Modified Tightening for Figure-of-Eight Sternal Wiring Closure
Abstract: This is a simple and quick method for the tightening of figure-of-eight wires routinely used for sternal closure. This technique gives a stable approximation, adequate reduction, and immobilization, providing higher strength and rigidity compared with conventional figure-of-eight closure. The advantage of this technique is that it tightens all the four wires equally, thus avoiding loose loops. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Thoracic Endovascular Aortic Repair in the Ascending Aorta
This article focuses on technical aspects of transapical stent graft deployment for ascending aortic pathologies. With improving device technology, diverse available stent grafts, and imaging modalities, thoracic endovascular aortic repair has become safer and holds promising potential to expand treatment options, especially for high-risk patients requiring ascending aorta treatment. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Aortic Annulus Stabilization Technique for Rapid Deployment Aortic Valve Replacement
This article describes a new technique developed to stabilize the aortic annulus and prevent paravalvular leak after RDAVR. To confirm the feasibility, this technique was performed in six patients with severe symptomatic aortic stenosis who were scheduled to undergo aortic valve replacement at our center. All patients survived surgery and were discharged from the hospital. There were no new intracardiac conduction system disturbances observed, and a permanent pacemaker implantation was not required in any of the patients. The intraoperative and postoperative echocardiogram confirmed successful positioning of the valve, and...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Extraction of Right-Sided Vegetation With Use of an Aspiration Catheter System
Abstract: Indications for surgical management of active right-sided endocarditis are under debate. In the presence of vegetation without valvular or surrounding tissue involvement, the mass may be removed with a suction device introduced via a transcatheter path. Herein, we report the successful removal of right-sided vegetation using the AngioVac Cannula, a percutaneous mechanical suction device, in three patients who presented with active endocarditis. The excellent midterm follow-up results highlight the effectiveness of such aspiration catheter systems. (Source: Innovations: Technology and Techniques in Cardiothoracic ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Endovascular Abdominal Aortic Aneurysm Repair Through a Persistent Sciatic Artery
We report the case of a 64-year-old woman with a rapidly expanding infrarenal abdominal aortic aneurysm. Preoperative computed tomography revealed a right persistent sciatic artery with an ipsilateral atrophic femoral artery. Her aortic aneurysm was successfully repaired using an endovascular approach with access through the right persistent sciatic artery and contralateral femoral artery. A persistent sciatic artery can be used as an access for endovascular treatment of an infrarenal aortic aneurysm. This technique can be extrapolated to the treatment of distal or contralateral aneurysms, precluding the need for open oper...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Importance of Full-Length Scan of Arterial Grafts in Coronary Artery Bypass Grafting
This article reports on two cases of suspected intra-arterial dissection of the left internal mammary artery despite satisfactory flow measurements. Routine ultrasound scanning of arterial conduits is helpful in distinguishing dissection and hematoma in the graft conduits. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Biologic Valve Leaflet Perforation Causing Persistent Aortic Insufficiency After Successful Transcatheter Closure of Paravalvular Leak
Abstract: Persistent paravalvular leak after aortic valve replacement prompted transcatheter closure with an Amplatzer VSD device. Although technically a successful procedure, aortic insufficiency persisted, leading to surgical reexploration and valve replacement. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Is There Any Benefit of Neuromonitoring During Descending and Thoracoabdominal Aortic Aneurysm Repair?
Conclusions: We demonstrate that MEPs are useful at predicting paraplegia in patients who lose their MEPs and do not regain them intraoperatively. To date, there is no consensus regarding the applicability and use of MEPs. Current evidence does not mandate or support MEP use. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Pretransfusion Comparison of Dialyser-Based Hemoconcentrator With Cell Saver System for Perioperative Cell Salvage
Conclusions: Dialyser-based system is economical, is equally efficacious in salvaging red blood cells, is more effective in salvaging platelets and proteins, and does not contain significant amount of free hemoglobin. Therefore, this salvaged blood can be safely transfused. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Minimally Invasive Mitral Valve Surgery in Truly High-Risk Patients: Are We Pushing the Boundaries?: An Observational Study
Conclusions: In this series of truly high-risk patients, minimally invasive mitral surgery was associated with acceptable early mortality and morbidity as well as long-term outcomes; both logistic and EuroSCORE II showed suboptimal discrimination power. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

New Approach to Exclude the Left Atrial Appendage During Minimally Invasive Cryothermic Surgical Ablation
Conclusions: The development of a reliable approach to LAA management during minimally invasive surgical ablation through right minithoracotomy has been challenging. This new approach is safe and effective and should offer a superior and consistent early and long-term solution compared with the current approach of endocardial stitch closure. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Simulated Prosthesis Overlay for Patient-Specific Planning of Transcatheter Aortic Valve Implantation Procedures
Conclusions: Three-dimensional prosthesis overlay in MDCT-derived patient data for patient-specific planning of TAVI procedures is feasible. It may improve valve selection compared with two-dimensional MDCT planning and thus yield better outcomes. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Uniportal Videothoracoscopic Surgery: Our Indications and Limits
Conclusions: Uniportal videothoracoscopic surgery has a wide range of indications: lung apex resections and pleurodesis for spontaneous pneumothorax treatment; pulmonary nodule assessment with or without preoperative localization; lung biopsy for interstitial diseases; unilateral or bilateral sympathectomy to treat hyperhidrosis; benign chest wall tumor evaluation. The limits of this technique are linked to pleural adhesions or lung nodules in difficult positions. In our experience, VATS-U results in minimal postoperative pain, allowing for fast functional recovery and a consequent short hospital stay; thus, we suggest tha...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Combined Mitral and Tricuspid Valve Surgery Performed via a Right Minithoracotomy Approach
Conclusions: In patients undergoing primary or reoperative mitral and tricuspid valve surgery, a right minithoracotomy approach is associated with a low perioperative morbidity and good midterm survival. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Retained Blood Syndrome After Cardiac Surgery: A New Look at an Old Problem
The objectives of this review were to define the clinical syndrome associated with retained blood over the spectrum of recovery and to review existing literature regarding how this may lead to complications and contributes to poor outcomes. To better understand and prevent this constellation of clinical complications, a literature review was conducted, which led us to create a new label that better defines the clinical entity we have titled retained blood syndrome. Analysis of published reports revealed that 13.8% to 22.7% of cardiac surgical patients develop one or more components of retained blood syndrome. This can pres...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Review Article Source Type: research

Editorial Board Changes
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, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Editorial Source Type: research

Sutureless Aortic Valve Replacement in the Setting of Triple-Valve Surgery
We present our surgical technique for sutureless aortic valve replacement in patients undergoing triple-valve surgery. This procedure has been performed in six patients with excellent clinical and echocardiographic results. Despite some technical concerns, sutureless aortic valve replacement in the setting of triple-valve surgery is simple and reproducible. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Minimally Invasive Transaortic Mitral Decalcification During Aortic Valve Replacement
Abstract: Mitral annular calcification accompanied by aortic stenosis is hazardous for both double-valve replacement and transcatheter aortic valve implantation. Less invasive mitral procedure is required in this condition, and minimally invasive approach may further reduce the operative risk in high-risk patients. Here, we report minimally invasive transaortic mitral decalcification during aortic valve replacement through minithoracotomy. We believe that this option is feasible in patients who are at prohibitive risk for double-valve replacement or transcatheter aortic valve implantation because of severe mitral annular c...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Novel Totally Robotic Repair of Right Ventricular Outflow Tract Obstruction
We described our successful novel surgical technique of totally robotic antegrade RVOT repair in two cases of pulmonary stenosis with concomitant repair of atrial septal defect using da Vinci SI Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA USA) with excellent surgical outcome. We conclude that robotic antegrade repair of the valvular and subvalvular subset of RVOT obstruction is feasible in adults. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Articles Source Type: research

Endoscopic Resection of a Giant Left Atrial Appendage
Abstract: A 23-year-old woman with a history of arterial hypertension presented to our institution complaining of dyspnea and chest pain. Her workup including echocardiography and magnetic resonance imaging revealed an aneurysm of the left atrial appendage. No thrombus was identified in the aneurysm or left atrial appendage, and the patient was in sinus rhythm. She was started on prophylactic anticoagulation, and surgical resection of the aneurysm was recommended as a definitive treatment of this lesion. The surgery was performed using a minimally invasive left-sided thoracoscopy approach. The entire left atrial appendage ...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Report Source Type: research

Use of the Impella 5.0 Device as a Bridge to Recovery in Adult Fulminant Viral Myocarditis
We present a case of a 48-year-old female patient successfully bridged to recovery with the Impella 5.0 microaxial pump (Abiomed, Danvers, MA USA) after presenting with cardiogenic shock secondary to acute fulminant viral myocarditis. After 1 week of flu-like symptoms, the patient presented to her community emergency department with chest pain and hypotension. A diagnosis of inferior ST elevation myocardial infarction was made; subsequent angiography demonstrated normal coronary arteries and a left ventricular ejection fraction of 10%. A provisional diagnosis of viral myocarditis was made. As her condition deteriorated fur...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

In-Graft Endovascular Stenting Repair for Supravalvular Stenosis From Aortic Rupture After Balloon-Expanding Transcatheter Aortic Valve Implantation
Abstract: An 81-year-old man with high-grade aortic valve stenosis and status post–coronary artery bypass grafting and supracoronary replacement of the ascending aorta was referred for transcatheter aortic valve implantation. He was in New York Heart Association class III and had dyspnea. After appropriate screening, we implanted a 29-mm SAPIEN XT valve (Edwards Lifesciences, Irvine, CA USA) through a transapical approach because of severe peripheral arterial occlusive disease. Postinterventional aortography revealed correct positioning and function of the valve and free coronary ostia but contrast extravasation in t...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Concurrent Minimally Invasive Aortic Valve Replacement and Coronary Artery Bypass via Limited Right Anterior Thoracotomy
Abstract: An 89-year-old man and an 80-year-old woman were treated surgically for critical aortic stenosis secondary to senile calcific aortic disease and high-grade calcified lesions in the ostium of the right coronary artery. Minimally invasive aortic valve replacement and concurrent coronary artery bypass grafting were performed concurrently through a 5-cm right anterior thoracotomy in the second intercostal space. Surgery was uncomplicated in both cases, with no adverse events. Both patients were alive and well at midterm follow-up. Concurrent minimally invasive aortic valve replacement and coronary artery bypass graft...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Fasudil Is an Effective Graft Vasodilator for Gastroepiploic Artery in Coronary Artery Bypass Grafting
Objective: The gastroepiploic artery (GEA) has been used as an alternative arterial in situ graft for coronary artery bypass grafting (CABG). However, because of the large individual differences and the spastic nature of the GEA, caution has to be exercised during harvesting. We evaluated the usefulness of fasudil, a Rho kinase inhibitor, as a vasodilator for right GEA (RGEA) graft after harvesting, compared with the conventional agents papaverine and verapamil-nitroglycerin. Methods: Between June 2009 and January 2013, 30 patients with ischemic heart disease who underwent isolated CABG using RGEA graft were randomly assig...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Early and Midterm Results of No-Touch Aorta Multivessel Small Thoracotomy Coronary Artery Bypass Grafting: A Propensity Score–Matched Study
Conclusions: The MVST CABG seems as safe as OPCABG and ONCABG and is associated with less wound infections, perioperative blood loss, shorter hospital length of stay and time to return to full physical activity. Multivessel small thoracotomy CABG can be applied to most patients with coronary heart disease saving the effectiveness during midterm follow-up. The MVST CABG can be introduced avoiding a prolonged learning curve. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Parannular Elliptical Posterior Resection: A Low-Impact Reparative Technique for Mitral Valve Prolapse
Conclusions: The parannular elliptical posterior leaflet resection, providing excellent stable midterm results, seems to be a safe alternative method for repair of PML prolapse. It avoids distortion and weakening of annulus and leaflet, and it allows restoring a proper coaptation surface and maintains a satisfactory PML motion. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Single-Center Experience With Adjustable Annuloplasty Ring in Degenerative Mitral Regurgitation
Conclusions: Further multicenter data are required to prove the concept of adjustable annuloplasty devices. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study
Conclusions: The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Transthoracic Extracorporeal Gastric Conduit Preparation for Minimally Invasive Ivor-Lewis Esophagectomy
Conclusions: Transthoracic gastric conduit preparation is a simple, minimally invasive alternative laparotomy for gastric conduit preparation during MIE. No additional incision is required. The technique may help surgeons overcome shortcomings of the laparoscopic approach without impacting perioperative risk. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Sutureless Aortic Valve Prosthesis Sizing: Estimation and Prediction Using Multidetector-Row Computed Tomography
Conclusions: Multidetector-row CT–derived estimates seem to have higher predictive value for valve size determination in patients undergoing RAMT with the Perceval S prosthesis, thus facilitating this delicate procedure and preventing the selection of wrong candidates. Possibly for precise aortic annulus measurement, contrast-enhanced MDCT is preferable. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

ISMICS Consensus Conference and Statements of Randomized Controlled Trials of Off-Pump Versus Conventional Coronary Artery Bypass Surgery
Conclusions: OPCAB compared with CCAB may improve outcomes in the short-term (stroke, renal dysfunction, blood transfusion, respiratory failure, atrial fibrillation, wound infection, ventilation time, and length of stay). However, over the longer-term, OPCAB may be associated with reduced graft patency, and increased risk of cardiac re-intervention and death. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - July 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Consensus Statement Source Type: research

Minimally Invasive Implantation of the EDWARDS INTUITY Rapid Deployment Aortic Valve Via a Right Minithoracotomy
Abstract: During the past decade, many surgeons have focused their interest on the development and improvement of minimally invasive techniques for aortic valve replacement. Although the minimally invasive approaches for the treatment of mitral valve disease have been standardized, the preferred route for aortic valve replacement remains a matter of debate. Access through a right minithoracotomy avoids opening the sternum; however, it requires a greater surgical ability and a learning period, even for experienced surgeons. This enhances the role of sutureless prostheses because these devices are associated with easier plac...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Article Source Type: research

Percutaneous Removal of Filter-Induced Iliocaval Thrombus Using the AngioVac Device
We describe the use of the AngioVac system (Angiodynamics, Latham, NY USA) for extraction of extensive iliocaval thrombus associated with an inferior vena cava filter followed by percutaneous inferior vena cava filter extraction in a patient with an absolute contraindication to thrombolysis. The AngioVac may be considered in this scenario as it does not require thrombolytics and can remove whole thrombus, thus overcoming some of the limitations of percutaneous mechanical thrombectomy devices in the setting of subacute and early chronic thrombus. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Trans-Carotid Placement of Balloon Expandable Covered Stent for Unplanned Left Carotid Coverage during Endovascular Repair of Distal Arch Aneurysm
We present a technique for endovascular management of unplanned coverage of the left common carotid artery during endovascular repair of a distal aortic arch aneurysm. A balloon expandable covered stent was placed into the proximal left common carotid artery by neck incision. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Introducer Development for Coronary Sinus Access From Parasternal Mediastinotomy
Conclusions: Parasternal mediastinotomy access to the coronary sinus for cardiac resynchronization, mitral annuloplasty, and instrumentation is feasible. Human computerized tomographic scans can be used to define curvatures and dimensions for marketed introducers. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

In Vitro Hemocompatibility Testing of Dyneema Purity Fibers in Blood Contact
Conclusions: Dyneema Purity fibers are noninferior in adhesion and coagulation activation compared with commonly used cardiovascular prostheses. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

SynCardia Portable Freedom Driver: A Single-Center Experience With 11 Patients
Conclusions: Patients with TAH-t can be considered for transfer to the portable Freedom Driver while awaiting transplantation. Issues that complicated this patient population included inadequate social support, hemodynamic instability, and concurrent morbidities. The potential benefits of the portable driver are currently undergoing assessment. These may include increased mobility and improved quality of life, opportunity for discharge home, and decreased overall medical costs. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Off-Pump Minimally Invasive Coronary Artery Bypass Grafting With a Heart Positioner: Direct Retraction for a Better Exposure
Conclusions: Most multivessel MICS CABG was feasible without pump assist even at the initiation period. This approach is easy and helpful in providing good exposure of target vessels without requirement of additional incisions. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Thoracoscopic Occlusion of the Left Atrial Appendage
Conclusions: Endoscopic AtriClip implantation appears to be a reproducible and safe method of LAA occlusion, with a minimal risk and a high efficiency. In our opinion, the AtriClip implantation is a reasonable part of thoracoscopic AF treatment and should be considered as an alternative tool for stroke risk reduction in patients with AF. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Propensity Score Adjusted Comparison of MIDCAB Versus Full Sternotomy Left Anterior Descending Artery Revascularization
Conclusions: MIDCAB was associated with a trend toward better short-term outcomes and excellent long-term results comparable to FS revascularization. According to these findings, surgeons should not be reluctant to perform MIDCAB in isolated LAD disease. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Chylothorax and Recurrent Laryngeal Nerve Injury Associated With Robotic Video-Assisted Mediastinal Lymph Node Dissection
Conclusions: RVATS MLND may be associated with increased rates of chylothorax and RLNI. Attention must be paid to identifying potential technical pitfalls with RVATS lung resections, adjusting surgical techniques accordingly, and minimizing patient morbidity. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Off-Pump Debranching and Thoracic Endovascular Aortic Repair for Aortic Arch Pathology
Conclusions: Off-pump aortic debranching with arch stenting is a reproducible procedure that could be favorable in certain situations, such as in patients with a higher operative risk profile, thereby reducing the risks associated with deep hypothermic circulatory arrest and also yielding favorable outcomes, even in an older patient cohort with more comorbidities. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Coronary Artery Bypass Grafting During Acute Coronary Syndrome: Outcomes and Comparison of Off-Pump to Conventional Coronary Artery Bypass Grafting at a Veteran Affairs Hospital
Objective: The management of acute coronary syndrome (ACS) has evolved dramatically over the last 50 years. Currently, management includes a multidisciplinary approach potentially including catheter-based therapy, surgery, or purely medical management. Where surgical therapy is indicated, data regarding long-term outcomes are limited. In particular, little data exist regarding on-pump (conventional coronary artery bypass grafting, cCABG) versus off-pump (OPCABG) outcomes for this group. Methods: A retrospective review of prospectively collected data was undertaken. Patients undergoing isolated CABG from January 2000 to Dec...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Design Concepts and Preclinical Results of a Miniaturized HeartWare Platform: The MVAD System
Conclusions: Hemocompatibility and biocompatibility of the modified MVAD System were demonstrated through pump parameters, blood chemistry panels, and histopathology analysis. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - May 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Implantation of the eSVS Mesh: Modification of Recommended Technique
Abstract: The eSVS Mesh is a knitted wire lattice manufactured in cylindrical sheaths of various diameters, designed to be placed around the outer surface of a saphenous vein graft before use in coronary surgery. The goal is to improve long-term vein graft patency by preventing expansive endothelial injury obviating neointimal hyperplasia and subsequent graft atherosclerosis. Since the First-In-Man feasibility trial of the eSVS Mesh, postmarket studies in Europe and a feasibility trial in the United States are ongoing. Consensus from the principal investigators indicated the trials had confounding variables that may impact...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: How-To-Do-It Article Source Type: research

Robotic Resection of a Superior Sulcus Neurogenic Tumor
We present a case of a 43-year-old woman with a superior sulcus neurogenic tumor impinging on the left subclavian vein, who underwent a successful resection without injury to nearby structures. We found that a robotic approach improved visualization of the tumor and nearby structures and increased instrument maneuverability relative to a thoracoscopic approach, along with less pain and recovery time compared with a thoracotomy. This experience suggests that robotics provides a promising alternative for excision of superior sulcus neurogenic tumors, which may reduce associated morbidity. (Source: Innovations: Technology and...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Novel Apical Coring Device for Apicoaortic Conduit Insertion to Treat Off-Pump Aortic Stenosis, Coronary Disease, and Lung Cancer
We report the case of a 66-year-old high-risk female patient with severe aortic stenosis as well as severely impaired left ventricular function associated with coronary artery disease involving the left anterior descending artery complicated from a severe functional mitral regurgitation in which an early-stage non–small cell carcinoma was incidentally discovered during workup. Because of the possibility of potential negative impact of cardiopulmonary bypass on the cancer prognosis and the severe impairment of systolic function of the left ventricle that impeded the treatment of lung cancer as the first step of such a...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Case Reports Source Type: research

Long-term Outcomes After Off-Pump or Conventional Coronary Artery Bypass Grafting Within a Veteran Population
Objective: Recently published data indicate that outcomes for off-pump coronary artery bypass grafting (OPCABG) may be inferior to conventional CABG (cCABG) within the Veteran population, but this has been only partly addressed within high-volume off-pump centers. Here, we seek to examine the long-term outcomes for these patients within the Veteran population at a single institution well experienced with OPCABG. Methods: With the use of a preexisting in-house database, all patients who had undergone isolated CABG from 2000 to 2011 (n = 1125) were identified. From these data, 18 demographic and risk factors were compared an...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Systemic Inflammatory Response During Cardiac Surgery: A Pilot Study
Conclusions: The use of COP-guided fluid resuscitation was associated with a significant reduction in perioperative fluid demand. However, patients prescribed to COP-guided fluid therapy did not experience a reduction in whole-body inflammation or improved surgical outcome as compared with conventional fluid management techniques. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Outcomes of Repeat Mitral Valve Surgery in Patients With Pulmonary Hypertension
Conclusions: Patients with pulmonary hypertension that undergo redo mitral valve surgery have a 55.9% 5-year survival rate. Increasing age, chronic renal insufficiency, peripheral vascular disease, and preexisting mitral valve prosthesis are associated with early mortality. The severity of pulmonary hypertension does not affect operative mortality rates, but it may decrease 1-, 3-, and 5-year survival. (Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery)
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research