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Robotic Tracheobronchoplasty: Technique
Tracheobronchomalacia (TBM) is a chronic condition characterized by weakening of the tracheobronchial cartilage that may cause excessive dynamic airway collapse (EDAC) of the posterior membranous wall particularly during expiration (1-2). This pathologic collapse produces mechanical outflow obstruction leading to symptoms such as chronic intractable cough, dyspnea, increased sputum production and inability to clear secretions (1-3). These typical symptoms of TBM predispose the patient to recurrent respiratory infections and can severely affect a patient's quality of life (1-3). (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - February 12, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Richard Lazzaro, Donna Bahroloomi, Gregory Wasserman, Byron Patton Tags: Thoracic Source Type: research

Techniques of Minimally Invasive Posterior Basal (S10) Segmentectomies of the Lower Lobes
Now, the standard treatment for clinical stage I non-small cell lung cancer (NSCLC) is lobectomy with systematic nodal dissection. Sublobar resections, such as segmentectomy and wedge resection are often performed in compromised patients with peripheral small-sized NSCLC who are unfit or at high risk for standard lobectomy or even in those with indolent NSCLC who are fit for lobectomy. Anatomical segmentectomy rather than non-anatomical wedge resection as sublobar resection is usually recommended. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 31, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Yasuhiro Tsutani, Morihito Okada Source Type: research

Robot-Assisted Laparoscopic Diaphragm Plication
Though their etiology and pathology are distinct, the treatment of symptomatic diaphragm eventration and paralysis is the same – diaphragm plication. Though there is little data to objectively compare plication techniques, all offer significant improvement in symptoms, pulmonary function, and respiratory quality-of-life scores. Nonetheless, potential advantages of a robot assisted laparoscopic approach to plication includ e lower morbidity than thoracotomy and laparotomy techniques; avoidance of single lung ventilation, less intercostal nerve pain, and greater working domain compared with thoracotomy and thoracoscopic ap...
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 30, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Valerie X. Du, Shawn S. Groth Source Type: research

A Simplified Approach Step-by-Step with Pearls and Pitfalls for Minimally Invasive Mitral Valve Surgery (Non-redo)
Minimally invasive mitral valve surgery was introduced in Europe and the United States in the late 1990's. There has been a low, but increasing adoption rate in the United States. The low adoption rate is likely secondary to the lack of formalized training during cardiothoracic surgery residency and a culture that has failed to accept the procedure. In this manuscript, we provide a detailed, step-by-step guide to minimally invasive mitral valve surgery via a limited right thoracotomy. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 24, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Mario Castillo-Sang, Tom C. Nguyen Tags: Adult Source Type: research

"A Simplified Approach Step-by-Step with Pearls and Pitfalls for Minimally Invasive Mitral Valve Surgery (Non-redo)"
Minimally invasive mitral valve surgery was introduced in Europe and the United States in the late 1990 ’s. The limited right thoracotomy approach has been the most widely adopted throughout the world. Despite ample data showing minimally invasive mitral valve surgery is safe achieving durable repairs, its adoption in the US remains low at 25% (1) while European countries like Germany have over 50% adoption rate for isolated mitral valve (2). The low adoption rate is likely secondary to the lack of formalized training during cardiothoracic surgery residency and a culture that has failed to accept the procedure. (Source: ...
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 24, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Mario Castillo-Sang, Tom C. Nguyen Tags: Adult Source Type: research

Pleural Tents and Pleural Space Reduction Techniques
This article describes the step by step technique to create a pleural tent after a videothoracoscopic upper lobectomy. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 20, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Michael R. Gooseman, Alessandro Brunelli Tags: Thoracic Source Type: research

Thoracoabdominal Aneurysms —Operative Steps for Crawford Extent II Repair
Open surgical repair remains the gold standard for treatment of thoracoabdominal aortic aneurysms (TAAA), aiming to replace the whole length of the diseased distal aorta while protecting the spinal cord and visceral organs to limit ischemia-related complications. This surgery carries significant risks, including death, paraplegia, renal failure requiring permanent dialysis and respiratory complications leading to prolonged ICU stay, but these still outweigh the natural history of TAAA with conservative treatment. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ana Lopez-Marco, Benjamin Adams, Aung Ye Oo Tags: Adult Source Type: research

Total aortic arch replacements with a 4 branched Frozen Elephant Trunk (FET) Graft in Acute aortic dissection (DeBakey type I).
The frozen elephant trunk (FET) technique was developed by Karck and colleagues [1], who modified Borst's ET technique[2] by using a stent graft to secure the distal ET section. Working in collaboration with Vascutek Terumo, we in Hannover Medical School introduced the 4-branched hybrid FET graft In 2012 (Thoraflex Hybrid)[3, 4]. However, the results after open aortic arch repair mainly depend on peri-operative management and patient factors. Over the years, peri-operative management and operative techniques have evolved greatly contributing to better results. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Malakh Shrestha, Erik Beckmann, Tim Kaufeld, Axel Haverich, Andreas Martens Tags: Adult Source Type: research

Thoracoabdominal Aneurysms - Operative steps for Crawford Extent II Repair
Open surgical repair remains the gold standard for treatment of thoracoabdominal aortic aneurysms (TAAA), aiming to replace the whole length of the diseased distal aorta while protecting the spinal cord and visceral organs to limit ischemia-related complications.This surgery carries significant risks, including death, paraplegia, renal failure requiring permanent dialysis and respiratory complications leading to prolonged ICU stay, but these still outweigh the natural history of TAAA with conservative treatment. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ana Lopez-Marco, Benjamin Adams, Aung Ye Oo Tags: Adult Source Type: research

Commentary: Uniportal VATS is here to stay
Uniportal VATS (video-assisted thoracoscopic surgery) is here to stay. This is what we believe is the final message from the careful and detailed description of uniportal VATS (uniVATS) lobectomy by Dr. Paradela de la Morena and colleagues.1 It is a sentence that encapsulates the years of struggle to advance awareness of a surgical approach that is destined to become an accepted tool in the armamentarium of modern thoracic surgeons.2,3 Dr. Gonzalez-Rivas and the group from A Coru a pioneered and developed the use of uniVATS for anatomic pulmonary resections,4,5 and their meticulous description of uniVATS right upper lobec...
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Facundo Iriarte, Gaetano Rocco Tags: Thoracic - Commentary Source Type: research

Illustrated technique of Branch-First total aortic arch replacement
We describe the branch-first technique for aortic arch replacement using a trifurcation graft with a side perfusion port (TAPP). It simplifies the delivery of continuous antegrade cerebral perfusion, and takes advantage of intracranial and extracranial networks to augment contralateral cerebral perfusion. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 29, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Michelle Kim, George Matalanis Source Type: research

Illustrated technique of “Branch-First” total aortic arch replacement
We describe the branch-first technique for aortic arch replacement using a trifurcation graft with a side perfusion port (TAPP). It simplifies the delivery of continuous antegrade cerebral perfusion, and takes advantage of intracranial and extracranial networks to augment contralateral cerebral perfusion. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 29, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Michelle Kim, George Matalanis Source Type: research

Rigid plate fixation for sternal closure
Median sternotomy provides standard access in cardiac surgery. Sternal closure traditionally involves use of stainless steel wires with satisfactory results. Fixation of sternum using titanium plates with screws has been used in some institutions over the last two decades. This technique uses sternal wires in combination with a rigid plate fixation system. The wires are passed at the manubrium and xiphoid to help with approximation, while plates are used to fix the body of the sternum. The screws are passed through the outer table and penetrate the inner table of the sternum. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 27, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Pankaj Saxena, Jaishankar Raman Source Type: research

Atrioventricular Valve Repair in Patients with Univentricular Circulation
Atrioventricular valve (AVV) disease remains a challenge in the management of patients with congenital heart disease, particularly those with single ventricle palliation. Within this group, atrioventricular valve (AVV) disease remains the Achilles heel of long-term successful palliation. In recent years we have learned how AVV pathology is detrimental to late survival, as well as how challenging it can be to obtain a competent and durable repair. In this expert review we outline strategies for AVV repair depending on AVV morphology: mitral, tricuspid, or common atrioventricular valve. (Source: Operative Techniques in Cardi...
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 16, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Elizabeth H. Stephens, Joseph A. Dearani Tags: Congenital Source Type: research

Commentary: time to set new standards for coronary bypass surgery?
CENTRAL MESSAGE: If the superiority of multi-arterial grafting is confirmed in randomized clinical trials, the cardiac surgical community might have to change the practice of their most common procedure. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 16, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Piero Farina, Mario Gaudino Source Type: research