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

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