Transcatheter Aortic Valve Replacement: Efficiency and Safety Improvements With Progressive Experience and Improved Technology
In this study, we investigated change in the safety and efficiency of the transcatheter aortic valve replacement procedure at our institution and patient outcomes comparing our first 100, second 100, and last 100 patients. Methods From March 2012 to June 2016, 544 patients underwent transcatheter aortic valve replacement at our center. Three hundred patients were selected for this study and were categorized in the following three groups: group A, first to 100th patient; group B, 101st to 200th patient; and group C, 444th to 544th patient. Preoperative, intraoperative, and postoperative data were collected. Results Th...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Epicardial, Biatrial Ablation With Integrated Uni-bipolar Radiofrequency Technology in Stand-alone Persistent Atrial Fibrillation
Conclusions Integrated uni-bipolar radiofrequency ablation technology showed to be effective for the surgical treatment of atrial fibrillation with a total endoscopic approach. A versapolar suction device with extensive right-left atrial lesion set may further improve outcomes in patients with nonparoxysmal atrial fibrillation. (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: Original Articles Source Type: research

Robotic Beating Heart Totally Endoscopic Coronary Artery Bypass in Higher-Risk Patients: Can It be Done Safely?
Conclusions We conclude that beating heart totally endoscopic beating heart coronary artery bypass surgery can be performed in patients with a higher STS predicted risk of mortality with excellent outcomes. Further studies are warranted to evaluate long-term results of totally endoscopic beating heart coronary artery bypass surgery in this challenging group of patients. (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: Original Articles Source Type: research

Clinical Experience in Minimally Invasive Cardiac Surgery With Virtually Wall-Less Venous Cannulas
Conclusions The performance of virtually wall-less venous cannulas designed for augmented peripheral venous drainage was tested in MICS and provided excellent flows at minimal vacuum levels, confirming an increased performance over traditional thin wall cannulas. Superior results can be expected for routine use. (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: Original Articles Source Type: research

A Phase 1 Study of a Novel Bidirectional Perfusion Cannula in Patients Undergoing Femoral Cannulation for Cardiac Surgery
Conclusions This study demonstrates that in patients undergoing femoral arterial cannulation for cardiopulmonary bypass during cardiac surgery, the use of a novel bidirectional cannula is safe and easy to insert and provides stable distal perfusion of the cannulated limb. Use of the device should largely obviate the need to insert a separate downstream perfusion cannula or use other techniques to protect against lower limb ischemia. Further research on a larger scale and in different patient populations is now warranted. (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: Original Articles Source Type: research

Current Trends in Aortic Root Surgery: The Mini-Bentall Approach
Conclusions An upper hemisternotomy is a feasible technique in patients undergoing elective aortic root replacement surgery. However, future prospective studies are required before these procedures become the standard of care. (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: Original Articles Source Type: research

Evolution of Minimally Invasive Coronary Artery Bypass Grafting: Learning Curve
This study reviewed a single surgeon's experience with minimally invasive coronary surgery coronary artery bypass grafting, including operative time, number of bypasses, and conversion to sternotomy. Methods A prospective database of consecutive minimally invasive coronary surgery coronary artery bypass grafting procedures from 2005 to 2013 was reviewed. A small anterolateral left thoracotomy allowed left internal mammary artery harvest, proximal anastomoses on the ascending aorta, and distal coronary anastomoses. Early cases were compared with the later cases, focusing on grafting strategies that led to a standardized ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Thymectomy for Nonthymomatous Myasthenia Gravis: Comparison of Video-Assisted Thoracoscopic and Transsternal Thymectomy
Conclusions VATS thymectomy is a safe and appropriate approach comparing with traditional methods such as TS thymectomy for patients with myasthenia gravis. This method has better results after surgery and can be used as a minimally invasive alternative method instead of TS thymectomy. (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: Original Articles Source Type: research

Sternotomy Sparing Thoratec HeartMate 3 Implantation Via Bilateral Minithoracotomy
A novel sternotomy sparing implantation technique for the Thoratec HeartMate 3 is described. Cannulation of the left ventricular apex is performed via a minithoracotomy in the left fourth or fifth intercostal space. The outflow graft is advanced through the pericardium to a second minithoracotomy in the right second intercostal space and then anastomosed to the ascending aorta. This approach was performed in three patients so far with no need for conversion. We did not observe any perioperative adverse events, such as bleeding or thromboembolic complications, as well as no short-term mortality. This technique is especially...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Left Axillary Artery Cannulation Facilitates Reoperative Total Aortic Arch Replacement
Total aortic arch replacement remains a technically formidable procedure, particularly in patients with previous proximal aortic dissection repair. Our case discussion highlights a useful strategy for extracorporeal support and circulation management to facilitate total arch reconstruction in the reoperative setting, based on cannulation of the left axillary artery. Our preference is to use a left axillary artery approach to initiate cardiopulmonary bypass and to ultimately revascularize the left arm via an extra-anatomic graft. Our technique, as described, affords the option to initiate cardiopulmonary bypass before stern...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Periareolar Access for Minimally Invasive Cardiac Surgery: The Brazilian Technique
The periareolar access has been the preferred technique used at our institution for minimally invasive cardiac surgery since 2006. The surgical approach consists of video-assisted minithoracotomy in the 4th right intercostal space, through a periareolar incision. Initially, the technique was restricted to minimally invasive mitral valve surgeries but, due to its feasibility and safety, was soon incorporated as an ideal access for other cardiac pathologies such as tricuspid valve disease, atrial septal defect, atrial fibrillation, and pacemaker leads endocarditis. The technique was performed in 214 patients, and it is assoc...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Single-Port Thoracoscopic Pericardial Window Under Local Anesthesia
We present a 44-year-old woman with metastatic breast cancer presenting with a new 2-cm pericardial effusion on ultrasound. In light of the patient’s palliative condition and the urgent need for chemotherapy, careful consideration was made for her surgical drainage of the pericardial effusion. Because of the patient’s medical comorbidities, a general anesthetic was deemed not to be in the patient's best interest. Furthermore, the invasive subxiphoid or thoracotomy approach for a pericardial window would have risked delaying her much needed chemotherapy. A single-port thoracoscopic pericardial window was perform...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Transcatheter Aortic Valve Replacement as a Bridge to Left Ventricular Assist Device Implantation
We describe a case of the pre-emptive use of transcatheter aortic valve replacement in a patient with end-stage ischemic cardiomyopathy and native aortic stenosis/aortic insufficiency as a bridge to left ventricular assist device implantation. The use of this strategy can not only medically optimize patients before left ventricular assist device implantation but also provide a minimally invasive bridge to left ventricular assist device support, avoiding concomitant surgical aortic valve replacement or closure. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Per-Ventricular Insertion of Melody Valve-in-Valve in the Neoaortic Position in a Single-Ventricle Patient
Percutaneous therapies for congenital heart disease have been evolving rapidly despite limited investment from industry. The Melody transcatheter pulmonary valve (Medtronic, Inc, Minneapolis, MN USA) replacement therapy represents an important advancement in this arena. It has been approved in the United States for use in the pulmonary position, on a Humanitarian Device Exemption status. Off-label use of the Melody transcatheter pulmonary valve has extended to the mitral, pulmonary, and aortic valves, especially in previously implanted valves with prosthetic valve degeneration. The single-ventricle patient poses additional...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Robotic Transthoracic Primary Repair of a Diaphragmatic Hernia and Reduction of an Intrathoracic Liver
This case involves a 70-year-old woman who presented after a low-speed motor vehicle collision with a traumatic right hemidiaphragm rupture and herniation of the liver into the right chest. She was brought to the operating room for a robotic-assisted minimally invasive transthoracic repair of this hernia with diaphragm plication. The case and video described in this report highlight the utility of the robotic platform in performing a transthoracic diaphragm repair and plication after a right-sided traumatic diaphragm rupture in a patient without concomitant abdominal injuries. (Source: Innovations: Technology and Technique...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Safety and Functionality of a Guidewire Fixator: Clinical Investigation of a New Endovascular Tool
Conclusions Deployment was uneventful in all ten patients. Retrieval according to the intended instruction for use was performed in nine of the patients. In one patient, a coaxial catheterization was necessary. All devices withstood a retention force of 3 N. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Acute Heart Failure at the Time of Transcatheter Aortic Valve Replacement Does Not Increase Mortality
Conclusions Transcatheter aortic valve replacement is an appropriate and effective treatment for patients with aortic stenosis presenting with high N-terminal pro-B-type natriuretic peptide and acute on chronic heart failure. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

A New Device for Securing Sternal Wires After Median Sternotomy: Biomechanical Study and Retrospective Clinical Assessment
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 (TORQTM 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. Methods Four cardiovascular surgeons performed manual and device-assisted closures on a biofidelic model. Closure for...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Does Robotic Beating Heart Connector Totally Endoscopic Coronary Artery Bypass Bridge the Gender Gap in Coronary Bypass Surgery?
Conclusions We conclude that the morbidity and mortality in women after robotic beating heart connector totally endoscopic coronary artery bypass in our center were similar to those seen in men. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Comparison of Automated Titanium Fasteners to Hand-Tied Knots in Open Aortic Valve Replacement
This study compared operative times and costs of titanium fasteners versus hand-tied knots for prosthesis securement in open aortic valve replacement. Methods A randomized control trial was conducted during a 16-month period at a single university medical center. Patients undergoing elective aortic valve replacement were randomized to the titanium fastener (n = 37) or hand-tied groups (n = 36). Knotting, aortic cross-clamp, cardiopulmonary bypass, and total operating room times were recorded. Hospital charges were also calculated for these procedures. Results Baseline characteristics, concomitant procedures, prosthet...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Long-Term Outcome of Patients Undergoing Minimally Invasive Direct Coronary Artery Bypass Surgery: A Single-Center Experience
Conclusions Within the limitations imposed by retrospective analyses, our study demonstrates excellent long-term outcome in patients undergoing minimally invasive direct coronary artery bypass with or without hybrid revascularization. For isolated left anterior descending artery disease minimally invasive direct coronary artery bypass should be considered, whereas hybrid revascularization (percutaneous coronary intervention and minimally invasive direct coronary artery bypass) should be considered for multivessel disease. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Dynamic Patient-Specific Three-Dimensional Simulation of Mitral Repair: Can We Practice Mitral Repair Preoperatively?
Conclusions Complex mitral valve modeling seems to predict an individual patient's mitral anatomy well, before surgery. Further investigation is required to determine whether deliberate preoperative practice can improve mitral repair outcomes. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Long-Term Clinical and Computed Tomography Angiographic Follow-up After Totally Endoscopic Coronary Artery Bypass Grafting
Conclusions Arrested heart–totally endoscopic coronary artery bypass grafting shows excellent clinical long-term results with a left internal mammary artery patency rate comparable with conventional coronary artery bypass graft at 10 years after surgery. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Suprasternal Transcatheter Aortic Valve Replacement in Patients With Marginal Femoral Access
Conclusions These data demonstrate the early clinical feasibility of suprasternal transcatheter aortic valve replacement. Key advantages of this approach include direct access to the innominate artery and ascending aorta, precise sheath control, and confident arterial closure. Additional experience is warranted to confirm these favorable results. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - January 1, 2018 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Axial to Centrifugal Continuous Flow LVAD Pump Exchange Using Minimally Invasive Technique
We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Totally Thoracoscopic Pulmonary Vein Isolation: A Simplified Technique
Since the introduction of thoracoscopic ablation for atrial fibrillation (AF), the field of minimally invasive AF treatment has evolved toward an established treatment option for AF, with an overall 2-year antiarrhythmic drug free success rate of 77%. Complications are usually minor, and the incidence of bleeding needing conversion to sternotomy or (mini-)thoracotomy varies between 0% and 1.6%. Bleeding is often related to encircling the pulmonary veins, which is a blind maneuver that has to be done without direct camera vision. We propose here a modified surgical technique to simplify the procedure, shorten the operating ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy
This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Hematomas in Tiger Territory: An Endovascular Alternative to Wading In
A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy. Renal artery stenting has been advoc...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Rapid Explantation of Rapid-Deployment Sutureless Valve in Case of Acute Endocarditis: How to Remove Safely Sutureless Perceval S Prostheses
We report a case of infective endocarditis on a Perceval S aortic valve bioprosthesis, and we describe a feasible and useful technique that can help remove the infected valve. These maneuvers consist of an “x-movement” reached with the aid of anatomical forceps. The risk of infective endocarditis in patients with prosthetic valves is a well-known phenomena in cardiac surgery, and it can represent a life-threatening event in many cases. According to guidelines, an emergency surgical intervention is required in case of high risk of embolization, vegetation superior than 1 cm or acute cardiac failure secondary to ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Totally Endoscopic Robotic Management of Failed Percutaneous Atrial Septal Defect Closure With Tricuspid Valve Injury
Totally endoscopic robotic surgery is a safe approach to atrial septal defect closure in adults. Robotic approach can be an alternative to traditional incisions in the management of concomitant tricuspid valve regurgitation with ruptured chordae tendineae. Herein, we describe a woman who presented with atrial septal defect and tricuspid insufficiency after an unsuccessful percutaneous intervention with device removal from the right ventricle. Concomitant closure of septal defect and tricuspid valve repair with artificial chords was successfully performed using robot assistance. (Source: Innovations: Technology and Techniqu...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta. Three patients were transferred from outside facilitie...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Pharmacomechanical Thrombolysis for Deep Vein Thrombosis in May-Thurner Syndrome
Conclusions In patients with May-Thurner syndrome, pharmacomechanical thrombolysis is an effective approach for the management of acute deep vein thrombosis, decreasing thrombus burden, and long-term postthrombotic syndrome when used in conjunction with stenting. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Three-Dimensional Printing of Life-Like Models for Simulation and Training of Minimally Invasive Cardiac Surgery
Conclusions This life-like model can be used as a standard simulator to train younger, less experienced surgeons to practice minimally invasive cardiac surgery procedures and may help develop new operative tools. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Impact of an Ultrasonically Activated Device in Robot-Assisted Distal Gastrectomy
This study therefore assessed the effect of ultrasonically activated device use on procedural times and on other early surgical outcomes. Methods Consecutive patients (N = 42) who underwent robot-assisted distal gastrectomy for gastric cancer were included. Clinicopathological characteristics and early surgical outcomes were compared between robotic-assisted gastrectomy procedures using an ultrasonically activated device (U group, n = 21) and those without it (NU group, n = 21). Results There were no significant differences in patient characteristics between the groups; however, the median operation time was signific...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart Without Robotic Assistance in 25 Patients
Conclusions Totally endoscopic operation for ASD closure on beating heart is safe, with short recovery period, and surgical scars are of high cosmetic value, especially in a woman and girl. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Long-Term Success With Driveline Exit Site Relocation for Deep Driveline Infection in Left Ventricular Assist Device Patients
Conclusions An aggressive surgical strategy, including debridement and formal relocation of the driveline exit site, can result in long-term device salvage after deep driveline infection. This approach is a less invasive alternative to device exchange for refractory driveline infections. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Morbid Obesity Does not Increase Morbidity or Mortality in Robotic Cardiac Surgery
Objective Morbid obesity (body mass index ≥ 35 kg/m2) usually confers a higher perioperative risk in cardiac surgery. Robotic cardiac surgery may have many advantages for these high-risk patients. Methods We retrospectively reviewed patients undergoing robotic cardiac surgery from July 2013 to April 2017 at our institution. We compared the outcomes of morbidly obese patients versus nonobese patients. Results A total of 486 patients underwent robotic cardiac surgery (322 men, median age = 65 years). The robotic procedures were the following: totally endoscopic beating heart coronary artery bypass (n = 263), mitra...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Pressure and Flow Characteristics of a Novel Bidirectional Cannula for Cardiopulmonary Bypass
Objective Femoral arterial cannulation is associated with a significant risk of lower limb ischemia. The aim of the study was to assess the pressure and flow in the femoral artery using a novel bidirectional femoral cannula in a sheep model of peripheral cardiopulmonary bypass. Methods Peripheral cardiopulmonary bypass was established using a multistage venous cannula inserted into the internal jugular vein and the bidirectional or a conventional arterial cannula into the femoral artery in seven adult ewes. Systemic and distal perfusion pressures and flow rates were measured during cardiopulmonary bypass with flow rat...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

The Need for Consistent Predictors of Success for Surgical Ablation of Atrial Fibrillation: A Call to Action
Conclusions The innate heterogeneity of published data precludes a meta-analysis for predictors of surgical ablation success. Of the few published studies that allow comparison, the most consistent predictors of failure were enlarged left atrium and long atrial fibrillation duration. These results underscore the need for consistent and reliable outcome predictors. We strongly recommend the development of a standardized system of measurement for consistent clinical parameters that can be used in outcome analyses for surgical ablation of atrial fibrillation. (Source: Innovations: Technology and Techniques in Cardiothoracic...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Benefits of Electromagnetic Navigational Bronchoscopy for Identifying Pulmonary Nodules for Robotic Resections
Conclusions Pleural dye marking via electromagnetic navigational bronchoscopy can provide an effective method for localizing pulmonary nodules, while maintaining a minimally invasive robotic approach. This tactic allows one to obtain diagnostic tissue more efficiently, while limiting the potential inability to localize a nodule. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Use of a New Expanded Polytetrafluoroethylene Multichordal Mitral Apparatus (MitraPatch) to Repair Complex Mitral Valve Lesions
We report a new expanded polytetrafluoroethylene multichordal mitral apparatus (MitraPatch) to simplify mitral repairs involving multiple cusps and sought to describe the surgical technique and demonstrate the efficacy of the device. Methods MitraPatch was laser cut from a single sheet of expanded polytetrafluoroethylene and mounted on a custom-designed handle. Surgical technique to deploy the apparatus on the native mitral valve was developed in ex vivo porcine hearts. Hemodynamic efficacy of repairing mitral prolapse and regurgitation was assessed in ex vivo hearts and in five 30-day chronic swine, with histopathology...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Minimally Invasive Surgical Pulmonary Embolectomy: A Potential Alternative to Conventional Sternotomy
Conclusions Minimally invasive surgical pulmonary embolectomy appears to be a feasible approach in the treatment of patients with a submassive pulmonary embolism. A larger, prospective analysis comparing this modality with conventional surgical pulmonary embolectomy may be warranted. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

VATS Plication of the Diaphragm: A Descriptive Observational 10-Year Southampton Experience
Conclusions We found minimal access VATS plication of the diaphragm to be feasible and safe, but no firm conclusions should be drawn from our limited resources. We report the feasibility of concomitant bilateral VATS plication of the diaphragm in two adults, and this was not previously reported in the adult population. There is a need for further good quality, prospective studies, and randomized controlled studies evaluating efficacy of VATS diaphragmatic plication. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Robotic Mitral Valve Repair: The Learning Curve
Conclusions Technical efficiency of robotic mitral valve repair improves with experience and permits its safe and effective conduct. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Pathways to Innovation in Cardiothoracic Surgery
No abstract available (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Presidential Address Source Type: research

2016 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 - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Editorial Source Type: research

Thank You From Innovations to Our Reviewers
No abstract available (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: Acknowledgment Source Type: research

Axial to Centrifugal Continuous Flow LVAD Pump Exchange Using Minimally Invasive Technique
We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Totally Thoracoscopic Pulmonary Vein Isolation: A Simplified Technique
Since the introduction of thoracoscopic ablation for atrial fibrillation (AF), the field of minimally invasive AF treatment has evolved toward an established treatment option for AF, with an overall 2-year antiarrhythmic drug free success rate of 77%. Complications are usually minor, and the incidence of bleeding needing conversion to sternotomy or (mini-)thoracotomy varies between 0% and 1.6%. Bleeding is often related to encircling the pulmonary veins, which is a blind maneuver that has to be done without direct camera vision. We propose here a modified surgical technique to simplify the procedure, shorten the operating ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy
This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2017 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research