Using the Hybrid Operating Room in Thoracic Surgery: A Paradigm Shift
We describe the integration of the hybrid operation room cone-beam computed tomography (CT) scan technology into the practice of general thoracic surgery. The combination of the following three techniques: (1) cone-beam CT scan augmented navigational bronchoscopy, (2) cone-beam CT-guided percutaneous biopsy and/or fiducial placement, and (3) fiducial or image-guided video-assisted thoracic surgery resection, into a single-stage, single-provider procedure allows for diagnosis and treatment in one setting. Rapid on-site evaluation of cytological or pathology specimens is key to this “all-in-one” approach. The tim...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Article Source Type: research

Totally Endoscopic Surgical Repair of Partial Atrioventricular Septal Defect in Children: Two Cases
In this report, we present two children who were successfully repaired partial atrioventricular septal defect by using totally endoscopic surgery without robotic assistance. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

CoreValve Double Jeopardy: Embolized Valve Capture With Subsequent Valve
We describe a case of self-expanding prosthesis embolization and present a solution using a second prosthesis to capture the embolized one. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Titanium Fastener Utilization During HeartMate 3 Left Ventricular Assist Device Implantation
The objective of this study was to investigate the feasibility of using titanium fasteners for securement of the inflow sewing ring during HeartMate 3 implantation. The secondary objective was to compare cardiopulmonary bypass and total operative times between the titanium fastener and hand-tied knot groups. Methods Clearance between the sewing ring and the HeartMate 3 device was assessed in vitro. Thirty-one patients undergoing HeartMate 3 implantation via median sternotomy at a single center from April 2017 to February 2018 were reviewed. The sewing ring was secured with hand-tied knots (n = 18) or titanium fasteners ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Evaluation of Conduction Disorders After Aortic Valve Replacement With Rapid Deployment Bioprostheses
Objective The aim of this retrospective, single-center study was to evaluate the occurrence of conduction disorders after rapid deployment aortic bioprosthesis implantation. Methods Electrocardiograms of patients undergoing INTUITY (Edwards Lifesciences, Irvine, CA USA) bioprosthesis implantation were collected at admission, during postoperative course, and at discharge. Primary end point was the occurrence of new-onset conduction disorders, defined as complete left bundle branch block, complete right bundle branch block, permanent pacemaker implantation, and worsening of pre-existing rhythm abnormalities. Secondary e...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Concomitant Left Atrial Reduction in Rheumatic Mitral Valve Disease With Giant Left Atrium: Our Technique With Midterm Results
Conclusions Concurrent left atrium reduction with mitral valve procedure is a feasible and effective technique for event-free survival of the patients having giant left atrium with mitral disease. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Nonrobotic Total Endoscopic Coronary Artery Bypass Grafting: A Proof-of-Concept Study in 20 Patients
Conclusions With a thoroughly surveyed learning curve, nonrobotic total endoscopic coronary bypass grafting procedure could become an alternative to other available treatment options; however, the value of the procedure has to be further investigated. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Robotic Versus Video-Assisted Thoracoscopic Surgery Pulmonary Segmentectomy: A Cost Analysis
Conclusions In this small series, cost and outcomes in our early experience with robotic-assisted segmentectomy were comparable with our video-assisted thoracic surgery approach with trends toward shorter length of stay and fewer complications. Larger series are needed to validate these results. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Minimally Invasive Ozaki Procedure in Aortic Valve Disease: The Preliminary Results
Conclusions Ministernotomy combined with Ozaki procedure might be feasible, as well as an alternative to conventional sternotomy. This approach is associated with low mortality and morbidity and may be beneficial in younger populations. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Right Mini-thoracotomy Bentall Procedure
Conclusions The Bentall procedure can be performed through a right anterior mini-thoracotomy in selected patients with excellent clinical results. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Learning Curve of Robotic Lobectomy for Early-Stage Non-Small Cell Lung Cancer by a Thoracic Surgeon Adept in Open Lobectomy
Conclusions Adoption of a robotic platform for lobectomy for early-stage non-small cell lung cancer by an experienced open thoracic surgeon is safe and feasible, with fewer complications, less blood loss, and equivalent nodal sampling rate even during the learning curve. The conversion to open rate significantly dropped after the first 40 robotic lobectomies, and operative time for robotic lobectomy approached open thoracotomy after 60 cases, after a bimodal curve. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Right Mini-thoracotomy Mitral Valve Surgery: The Art and Science of the Tailoring Approach
No abstract available (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Editorial Source Type: research

Minimally Invasive Mitral Repair: Direct Aortic Cannulation Via Right 2nd Intercostal Space
The right 2nd interspace minithoracotomy has advantages over femoral arterial cannulation providing an alternative that should be in the arsenal of the minimally invasive surgeon; we describe here the method, the advantages, and the pitfalls. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

The “Paper Roll”: A Simple but Useful Tool for Minimal Invasive Mitral Valve Repair Surgery
During minimal invasive mitral valve repair, excessive valve tissue, as in myxomatous or Barlow disease, might be cumbersome to analyze and treat the subvalvular mitral valve apparatus. We developed a new, adaptive, flexible, and easy-to-use technique for better visualization of the subvalvular apparatus. After visualization of the mitral valve, a simple sterile paper ruler was curled up to a roll 1 cm in diameter and inserted through the mitral valve. By means of two endo forceps, the paper roll was uncurled to the desired diameter, thus pushing the valve leaflets away, allowing for a direct view onto the subvalvular appa...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Novel Sternal Reconstruction With Custom Three-Dimensional–Printed Titanium PoreStar Prosthesis
We report the first Australian use of a three-dimensional–printed titanium and PoreStar prosthesis in a 39-year-old woman for reconstruction after major surgical resection of the sternum for metastatic breast cancer. The patient successfully underwent excision of the sternum and costal cartilages as well as implantation of the prosthesis. We conclude that three-dimensional–printed prostheses are technically feasible to deliver excellent cosmetic result. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Single-Stage Total Arch Replacement With Open Stent Graft for Kommerell's Diverticulum With Right-Sided Aortic Arch
We treated a 70-year-old patient with Kommerell's diverticulum associated with an aberrant left subclavian artery and right aortic arch using single-stage total arch replacement with a commercially available open stent graft through only a median sternotomy. A four-branched prosthetic graft was implanted after insertion of the open stent graft through the anastomotic site under moderate hypothermia and cardiopulmonary bypass with selective cerebral perfusion. The aberrant subclavian artery was occluded by coil embolization from the distal site and anatomically reconstructed from the prosthetic graft. This approach is safe ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Direct Femoral Cannulation in Minimal Invasive Pediatric Cardiac Surgery: Our Experience With Midterm Result
Conclusions Femoral arterial and venous cannulation is a feasible, reliable, and efficient method for institution of cardiopulmonary bypass in minimally invasive pediatric cardiac surgery. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Silver-Impregnated Dressing Does Not Decrease Incidence of Surgical Site Infection After Adult Cardiac Surgery
Conclusions Silver dressings did not reduce sternal wound infection after sternotomy for cardiac surgery in a large-cohort study. We discontinued the routine use of silver dressings for adult cardiac surgery based on these results because traditional gauze likely represents an equally effective and less costly alternative. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Mini Right Anterior Thoracotomy Approach Versus Sternotomy for Resection of Intracardiac Myxoma
Conclusions A minimally invasive surgery through mini right anterior thoracotomy is a good alternative technique for treating cardiac myxoma. Despite the small size of the experience, there is a clear diminution in preoperative blood loss and an interesting trend toward a shorter intensive care unit and hospital stay. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Intravenous Acetaminophen Improves Outcomes After Transapical Transcatheter Aortic Valve Replacement
Conclusions In patients undergoing transapical transcatheter aortic valve replacement, a multimodal pain management strategy incorporating intravenous acetaminophen was associated with reductions in narcotic use on the day of surgery and overall length of stay. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Cost and Outcome of Minimally Invasive Techniques for Coronary Surgery Using Robotic Technology
Objective Totally endoscopic coronary artery bypass (TECAB) with robotic distal anastomosis and robotic-assisted minimally invasive coronary artery bypass (RA-MIDCAB) with robotic internal mammary artery harvest and direct hand-sewn distal anastomosis via an anterior thoracotomy have both been reported as safe and efficacious. We compared hospital cost and short-term outcomes between these techniques. Methods Patients who underwent robotic-assisted minimally invasive single-vessel Coronary artery bypass grafting (2011–2014) were retrospectively reviewed. One hundred consecutive patients underwent either TECAB (n...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Multicenter Assessment of Grafts in Coronaries: Midterm Evaluation of the C-Port Device (the MAGIC Study)
Conclusions The C-Port device is safe and effective in creating the distal anastomosis with equivalent patency rates to hand-sewn grafts at 12 months. When compared with hand-sewn anastomoses from a recent large prospective trial, the C-Port device demonstrated a statistically significant reduction in midterm graft occlusion. Further studies are required to evaluate its effect in less invasive coronary surgery. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Magna Ease Versus Trifecta Early Hemodynamics: A Systematic Review and Meta-analysis
Objective This meta-analysis compares the early echocardiographic outcomes of aortic valve replacement using the two most commonly implanted stented bioprostheses. Methods We searched MEDLINE and EMBASE databases until 2017 for studies comparing Magna or Magna Ease (Edwards Lifesciences, Irvine, CA USA) versus Trifecta (St Jude Medical, St. Paul, MN USA) aortic bioprosthetic valves. A random-effects meta-analysis was performed for the primary outcome of mean gradient on echocardiography and secondary outcomes of effective orifice area, indexed effective orifice area, and in-hospital mortality. Results There were tw...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Minimally Invasive Versus Full-Sternotomy Septal Myectomy for Hypertrophic Cardiomyopathy
This study compared a minimally invasive septal myectomy performed at our institution with the traditional full-sternotomy approach. Methods Patients receiving a stand-alone septal myectomy were retrospectively reviewed from November 1999 to December 2016 (N = 120). Patients were stratified by surgical approach: traditional full sternotomy (n = 34) and ministernotomy (n = 86). Preoperative and perioperative variables were compared as well as follow-up symptomatic and echocardiographic outcomes. Results Both groups had a significant decrease in New York Heart Association class heart failure symptoms (P (Source: Innova...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Outcomes of Impella 5.0 in Cardiogenic Shock: A Systematic Review and Meta-analysis
Conclusions Impella 5.0/LD is associated with favorable survival outcomes and higher rate of myocardial recovery in patients with cardiogenic shock. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Geometric Ring Annuloplasty for Aortic Valve Repair During Aortic Aneurysm Surgery: Two-Year Clinical Trial Results
Objective An aortic annuloplasty ring could be useful for aortic valve repair. This trial evaluated intermediate-term outcomes of internal geometric ring annuloplasty for repair of trileaflet and bicuspid aortic insufficiency associated with ascending aortic and/or aortic root aneurysms. Methods Under regulatory supervision, 47 patients with aortic insufficiency and ascending aortic (n = 22) and/or aortic root (n = 25) aneurysms were managed with aortic valve repair and aneurysm resection. Valve repair was performed using trileaflet (n = 40) or bicuspid (n = 7) internal geometric rings, together with leaflet reconstru...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

It's About Time
No abstract available (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Presidential Address Source Type: research

2017 Best Manuscript Awards
No abstract available (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Editorial Source Type: research

Sutureless Prosthesis Implantation and Ascending Aorta Replacement Through a Ministernotomy Approach
We describe our technique of sutureless prosthesis implantation and concomitant ascending aorta replacement through an upper ministernotomy. Seven patients underwent aortic valve replacement with a sutureless prosthesis and concomitant ascending aorta replacement between November 2014 and October 2016. A J-shaped upper ministernotomy was performed in all patients. Diameter of vascular graft for the replacement of the dilated ascending aorta was chosen according to the size of the selected prosthesis, to recreate a ratio between diameters of the new sinotubular junction and the aortic annulus that should be less than 1.3. P...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

A Simplified Technique for Correcting Mitral Valve Regurgitation Via Minimally Invasive Approach
Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months,...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Video-Assisted Thoracoscopic Monitoring of Laser Lead Extraction by Femoral Route
We report a case of laser-assisted transvenous lead extraction unconventionally performed by the femoral route. A preventive minimally invasive cardiac surgery was implemented to provide more safety in this high-risk procedure. This technique may avoid the need of a full sternotomy in case of major bleeding complications. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Minimally Invasive Cardiac Surgery: Removal of an Interatrial Intraseptal Bronchogenic Cyst Through a Periareolar Approach
A 58-year-old white male with a history of stroke and deep vein thrombosis presented with an interatrial intraseptal mass. Cardiac-computed tomography demonstrated a thin-walled, well-demarcated cyst in the inferior border of the fossa ovalis protruding into both atria. Removal of the interatrial intraseptal cyst was performed using a minimally invasive three-dimensional endoscopic periareolar approach. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Thoracoscopic Resection of Congenital Cystic Adenomatoid Malformation in a Patient With Fused Lung Fissure Using Hookwire
Thoracoscopic resection is being used more commonly for the treatment of congenital cystic adenomatoid malformation in neonates and infants. However, in the rare case of congenital cystic adenomatoid malformation with congenital absence of lung fissure, thoracoscopic lobectomy cannot be performed safely. Moreover, if the lung lesion is deep-seated and cannot be visualized on the pleural surface, wedge resection may result in residual lesion. Here, we reported our approach of thoracoscopic resection under hookwire guidance to tackle this problem. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Minimally Invasive Direct Access Balloon-Expandable Transcatheter Mitral Valve Replacement for Extensive Mitral Annular Calcification after Transcatheter Aortic Valve Replacement
This report describes a patient who previously received a transcatheter aortic valve replacement and then subsequently underwent a minimally invasive right thoracotomy for transcatheter mitral valve replacement with a successful result. We discuss technical pearls and operative considerations based on an extensive experience with minimally invasive valve surgery from a right mini-thoracotomy. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Minimally Invasive Left Ventricular Assist Device Implantation: Implementation Early in a Surgical Career
Conclusions Compared with conventional sternotomy, minimally invasive ventricular assist device implantation, performed by a surgeon in his first year of practice, had similar perioperative outcomes and excellent survival. Based on these data, minimally invasive implantation may be a feasible strategy for device implantation even early in a surgeon's career. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Transesophageal Echocardiography–Guided Epicardial Left Ventricular Lead Placement by Video-Assisted Thoracoscopic Surgery in Nonresponders to Biventricular Pacing and Previous Chest Surgery
Conclusions In patients who are nonresponders to conventional biventricular pacing, intraoperative left ventricular lead placement using anatomical and functional characteristics via a video-assisted thoracoscopic surgery approach is effective in improving heart failure symptoms. This optimized left ventricular lead placement is feasible and safe. Previous chest surgery is no longer an exclusion criterion for a video-assisted thoracoscopic surgery approach. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

A Novel Approach Using Computed Tomography Angiograms to Predict Sternotomy or Complicated Anastomosis in Patients Undergoing Robotically Assisted Minimally Invasive Direct Coronary Artery Bypass
Conclusions In our experience, patients with left anterior descending artery to the myocardium distance of 0 mm were at significantly higher risk of either conversion to sternotomy or technically challenging anastomosis, with 8 (57.1%) of 14 patients in this group experiencing either end point. This novel measurement may be useful to identify patients who may have anatomy, which is not well suited to the robotically assisted minimally invasive direct coronary artery bypass approach. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Preoperative Planning of Transapical Beating Heart Mitral Valve Repair for Safe Adaptation in Clinical Practice
Conclusions We demonstrate a method to safely start the TOP-MINI program with precise patient selection and preoperative planning, allowing us to determine procedural strategy and assessment of surgical success probability. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Predictors of Persistent Tricuspid Regurgitation After Transcatheter Aortic Valve Replacement in Patients With Baseline Tricuspid Regurgitation
This study sought to analyze outcomes in patients with moderate-severe tricuspid regurgitation (TR) undergoing transcatheter aortic valve replacement (TAVR). The consequences of uncorrected significant TR in patients undergoing TAVR remain undefined. Methods Between 2009 and 2014, 369 patients underwent TAVR at our institution, and 58 of these had baseline moderate-severe TR. Preoperative, 30-day, and 1-year transthoracic echocardiograms were analyzed. Predictors of persistent TR at 30 days and survival were assessed. Results Fifty-eight patients with baseline moderate-severe TR underwent TAVR. Transcatheter aortic v...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Combined Hookwire and Methylene Blue Localization of Pulmonary Nodules: Analysis of 74 Patients
Conclusions This study demonstrates that utilization of Hawkins hookwire in combination with methylene blue injection is an effective method to successfully localize pulmonary nodules for thoracoscopic wedge resection and should prompt further investigation for its utilization. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Outcomes of a Rapid Deployment Aortic Valve Versus Its Conventional Counterpart: A Propensity-Matched Analysis
Objective The aim of this study was to compare outcomes after rapid-deployment aortic valve replacement (RDAVR) and conventional aortic valve replacement (AVR) from two studies. Methods Patients who underwent RDAVR (INTUITY valve) in the prospective, 5-year, single-arm multicenter TRITON study, or conventional AVR (Perimount Magna Ease valve) in the prospective Perimount Magna Ease postmarket study, were propensity score matched and compared for procedural, hemodynamic, safety, and clinical outcomes. Results Matched RDAVR (n = 106) and conventional AVR (n = 106) patients had similar baseline characteristics (mean &...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Aortic Valve-in-Valve in Externally Mounted Bioprosthesis: A Safe Treatment Option for Bioprosthetic Structural Valve Dysfunction
Conclusions Our data suggest that aortic valve-in-valve implantation can be safely performed in carefully selected patient with internally and externally mounted leaflet bioprosthesis. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Homograft Versus Conventional Prosthesis for Surgical Management of Aortic Valve Infective Endocarditis: A Systematic Review and Meta-analysis
Conclusions Homografts and conventional prostheses offer similar survival and freedom from recurrent endocarditis and reoperation for aortic valve IE. Homografts may be associated with greater risk of reoperation compared with mechanical valves. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Three-Year Survival Comparison Between Transcatheter and Surgical Aortic Valve Replacement for Intermediate- and Low-Risk Patients
Transcatheter aortic valve implantation is a suitable therapeutic intervention for patients deemed inoperable or high risk for surgical aortic valve replacement. Current investigations question whether it is a suitable alternative to surgery for intermediate- and low-risk patients. The following meta-analysis presents a comparison between transcatheter versus surgical aortic valve replacement in patients that are intermediate and low risk for surgery. Articles were collected via an electronic search using Google Scholar and PubMed. Articles of interest included studies comparing the survival of intermediate- and low-risk p...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Review Article Source Type: research

Closure of Large Percutaneous Femoral Venous Access Using a Modified “Figure-of-Eight” Suture
We describe a modified “figure-of-eight” suture technique for minimizing the risk of accidental puncture of the vein while grabbing the subcutaneous tissue. We examined the safety and feasibility of this technique combined with early mobilization in a real-world setting. We performed a retrospective analysis on 56 consecutive patients undergoing percutaneous mitral valve repair using large femoral venous access. The patient population was heterogeneous and bleeding risk characteristics were common. Bleeding Academic Research Consortium Consensus (BARC)-classifiable bleeding complications occurred in eight patie...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Pericardial Patch Exclusion Technique for Left Atrial Appendage Closure
We describe a technique of left atrial appendage occlusion that consists of autologous pericardial patch closure of the left atrial appendage orifice from within the left atrium. This pericardial patch exclusion technique has little added risk of bleeding, can be performed through sternotomy or right minithoracotomy, and can be used in re-operative situations. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

The C-Port Distal Coronary Anastomotic Device Is Comparable With a Hand-Sewn Anastomosis: Human Histological Case Study
This report examines the histological attributes of such an anastomosis in a patient who underwent heart transplantation approximately 1 year after robotic totally endoscopic stapled coronary bypass using the C-Port anastomotic device. There have been no previous reports of histological examination of this type of bypass graft in humans in the literature. We found that the C-Port single-shot stapled coronary anastomotic device had a similar histological appearance to a traditional hand-sewn technique using monofilament suture. The amount of inflammation around the anastomosis using the two techniques was found to be compar...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Totally Endoscopic Resection of Giant Left Atrial Myxoma Without Robotic Assistance
There was no report on the application of totally endoscopic surgery for giant atrial myxoma resection. A 62-year-old female patient with giant atrial myxoma causing severe mitral stenosis and acute pulmonary edema underwent a successful operation by totally endoscopic techniques without the assistance of robotic systems using four small trocar ports (three 5-mm trocars and one 12-mm trocar). The patient recovered uneventfully and was satisfied with cosmetic results. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Transcaval Valve-in-Valve-in-Valve Aortic Valve Replacement for Bioprosthetic Valve Degeneration
A 74-year-old man presented with progressive dyspnea on exertion. History included peripheral arterial disease and coronary artery bypass grafting with aortic valve replacement 12 years ago. Subsequently, the surgical valve developed severe stenosis and moderate insufficiency. He underwent a transapical valve-in-valve transcatheter aortic valve replacement 5 years before presentation. This second valve developed a mean gradient of 66 mm Hg with mild insufficiency. The patient was treated with a third aortic valve using an alternative transcaval approach, significantly alleviating his symptoms. (Source: Innovations: Technol...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Significantly Elevated C-Reactive Protein Levels After Epicardial Clipping of the Left Atrial Appendage
Objective Besides mechanical and anatomical changes of the left atrium, epicardial closure of the left atrial appendage has also possible homeostatic effects. The aim of this study was to assess whether epicardial clipping of the left atrial appendage has different biochemical effects compared with complete removal of the left atrial appendage. Methods Eighty-two patients were included and underwent a totally thoracoscopic AF ablation procedure. As part of the procedure, the left atrial appendage was excluded with an epicardial clip (n = 57) or the left atrial appendage was fully amputated with an endoscopic vascular ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research