Zhang, Hua Cao
BACKGROUND: Right submammary thoracotomy and right vertical infra-axillary thoracotomy are performed for ventricular septal defect (VSD) to reduce the invasiveness of the conventional surgical repair through median sternotomy approach. No comparative studies have been conducted among these three procedures. METHODS: From January 2016 to December 2016, 182 patients with isolated VSD who underwent surgical repair via one of these 3 approaches were reviewed to compare these three procedures...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29782264/-the-case-of-successful-surgical-treatment-of-a-patient-with-thoracic-endograft-infection-in-5-years-after-thoracic-endovascular-aortic-repair
#3
V A Popov, A N Korostelev, E S Malyshenko, A S Revishvili
We present here a case of successful staged treatment of a patient with para-aortic abscess that arose 5 years after thoracic endovascular aortic repair because of thoracic aortic aneurysm. After stabilization of the patient's condition by intensive antibiotic therapy we performed left-subclavian extra-thoracic debranching as the first stage of the surgical treatment. In 2 weeks via median sternotomy and on-pump we removed the infected endograft and performed extraanatomical ascending-to-descending aortic bypass with good postoperative result...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29781589/right-mini-thoracotomy-bentall-with-traditional-and-automated-suturing-devices
#4
Carl Johnson, Juan Siordia, Davida Robinson, Peter Knight
Bentall procedures are traditionally performed through a median sternotomy. However, minimally invasive approaches are increasingly being utilized. A right mini-thoracotomy approach may improve postoperative recovery.  A 5-cm mini-thoracotomy is performed in the right 2nd intercostal space. A camera port is placed lateral to this incision. Peripheral cannulation is performed. The ascending aorta is cross-clamped. Cardioplegia is administered and the patient is placed in deep hypothermic circulatory arrest to construct the distal aortic anastomosis...
May 18, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29780726/operative-techniques-for-improving-surgical-exposure-in-basic-cardiac-surgery
#5
Dawn S Hui, Jason M Lizalek, Vikram S Chawa, Richard Lee
Operative exposure is key to ensuring surgical efficiency and patient safety in cardiac surgery. As the population ages and the prevalence of obesity increases, cardiac surgeons will be challenged to consider obese patient physiology and body habitus, surgical exposure and sternotomy closure techniques, and postoperative medical management to ensure optimal outcomes. In this article, we describe techniques to improve operative exposure in both obese and non-obese patients undergoing basic cardiac surgery and highlight the roles of surgical team members to ensure patient safety and provide optimal anesthetic management...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780069/successful-rescue-of-a-ruptured-tracheoinnominate-fistula-with-extracorporeal-membrane-oxygenation-endovascular-stents-and-debranching-surgical-bypass
#6
Yu-San Chien, Yen-Chun Chao, Kuo-Sheng Lee, Kung-Hong Hsu
We reported a case of ruptured tracheoinnominate fistula in a 14-year-old boy with history of repeated sternotomy. Tracheostomy was performed at age 2 years. Slide tracheoplasty was done at age 13 years. He presented to outpatient clinic with episodic hemosputum. Massive blood emanated from stoma during bronchoscopy evaluation. Venous-arterial extracorporeal membrane oxygenation was installed for resuscitation. A contrast-enhanced computed tomography (CT) and angiography confirmed the diagnosis. Immediate control of bleeding was achieved by an endovascular stent graft deployed at innominate artery...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29779892/-cardiac-compression-of-hydatid-origin
#7
I Bouassida, C Pricopi, G Mangiameli, A Arame, J B Auliac, B Gorbatai, M Riquet, F Le Pimpec Barthes
INTRODUCTION: Cardiac hydatid disease is uncommon and occurs in 0.5 to 2% of patients with hydatidosis. Isolated intrapericardial hydatid cystic disease is extremely rare. OBSERVATION: We report the case of a young woman with cardiac compression due to multiple primary intrapericardial hydatid cysts. Since 1 year, she had gradual general health deterioration including dyspnoea, sweats and weight loss of 8kg. A widening of the mediastinum was observed on chest X-ray...
May 17, 2018: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29779035/combined-coronary-artery-bypass-graft-cabg-surgery-and-lung-resection-for-lung-cancer-in-patients-more-than-50-years-of-age
#8
Ban Liu, Chao Chen, Chang Gu, Qianfan Li, Jingjing Liu, Yiwei Pu, Yu Lin, Zilun Wei, Zhi Li, Yangyang Zhang
BACKGROUND The co-existence of coronary heart disease (CHD) and lung cancer is increasing in an increasingly aging population. The aim of this study was to evaluate patient outcome from combined off-pump coronary artery bypass graft (CABG) surgery and lung resection in patients more than 50 years-of-age. MATERIAL AND METHODS A retrospective clinical study of 23 patients with a mean age of 70.2±8.4 years (range, 51-86 years) included 18 men and five women with CHD and lung cancer who underwent a single operation with combined off-pump CABG surgery and lung resection, for non-small cell lung cancer (NSCLC) (n=22) and small cell lung cancer (n=1)...
May 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29778340/prospective-randomized-controlled-trial-of-polymer-cable-ties-versus-standard-wire-closure-of-midline-sternotomy
#9
Silvana F Marasco, Louise Fuller, Adam Zimmet, David McGiffin, Michael Seitz, Stephanie Ch'ng, Shivanand Gangahanumaiah, Michael Bailey
OBJECTIVE: Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. METHODS: A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60)...
April 16, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29770873/xiphoidectomy-for-intractable-xiphodynia
#10
Patrick Dorn, Michael A Kuhn, Barbara A Schweizer, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Xiphodynia is a rare condition with hardly any data published regarding xiphoidectomy as a valid treatment option for intractable disease. It is necessary to bear this syndrome in mind after having filtered out other differential diagnoses. METHODS: Between 2003 and 2015, 11 patients underwent xiphoidectomy for intractable xiphodynia at our institution. Patients' charts were reviewed including preoperative workup, operative technique, and results. Every patient had routine follow-ups, 4 weeks after the procedure and 1 year after surgery...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29768973/myasthenia-gravis-appearing-after-thymectomy-heralding-recurrent-thymoma
#11
Paul A J Beckers, Rudy Mercelis, Stijn Heyman, Lies Verheuen, Patrick Lauwers, Jeroen M Hendriks, Paul E Van Schil
INTRODUCTION: Thirty to fifty percent of thymoma patients develop myasthenia gravis (MG). In 1.5-28% of cases, MG appears many years after removal of a thymoma. PATIENTS AND METHODS: We present a case report of a 72-year-old female who presented with MG four months after total thymectomy. RESULTS: A 72-year-old female patient presents with MG four months after total thymectomy. Imaging revealed a PET-positive nodule anterior to the superior vena cava...
May 17, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29766749/enhanced-sternal-healing-via-platelet-rich-plasma-and-biodegradable-gelatin-hydrogel
#12
Masafumi Shibata, Gen Takagi, Mitsuhiro Kudo, Jiro Kurita, Yoko Kawamoto, Yasuo Miyagi, Mikimoto Kanazashi, Takashi Sakatani, Zenya Naito, Yasuhiko Tabata, Masaaki Miyamoto, Takashi Nitta
Platelet-rich plasma (PRP) contains numerous growth factors and promotes bone fracture healing. The aim of this study was to evaluate the effectiveness of the controlled release of PRP from biodegradable gelatin hydrogel for promoting healing in a rabbit ischemic sternal model. PRP was prepared from the whole blood of a Japanese white rabbit. Sixteen rabbits were randomized into four groups (each n = 4) and all underwent median sternotomy and bilateral internal thoracic artery removal. Before the sternum was closed, the following solutions were applied between the sternum incisions in three of the groups: 30 mg of gelatin hydrogel incorporating 300 μL of phosphate-buffered saline, 300 μL of a solution form of PRP, or 30 mg of gelatin hydrogel incorporating 300 μL of PRP (PRP+Gel)...
May 16, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29759788/novel-extravascular-defibrillation-configuration-with-a-coil-in-the-substernal-space-the-asd-clinical-study
#13
Joseph Y S Chan, Jacek Lelakowski, Francis D Murgatroyd, Lucas V Boersma, Jian Cao, Vladimir Nikolski, Griet Wouters, Mark C S Hall
OBJECTIVES: This study assessed the defibrillation efficacy of the substernal-lateral electrode configuration. BACKGROUND: Subcutaneous implantable cardioverter-defibrillators (ICDs) are regarded as alternatives to transvenous ICDs in certain subjects. However, substantially higher shock energy of up to 80 J may be required. Proposed is a new defibrillation method of placing the shock coil into the substernal space. METHODS: This prospective, nonrandomized, feasibility study was conducted in subjects scheduled for midline sternotomy or implant of ICD...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29755812/is-bilateral-staged-muscle-sparing-thoracotomy-performed-within-1-week-for-lung-hydatid-cysts-safe-for-pediatric-patients
#14
Ömer Önal, Ömer Faruk Demir
OBJECTIVES: Median sternotomy or staged thoracotomies are generally the preferred surgical treatment options for bilateral lung hydatid cysts. According to literature, it is usually recommended to wait from 3 weeks to 3 months between bilateral staged thoracotomies. The aim of this study is to compare postoperative complications, hospitalization days and morbidity and mortality ratios between unilateral thoracotomy and bilateral staged thoracotomy groups and to evaluate the safety of performing bilateral staged thoracotomy within 1 week for lung hydatid cysts in pediatric patients...
April 2018: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29755625/minimal-invasive-technique-in-atrial-septal-defect-surgery
#15
Feridoun Sabzi, Reza Faraji, Mahmood Kazeminasab
Background: Median sternotomy with minimal skin incision (MSWMSI) and modified anterior mini-thoracotomy (MAMT) approach that both are innovative techniques modified from previous documented techniques are important alternative to conventional median sternotomy in atrial septal defect (ASD) repair. Our aim is to explain the details of two performed techniques in our center and explain the results. Methods: Totally 54 children with ASD (20 female and 34 male) were operated with two different techniques i...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29755093/-concomitant-atrial-septal-defect-closure-and-repair-of-pectus-excavatum-in-a-50-year-old-patient-report-of-a-case
#16
Atsushi Tamura, Hajime Kinoshita, Kei Kazuno, Hiroshige Sato, Seiichiro Murata, Hiroshi Iida
We report a case of atrial septal defect (ASD) with severe pectus excavatum. A 50-year-old female had a stroke due to paradoxical embolism from deep vein thrombosis thorough ASD. Her preoperative computed tomography(CT) revealed a severe pectus excavatum (Haller CT index 28.6). The patient underwent ASD closure and repair of the pectus excavatum concomitantly. Median full sternotomy was performed for ASD closure. And we adopted sterno-costal elevation for pectus excavatum repair. Cartilages of the 3rd to the 7th rib were segmentally resected and the remainders were re-sutured to the sternum...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#17
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750930/a-simplified-technique-for-complex-mitral-valve-regurgitation-via-minimally-invasive-approach
#18
Giuseppe Speziale, Marco Moscarelli, Nicola Di Bari, Raffaele Bonifazi, Massimo Salardino, Teresa De Donatis, Giusepe Nasso
BACKGROUND: Complex mitral valve disease can require surgical repair techniques that are challenging in a minimally invasive context and may expose patients to prolonged cardiopulmonary bypass and cross clamp times. Here, we review our simplified stepwise operative approach for the treatment of complex bileaflet mitral disease, on early outcomes and mid-term follow-up. METHODS: One hundred and forty consecutive patients with bileaflet disease underwent video-assisted right minimally invasive mitral valve repair at our surgical center between 2008 and 2016...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750405/heartmate-3-implantation-via-left-antero-lateral-thoracotomy-to-avoid-resternotomy-in-high-risk-patients
#19
Raymond Pfister, Piergiorgio Tozzi, Roger Hullin, Patrick Yerly, Fritz-Patrick Jahns, René Prêtre, Matthias Kirsch
Left ventricular assist devices (LVADs) are currently the best alternative to cardiac transplantation for patients with end-stage heart failure (HF) as a bridge to transplant or to decision, or as destination therapy. Full median sternotomy or minimally invasive techniques are the more standard approaches used at present.  LVADs are usually implanted between the left ventricle apex and the ascending aorta. An implantation through a left thoracotomy with an outflow graft connected to the descending aorta is much less performed nowadays due to the longer times to extubation, higher incidence of postoperative pain, and poorer hemodynamics in the ascending aorta, which may lead to thrombosis...
April 25, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29748938/an-entire-clinical-course-of-mediastinal-myxofibrosarcoma-treated-by-surgery-and-radiation
#20
Yasoo Sugiura, Hiroyuki Fujimoto, Toshinori Hashizume, Go Ogura, Etsuo Nemoto
A woman in her 70s with an 8.6-cm tumor in the anterior mediastinum underwent tumor excision by median sternotomy, which combined resection of the fifth and sixth ribs. The pathological diagnosis was myxofibrosarcoma, and pathologically curative resection was accomplished. Local recurrence was detected at 10, 19, 23 and 28 months after the initial surgery. After repeated surgical resection, radiation therapy for the fourth unresectable recurrence resulted in failure. She died 34 months after the initial surgery...
May 10, 2018: General Thoracic and Cardiovascular Surgery
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