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Multi-arterial Coronary Grafting
Arterial conduits, especially the internal thoracic arteries (ITAs), are rarely affected by intimal hyperplasia or atherosclerosis, major contributors to early and late vein graft failure. Improved survival and freedom from reintervention with multi-arterial grafting (MAG) are reported in large observational studies, particularly when they supply more than one anatomically important coronary territory.Several grafting configurations are possible depending on conduit and target characteristics, with the left ITA to the left anterior descending (LITA-LAD) typically being the cornerstone around which the rest of the conduits ...
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 18, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Rami Akhrass, Faisal G. Bakaeen Source Type: research

Minimally invasive temporary biventricular mechanical circulatory support
The management of biventricular heart failure presents a significant challenge. Recently, percutaneous options for univentricular support that may be combined to provide full biventricular support have come to market. These support configurations allow patients to be bridged to recovery, durable mechanical circulatory support, or to transplantation. Due to the minimally invasive nature of these systems, patients may be rapidly extubated, and some may be mobilized with full biventricular support. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 17, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Dominic Emerson Source Type: research

Introduction for Volume 26, Number 3 Autumn 2021
Bioprosthetic valve fracture (BVF) has emerged as a useful technique in valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) to reduce TAVR gradients. Allen et al. provide a step by step approach for planning and performing BVF to facilitate and reduce gradients in patients undergoing VIV-TAVR procedures. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Editorial Board
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Table of Contents
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Recent Articles in AATS Journals
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - September 1, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Surgery for Taussig-Bing anomaly with aortic arch obstruction
Taussig-Bing anomaly with aortic arch obstruction is uncommon and presents a significant technical challenge to the pediatric cardiac surgeon. Herein we describe the arterial switch operation with technical modifications appropriate to the Taussig-Bing anomaly as well as the preferred end to side arch repair. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 26, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Tyson A. Fricke, Igor E. Konstantinov, Edward Buratto, Christian P. Brizard Source Type: research

Commentary: Ross Procedure - Supporting the Gold Standard
Aortic valve replacement with a pulmonary autograft provides excellent functional results. The Ross procedure is associated with improved long-term survival compared to mechanical aortic valve replacement and is therefore the gold standard in young patients.1 However, dilatation of the sinotubular junction, and annulus can cause development of neo-aortic valve regurgitation. In particular free-standing replacement of the aortic root has been associated with an increased risk for dilatation.2 (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 25, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Antonia Schulz, Edward Buratto, Igor E. Konstantinov Tags: Congenital - Commentary Source Type: research

Half-turned truncal switch operation for transposition of the great arteries with left ventricular outflow obstruction
To address various problems with conventional surgical procedures for transposition of the great arteries with left ventricular outflow obstruction, the aortic translocation procedure has been reconsidered as an alternative surgical procedure. We developed another innovative translocation technique, the half-turned truncal switch operation, to make use of various anatomical characteristics. The truncal block involving both semilunar valves is harvested en bloc and anastomosed to the opposite ventricular outflow tract after a half-turn. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 25, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Masaaki Yamagishi Source Type: research

Commentary: Supporting the Gold Standard
Aortic valve replacement with a pulmonary autograft provides excellent functional results. The Ross procedure is associated with improved long-term survival compared to mechanical aortic valve replacement and is therefore the gold standard in young patients1. However, dilatation of the sinotubular junction and annulus can cause development of neo-aortic valve regurgitation. In particular free-standing replacement of the aortic root has been associated with an increased risk for dilatation2. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 25, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Antonia Schulz, Edward Buratto, Igor E. Konstantinov Tags: Congenital - Commentary Source Type: research

Commentary: Surgical technique and future of the Transcervical Extended Mediastinal Lymphadenectomy
Transcervical Extended Mediastinal Lymphadenectomy (TEMLA) is a demanding technique that requires surgical perfection based on the thorough knowledge of the anatomy of the mediastinum. Yendamuri and Demmy proved such proficiency in TEMLA in their article accepted for publication in the Operative Techniques in Thoracic and Cardiovascular Surgery [1]. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 16, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Zielinski Marcin Source Type: research

Minimally invasive valve surgery using high resolution (3D) scope
We describe our technique for totally endoscopic valve operation that was iteratively improved over the years. A skin incision is limited to 3-4 centimeters without the need for rib-spreading.Central Message: Totally endoscopic valve surgery can be performed minimal three-port system utilizing 3D-endoscope (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 16, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Toshiaki Ito, Soh Hosoba, Mamoru Orii, Riku Kato Source Type: research

Yasui conversion after biventricular repair in patients with left ventricular outflow tract obstruction
Surgical reintervention for progressive left ventricular outflow tract obstruction after a standard biventricular repair of aortic arch obstruction and ventricular septal defect is rare but can occur. In this situation, left ventricular outflow bypass surgery can be performed to relieve left ventricular outflow tract obstruction by creating an intraventricular baffle to channel the re-opened ventricular septal defect to the pulmonary valve, Damus-Kaye-Stansel anastomosis, and right ventricle-to-pulmonary artery connection with a valved conduit. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 15, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Toshihide Nakano Tags: Congenital Source Type: research

Atrioventricular valve repair in patients with a single ventricle: emulating the fibrous skeleton of the heart
Atrioventricular valve (AVV) dysfunction is a common cause of reoperation and morbidity in patients with atrioventricular septal defects (AVSDs). In the setting of AVSD with single ventricle physiology, the risk of AVV failure is particularly high, and repair of the common AVV in these patients is notoriously challenging. Furthermore, patients with significant residual AVV regurgitation, after attempted repair, are at particularly high risk of mortality. One of the key factors which contributes to regurgitation in patients with a common AVV is the lack of a normal fibrous skeleton of the heart. (Source: Operative Technique...
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 14, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Edward Buratto, Igor E. Konstantinov Tags: Congenital Source Type: research

Atrioventricular valve repair in patients with single ventricle: emulating the fibrous skeleton of the heart
Atrioventricular valve (AVV) dysfunction is a common cause of reoperation and morbidity in patients with atrioventricular septal defects (AVSD). In the setting of AVSD with single ventricle physiology, the risk of atrioventricular valve failure is particularly high, and repair of the common AVV in these patients is notoriously challenging. Furthermore, patients with significant residual AVV regurgitation, after attempted repair, are at particularly high risk of mortality. One of the key factors which contributes to regurgitation in patients with common AVV is the lack of a normal fibrous skeleton of the heart. (Source: Ope...
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 14, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Edward Buratto, Igor E. Konstantinov Tags: Congenital Source Type: research