Bioprosthetic Pulmonary Valve Replacement
An increasing number of patients will require pulmonary valve replacement following repair of tetralogy of Fallot. Most of these patients have a history of surgical repair with a transannular patch (i.e., pulmonary valve not preserved). Ten to twenty years after the initial repair, severe pulmonary regurgitation results in right ventricular dilation and dysfunction. There are multiple prosthetic valve options and techniques to use when performing pulmonary valve replacements. Herein, we describe our technique of bioprosthetic pulmonary valve replacement. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Yasuhiro Kotani, Shingo Kasahara Tags: Congenital Source Type: research

Valve-Sparing Neoaortic Root Replacement Post Norwood
Progressive aortic root dilatation following palliation for hypoplastic left heart syndrome has become increasingly recognized and constitutes a significant issue with potential morbidity. Although little is known about the natural history and the optimal management strategy, currently the indications and optimal timing for surgical intervention are undefined and largely due to significant associated issues, most commonly important semilunar valve regurgitation and/or compromise of the Fontan circulation due to central pulmonary artery obstruction secondary to extrinsic compression by the aneurysm. (Source: Operative Techn...
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 17, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Christian Pizarro Tags: Congenital Source Type: research

Valve-sparing neo-aortic root replacement post Norwood
Progressive aortic root dilatation following palliation for hypoplastic left heart syndrome (HLHS) has become increasingly recognized and constitutes a significant issue with potential morbidity. Although little is known about the natural history and the optimal management strategy, currently the indications and optimal timing for surgical intervention are undefined and largely due to significant associated issues, most commonly important semilunar valve regurgitation and/or compromise of the Fontan circulation due to central pulmonary artery obstruction secondary to extrinsic compression by the aneurysm. (Source: Operativ...
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 17, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Christian Pizarro Tags: Congenital Source Type: research

Introduction
Injection drug use-related infective endocarditis hospitalizations have markedly increased over the past decade. Right-sided infective endocarditis is strongly associated with intravenous drug use, and 90% of right-sided endocarditis involves the tricuspid valve. There has been an increase in the need for surgical therapy for tricuspid valve endocarditis. In this issue of Operative Techniques, Brescia and associates discuss the indications for tricuspid valve surgery for endocarditis and provide detailed description of techniques for tricuspid valve leaflet repair and augmentation. (Source: Operative Techniques in Cardiac ...
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMi: Editorial Board
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMii: Topics
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMiii: Table of Contents
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Stepwise Approach for Postlobectomy Bronchopleural Fistula
Although rare, bronchopleural fistula (BPF) following anatomic lung resection is a serious complication associated with high rates of mortality (25%-71%). Risk factors for BPF include surgical approach, neoadjuvant therapy, diabetes mellitus, and chronic obstructive pulmonary disease. As neoadjuvant treatment is increasingly being administered to patients with locally advanced lung cancer, and as more patients are being diagnosed with lung cancer at an older age —elderly patients present with a higher index of multiple comorbidities—the incidence of BPF among patients undergoing anatomic resection for lung canc...
Source: Operative Techniques in Cardiac and Thoracic Surgery - November 28, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Andrei Y. Gritsiuta, Takashi Eguchi, David R. Jones, Gaetano Rocco Tags: Thoracic Source Type: research

Benign Tracheal Esophageal Fistula
Benign acquired tracheoesophageal fistula (TEF) is a rare complication related to prolonged mechanical ventilation, esophageal and mediastinal surgeries, chest trauma, or infection. TEF should be suspected in ventilated patients with persistent air leak, recurrent pneumonias, or those with persistent cough immediately following swallowing (Ono sign). Once identified, the only definitive solution for TEF is surgical correction. In preparation for surgical repair, most opt to wean patients from the ventilator and place a percutaneous gastrostomy tube for diversion. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - November 25, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Taylor Elser, Allison Frederick, Edward Penn, William Bolton, James Stephenson, Sharon Ben-Or Tags: Thoracic Source Type: research

Pectoralis Muscle Flaps for Mediastinal Reconstruction
Post-sternotomy mediastinitis (PSM) from deep sternal wound infection (DSWI) is an infrequent but devastating complication of open-heart surgery. Historically, mortality has been reported as high as 50%. Early detection and aggressive surgical management has significantly improved outcomes. Removal of hardware and generous debridement of all necrotic tissue often results in large midline defects. In this article we describe using the pectoralis major for mediastinal reconstruction.The pectoralis major muscle is primarily fed by the internal mammary artery (IMA) and thoracoacromial artery. (Source: Operative Techniques in C...
Source: Operative Techniques in Cardiac and Thoracic Surgery - November 25, 2019 Category: Cardiovascular & Thoracic Surgery Authors: S. Nicole Rochester, William Lorenz, William Bolton, James Stephenson, Sharon Ben-Or Tags: Thoracic Source Type: research

Tricuspid Valve Leaflet Repair and Augmentation for Infective Endocarditis
Intravenous drug use has increased substantially over the past decade, with heroin abuse more than doubling. Injection drug use-related infective endocarditis hospitalizations have similarly increased over the same period. Right-sided infective endocarditis is strongly associated with intravenous drug use, and 90% of right-sided endocarditis involves the tricuspid valve. During the period of the opioid epidemic, tricuspid-related endocarditis rates have increased, while the incidence of surgery for tricuspid endocarditis has increased as much as five-fold. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - October 25, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Alexander A. Brescia, Tessa M.F. Watt, Aaron M. Williams, Matthew A. Romano, Steven F. Bolling, Michigan Mitral Research Group (MMRG) Tags: Adult Source Type: research

Chimney technique for aortic arch repair in the Norwood operation
Aortic arch repair is an important technical element in the Norwood operation for hypoplastic left heart syndrome that could adversely affect long-term results. Therefore, there are many controversies surrounding this procedure. We developed an alternative chimney technique for aortic arch repair without any supplemental materials. Both pulmonary branch orifices were resected en bloc from the posterior wall of the pulmonary trunk. The pulmonary defect was closed by longitudinal direct anastomosis. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - October 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Masaaki Yamagishi Source Type: research

Operative Technique in Pulmonary Thromboendarterectomy
Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease, which predominantly results from recurrent or incomplete resolution of pulmonary embolism.1 The thromboembolic material undergoes fibrotic transformation, causing mechanical obstruction of the pulmonary arteries.2 Such obstruction leads to increased pulmonary vascular resistance (PVR) and pulmonary vascular remodeling, which subsequently results in progressive pulmonary hypertension (PH) and right ventricular (RV) systolic failure. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - October 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Yan K. Gernhofer, Victor Pretorius Source Type: research

Frozen Elephant Trunk Procedure
Aortic arch pathology including aneurysm and dissection poses a significant technical challenge to operative repair, often requiring two-stage repair via sternotomy followed by left thoracotomy. The traditional elephant trunk procedure was developed to facilitate this two-stage approach. With wide adoption of thoracic endovascular aortic repair (TEVAR) emerged the “frozen elephant trunk” (FET) technique, which uses antegrade deployment of TEVAR endografts along with total arch replacement to accomplish a one-stage repair of complex aortic arch pathology. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - October 22, 2019 Category: Cardiovascular & Thoracic Surgery Authors: George J. Arnaoutakis, Tomas D. Martin, Thomas M. Beaver Source Type: research

Introduction
In the last decades, mortality and morbidity related to acute aortic type A dissection significantly decreased based on technological progression and improved patient care. Better awareness of this disease allows quicker diagnostic processes and referral to high volume centers able to deal with the most complicated cases. Consequently, surgeons are treating higher numbers of high-risk patients with attention to optimal management of the aortic arch and the descending thoracic aorta to reduce reinterventions and delayed aorta-related mortality. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - October 16, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Extracorporeal Cardiopulmonary Resuscitation (ECPR): Initiation and Surgical Technique in the Pediatric Population.
Surgical outcomes in the field of congenital heart surgery have dramatically improved over the last several decades. This success has led to sicker and more complex children presenting for major corrective surgery. Extracorporeal cardiopulmonary resuscitation (ECPR) in a form of mechanical circulatory support that has become an integral service of most congenital heart programs. The concept of ECPR is essentially the rapid and effective initiation of extracorporeal membrane oxygenation (ECMO), usually at the bedside and often on an infant who has just undergone repair of a complex congenital heart defect. (Source: Operativ...
Source: Operative Techniques in Cardiac and Thoracic Surgery - October 14, 2019 Category: Cardiovascular & Thoracic Surgery Authors: James D. St. Louis, Mark D. Plunkett Tags: Congenital Source Type: research

Venoarterial Extracorporeal Membrane Oxygenation Neck Cannulation: A Fixation Strategy Without Tourniquets
Extracorporeal corporeal membrane oxygenation has been used for circulatory and respiratory support in pediatric heart centers for over 40 years and, in the last 2 decades, this support has been extended into adult institutions. Pediatric heart centers should maintain a high level of expertise to manage this support modality. When initiating extracorporeal corporeal membrane oxygenation support, central and peripheral can be utilized. In adult patients, femoral vessels are commonly used for peripheral cannulation. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 30, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Michiaki Imamura, Christopher A. Caldarone Tags: Congenital Source Type: research

Venoarterial Extracorporeal Membrane Oxygeneation Neck Cannulation: A fixation strategy without tourniquets
Extracorporeal corporeal membrane oxygenation (ECMO) has been used for circulatory and respiratory support in pediatric heart centers for over forty years and, in the last two decades, this support has been extended into adult institutions. Pediatric heart centers should maintain a high level of expertise to manage this support modality. When initiating ECMO support, central and peripheral can be utilized. In adult patients, femoral vessels are commonly used for peripheral cannulation. In contrast, peripheral cannulation in pediatric patients commonly utilizes the neck vessels. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 30, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Michiaki Imamura, Christopher A. Caldarone Tags: Congenital Source Type: research

Complex Pulmonary Artery Reconstruction
(PAR) evolved through our long-term clinical experience in the surgical management of patients with major aortopulmonary collateral arteries (MAPCAs). A midline sternotomy approach, utilizing novel techniques for exposure and mobilization, enables access to the distal pulmonary artery tree to the segmental and sub-segmental levels. This allows reconstructive procedures to address both discrete stenoses and areas of long-segment hypoplasia, to reduce pulmonary hypertension and improve and/or preserve right ventricular function. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 25, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Michael Ma, Olaf Reinhartz, Richard D. Mainwaring, Frank L. Hanley Tags: Congenital Source Type: research

Cardiac Transplantation After HeartMate 3 Implantation Inclusive Implantation Tips: Step by Step
Heart transplantation is still the primary surgical treatment for end-stage heart failure. Due to limited donor heart availability, alternative and improved strategies are required. The tremendous developments in the field of active left ventricular assist devices (LVADs) have resulted in increased usage of LVADs as a bridge to transplant strategy and pose a technical challenge for LVAD preparation and removal during heart transplantation. The HeartMate 3 is the latest generation of fully magnetically levitated centrifugal left ventricular assist device and can be completely intrapericardially implanted in many different c...
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 13, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Jens Garbade, Anna L. Meyer Tags: Transplant Source Type: research

Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas
Heart transplantation is still the primary surgical treatment for end-stage heart failure. Due to limited donor heart availability, alternative and improved strategies are required. The tremendous developments in the field of active left ventricular assist devices (LVADs) have resulted in increased usage of LVADs as a bridge to transplant strategy and pose a technical challenge for LVAD preparation and removal during heart transplantation. The HeartMate 3 is the latest generation of fully magnetically levitated centrifugal left ventricular assist device and can be completely intrapericardially implanted in many different c...
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 13, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Jens Garbade, Anna L. Meyer Tags: Transplant Source Type: research

Introduction
Aortic surgery is still one of the most challenging and interesting field of cardiac surgery, especially in terms of technical progression and outcome improvements. While in the past extensive diseases of the aorta were only partially treated, nowadays patients suffering from degenerative aneurysm or aortic dissection routinely undergo surgery. The introduction of the traditional elephant trunk technique allowed for an easier second stage procedure via left thoracotomy. However, a big step was made with the introduction of hybrid prostheses and the development of the frozen elephant trunk approach. (Source: Operative Techn...
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMi: Editorial Board
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMii: Topics
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMiii Table of Contents
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heart Transplantation for Congenital Heart Disease
Heart transplantation for children with congenital heart disease is a challenging procedure that requires significant pre-operative planning and occasionally some intra-operative ingenuity. Failed single ventricle palliation has become the most common indication for heart transplantation in the diagnostic group of congenital heart disease. Reconstructive procedures in addition to the transplant procedure itself are often necessary, particularly in patients with single ventricle anomalies. Situs inversus with dextrocardia is probably the most challenging diagnosis for transplantation. (Source: Operative Techniques in Cardia...
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 21, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Charles B. Huddleston, Samuel Richey, Andrew C. Fiore Tags: Congenital Source Type: research

Introduction
Diseases affecting the thoracic aorta demonstrated a constant increase over the past decades, leading to a higher number of patients undergoing surgery for this pathology. Thanks to the technological progression, the improvement in cerebral protection techniques and the development of new grafts for aortic arch replacement, a higher number of patients requiring aortic surgery can be treated nowadays with good outcomes. Nevertheless, cerebral protection and stroke prevention is still a matter of discussion, especially in high-risk patients. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 16, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Beatrice Mendez Source Type: research

SURGICAL MANAGEMENT OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT AND MAJOR AORTOPULMONARY COLLATERAL ARTERIES: Part II —Midline unifocalization and Unifocalization revision
Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs) is a rare and heterogeneous form of congenital heart disease. Despite improvements in the surgical management of this disease, there is still an ongoing controversy regarding the optimal treatment. Part II of this paper will focus on the surgical results of unifocalization and the need and techniques used for unifocalization revision at Stanford University. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 21, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Richard D. Mainwaring, William L. Patrick, Frank L. Hanley Tags: Congenital Source Type: research

Neopulmonary Stenosis After Arterial Switch
The most common long-term complication following arterial switch is supravalvar neopulmonary stenosis. Balloon dilatation has not been effective in treating this problem since the stenosis is often found at multiple levels which will require complex surgical interventions. These include patch augmentation of the supravalvar apparatus, patch augmentation of the distal main and branch pulmonary arteries, and subvalvar muscular resection as needed. The surgical considerations to avoid and treat supravalvar neopulmonary stenosis are: (1) prevention at the time of arterial switch by the use of a pantaloon autologous pericardial...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 20, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Constantine Mavroudis Tags: Adult Source Type: research

Neo-Pulmonary Stenosis after Arterial Switch
The most common long-term complication following arterial switch is supravalvar neo-pulmonary stenosis. Balloon dilatation has not been effective in treating this problem since the stenosis is often found at multiple levels which will require complex surgical interventions. These include patch augmentation of the supravalvar apparatus, patch augmentation of the distal main and branch pulmonary arteries, and subvalvar muscular resection as needed. The surgical considerations to avoid and treat supravalvar neopulmonary stenosis are: (1) prevention at the time of arterial switch by the use of a pantaloon autologous pericardia...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 20, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Constantine Mavroudis Tags: Adult Source Type: research

Introduction
Leiomyoma of the esophagus often become symptomatic necessitating their removal. As tools and technique progress, endoscopic techniques are being applied to progressively more complicated esophageal pathologies. As one of the pioneers in this technique, building on his extensive PEOM experience, Lee Swanstrom and his co-authors describe the steps and pitfalls in the endoscopic resection of submucosal leiomyomas. This technique is truly innovative, as the entire operation can be performed endoscopically, avoiding skin incisions as well as the recovery associated with the standard approach to this pathology. (Source: Operati...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 18, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Dr. Beatrice Mendez Source Type: research

SURGICAL MANAGEMENT OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT AND MAJOR AORTOPULMONARY COLLATERAL ARTERIES: Part I —Anatomy, Physiology, and Palliative procedures
Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs) is a relatively rare and extremely heterogeneous form of congenital heart disease. Despite vast improvements in the surgical management of this disease, there is still an ongoing controversy regarding the optimal treatment. The purpose of this paper is to summarize the surgical algorithm and experience at Stanford University. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 11, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Richard D. Mainwaring, William L. Patrick, Frank L. Hanley Tags: Congenital Source Type: research

The Surgical Treatment of Atrial Fibrillation via Median Sternotomy
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States and remains a major cause of significant morbidity and mortality. Current treatment options include medical management, catheter ablation, and surgical techniques, which have been improved over the past decades through surgical innovation and advancement in instrumentation. The gold-standard of surgical treatment for AF is the Cox-Maze procedure (CMP). First introduced clinically in 1987, the procedure used multiple incisions in the left and right atria to eliminate AF. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 9, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Robert M. MacGregor, Ali J. Khiabani, Ralph J. Damiano Source Type: research

Distal Extent of Surgery for Acute Type A Aortic Dissection
Acute type A aortic dissection (TAAD) is a complex disease associated with extremely high morbidity and mortality for which we advocate a coordinated, protocol-driven system of care delivery that begins at patient diagnosis and continues throughout and beyond aortic reconstruction. Essential components of TAAD repair include prompt restoration of true lumen blood flow with obliteration of the false lumen flow, resection of the primary tear sites, restoration of valvular competency, and elimination of any organ malperfusion. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Keith A. Dufendach, Ibrahim Sultan, Thomas G. Gleason Tags: Adult Source Type: research

Aortic Arch Replacement with a Trifurcated Graft
The critical consideration in approaching aortic arch (AA) surgery is how best to protect the brain while providing surgical access to the cerebral vessels. Between 1999 – 2016, 285 patients underwent aortic arch replacement using the trifurcated graft technique, with 7.4% mortality (hospital/30 day). Neurologic outcomes included 5.1% temporary neurologic deficits, 3.9% permanent neurologic deficits and no spinal cord injury. The trifurcated graft technique addres ses the two most important aspects of cerebral protection: minimizing cerebral ischemia and preventing cerebral embolization of air and atheromatous debris...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 4, 2019 Category: Cardiovascular & Thoracic Surgery Authors: David Spielvogel, Joshua B. Goldberg, Masashi Kai, Ramin Malekan, Steven L. Lansman Tags: Adult Source Type: research

Rehabilitation of pulmonary arteries in pulmonary atresia, VSD and Mapcas
Patients with pulmonary atresia, VSD and Major Aorto Pulmonary Collateral Arteries (Mapcas) have a lung circulation depending primarily from perfusion by collateral arteries. A large proportion of them will have central pulmonary vessels connected to a variable proportion of segmental pulmonary vessels. A strategy of rehabilitation of central pulmonary vessels consist in the realisation of shunts and conduits between the aorta or the right ventricle and these central vessels in order to obtain a dilatation of these vessels to assist the reconstruction of a pulmonary vascularisation. (Source: Operative Techniques in Cardiac...
Source: Operative Techniques in Cardiac and Thoracic Surgery - June 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Yves d'Udekem Tags: Congenital Source Type: research

Per-oral Excision of Benign Tumors of the Esophagus
Benign lesions of the esophagus pose a therapeutic challenge as their resection can sometimes involve technically challenging and somewhat morbid operations. Flexible endoscopic approaches offer a less invasive approach and, if approached correctly, even larger esophageal masses can be resected. Here we describe in detail an advanced endoscopic technique for approaching larger benign esophageal masses, in this case a leiomyoma. This approach entails a submucosal tunneling technique with circumferential and transmural mobilization of the mass and extraction through the submucosal tunnel with endoscopic closure of the mucoso...
Source: Operative Techniques in Cardiac and Thoracic Surgery - June 4, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kelly R. Haisley, Michael A. Antiporda, Kevin M. Reavis, Lee L. Swanstr öm Tags: Thoracic Source Type: research

FMi: Editorial Board
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - June 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMii: Topics
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - June 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMiv: Table of Contents
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - June 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Minimally Invasive Pectus Excavatum Repair (MIRPE)
Pectus excavatum (PE) involves the inward deformity of the sternum and accompanying cartilage attachments. Compression of the right heart and lungs can cause cardiopulmonary disability. Surgical correction is recommended for severe, symptomatic cases. Pectus excavatum can be corrected with a minimally invasive technique that involves placing temporary intrathoracic support bars under the sternum. These bars are then removed after 2-3 years. The minimally invasive Nuss procedure is the standard of care for PE repair in children and adolescents. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - May 28, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Dawn E. Jaroszewski, Cristine S. Velazco Tags: Congenital Source Type: research

Introduction
One of the most interesting fields of research and development in cardiac surgery is focusing on aortic diseases with special attention to valve sparing approaches and aortic valve repair techniques. Since the introduction of the first valve sparing procedure for the treatment of root aneurysms with pliable bicuspid or tricuspid aortic cusps, several approaches have been described and applied in a wide spectrum of diseases and patients, including the youngest ones. The main reason for this growing interest lays in the fact that the preservation of a native valve can guarantee a better quality of life and fewer valve-relate...
Source: Operative Techniques in Cardiac and Thoracic Surgery - May 7, 2019 Category: Cardiovascular & Thoracic Surgery Authors: David Allen Source Type: research

Transcatheter Double Valve Replacement of an Aortic and Mitral Valve in the Native Annulus
Surgical techniques for valve replacement have evolved substantially over time, from open sternotomy approaches to minimally invasive cardiac surgery to robotic procedures. However, all techniques involve incisions and can never be less invasive than percutaneous technology. In recent years, significant advancement in percutaneous technology became widely available for percutaneous valve replacement. This is most evident in transcatheter Aortic valve replacement surpassing open AVR beginning of 2016. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - May 2, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Firas Zahr, Olivia Atari, Phillip A. Horwitz, Mohammad Bashir Tags: Adult Source Type: research

Subxiphoid Minimally Invasive Epicardial Ablation (Convergent Procedure) with Left Thoracoscopic Closure of the Left Atrial Appendage
Invasive interventions for atrial fibrillation have advanced considerably since the advent of the first Cox-Maze operation.1,2 The development of catheter based endocardial ablation represented a significant shift in the treatment of atrial fibrillation. Advances in ablation technology energy sources and techniques have improved both surgical and catheter treatment outcomes. Minimally invasive surgical approaches have also incrementally decreased the morbidity associated with such procedures.3 Paroxysmal atrial fibrillation is usually well controlled with pulmonary vein isolation, and catheter based ablation alone is often...
Source: Operative Techniques in Cardiac and Thoracic Surgery - April 30, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Lawrence S. Lee Tags: Adult Source Type: research

Simplified mitral valve repair in pediatric patients with connective tissue disorders
Congenital cardiac surgeons are rarely called upon to correct severe mitral valve regurgitation (MR) in pediatric patients with connective tissue disorders (CTD). Patients in this relatively uncommon diagnostic group will present in childhood with aortic root enlargement, MR, or both. Severe MR is the typical mode of early clinical presentation of patients with infantile Marfan Syndrome (MFS), and can be associated with failure to thrive, pulmonary hypertension, congestive heart failure and ventilator-dependence. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - April 3, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Luca A. Vricella, Duke E. Cameron Source Type: research

Aortic Root Remodeling
Valve-preserving aortic root replacement has become an attractive alternative to composite replacement leading to better quality of life and minimal valve-related complications. Root remodeling requires less surgical dissection and has been shown to lead to more physiological hemodynamics compared to valve reimplantation.Over the last 2 decades, improvements have been made regarding assessment of cusp and root configuration. Aggressive correction of cusp prolapse extended the application of root remodeling to a larger patient population and has markedly improved valve stability, even in patients with connective tissue diso...
Source: Operative Techniques in Cardiac and Thoracic Surgery - March 28, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Ulrich Schneider, Hans-Joachim Sch äfers Tags: Adult Source Type: research

Introduction
In addition to coronary and peripheral artery diseases, aortic diseases contribute to the wide spectrum of arterial diseases with entities such as chronic aortic aneurysms or acute aortic syndromes and dissections. The main goal of their surgical treatment must address the problem of restoring the normal dimension of the ascending aorta through the resection of the diseased aorta and the implantation of a prosthetic graft. The diseases involving the aortic root are commonly treated using the techniques described by Bentall and De Bono or David and Feindel. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - March 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMi: Editorial board
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - March 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMii: Topics
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - March 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

FMiii: Table of Contents
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - March 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research