Operative Techniques in Cardiac and Thoracic Surgery This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Recent Articles in AATS Journals
(Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 11, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Management of Cardiac Paragangliomas
Primary cardiac tumors are uncommon with 75% being benign and 25 % malignant. Most benign tumors are relatively easy to manage surgically. There are however, benign tumors that can present management and technical challenges for surgical care. Paraganglioma is one of these tumors. These tumors may present as cathecholamine producing tumors requiring pre-operative preparation for safe resection and tend to be large and in difficult anatomic locations to remove. This manuscript details our approach to these tumors. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 10, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Edward Y Chan, Thomas E. MacGillivray, Michael J. Reardon Source Type: research

Pitfalls in Extracardiac Conduit Fontan Technique
Optimizing Fontan blood flow dynamics is essential to attain the best early and late outcomes after the Fontan procedure. Although the extracardiac conduit is the most favored variant, recent studies have suggested it may not always carry the best outcomes. The apparent simplicity of the procedure may mask some of the technical nuances that need to be considered and addressed at the time of operation. We list the common technical pitfalls that may impact the outcomes and our recommendations for addressing them. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Michael Daley, Bill Reid, Yves d'Udekem Tags: Congenital Source Type: research

Pitfalls in Extra-Cardiac Conduit Fontan Technique
Optimising Fontan blood flow dynamics is essential to attain the best early and late outcomes after the Fontan procedure. Although the extra-cardiac conduit is the most favoured variant, recent studies have suggested it may not always carry the best outcomes. The apparent simplicity of the procedure may mask some of the technical nuances that need to be considered and addressed at the time of operation. We list the common technical pitfalls that may impact the outcomes and our recommendations for addressing them. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Michael Daley MD, Bill Reid, Yves d'Udekem Source Type: research

Isthmus Flap Aortoplasty for Repair of Long-segment Coarctation of the Aorta
Although resection with end-to-end anastomosis is currently the standard approach in the patients with coarctation of the aorta, repair for a long and narrow isthmus has been a surgical challenge. Herein, we describe a novel surgical technique including aortic isthmus reconstruction that allows for direct anastomosis without the use of foreign materials or tension-relieving procedures such as subclavian flap aortoplasty. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yoshinori Miyahara, Suguru Tarui, Kozo Ishino Source Type: research

Autotransplant and advanced techniques for extensive cardiac sarcomas
Left heart sarcomas and very complex left heart tumors may require cardiac explantation, ex vivo resection and reconstruction and re implantation of the heart - cardiac autotransplantation. Combined extensive cardiac resection and pneumonectomy may require a two-step approach - the Texas Two Step. Finally, extensive ventricular tumors may require complete cardiac replacement. Our techniques for these difficult cases are discussed in this manuscript. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - August 2, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Thomas E. McGillivray, Michael J Reardon Source Type: research

Suprasternal Access for Transcatheter Aortic Valve Replacement
Approximately 5% of patients undergoing transcatheter aortic valve replacement (TAVR) are not candidates for transfemoral (TF) access and existing alternative access strategies are imperfect. Suprasternal access is an alternative access technique where the innominate artery is cannulated from a small incision above the sternal notch. This technique provides excellent visualization of the innominate artery and the transcatheter valve can be aligned coaxially with the native aortic valve with minimal catheter angulation. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 24, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Michael I. Brener, Michael P. D'Angelo, Isaac George Source Type: research

Commentary: techniques within arm's reach
Multiple arterial revascularization (MAR) in coronary artery bypass grafting (CABG) has seen increased use1 for its mortality and morbidity benefits,2 and currently receives a IIa recommendation by the European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS). The radial artery (RA) has a ESC/EACTS Class I recommendation based on promising long-term clinical and patency outcomes.3 Dr. Mario Gaudino has contributed significantly to the current understanding of RA grafting and its ’ acceptance as an excellent conduit choice. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 21, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Mimi X. Deng, Derrick Y. Tam, Stephen E. Fremes Tags: Adult - Commentary Source Type: research

Transcervical Extended Mediastinal Lymphadenectomy (TEMLA)
Mediastinal lymph node staging is often the most important determinant of the long-term outcomes of surgical resection. In addition to determining the appropriateness of surgical resection, the “N” descriptor often determines the sequence of therapies in a multimodal treatment strategy. Historically, the gold standard for mediastinal lymph node staging was the cervical mediastinoscopy. Over the last decade, this procedure has been all but replaced with endobronchial ultrasound guided f ine needle aspiration. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 7, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Sai Yendamuri, Todd L. Demmy Tags: Thoracic Source Type: research

Commentary: Collaboration and Ambulation is King in Providing Temporary Mechanical Support in the Heart Failure Population
In this issue of Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas de Salas and colleagues beautifully describe the technique of surgical exposure and placement under fluoroscopic guidance of the Impella 5.5 percutaneous micro-axial left ventricular assist device.1 The authors provide a detailed, step by step guide for our readership as to the pre-operative workup, surgical planning, operative steps, and post-operative considerations for this procedure. The intra-operative photographs, coupled with radiographic images, anatomic roadmaps, and echocardiography still shots properly guide the car...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 3, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Amy G. Fiedler Tags: Adult - Commentary Source Type: research

Commentary: Transcatheter Tricuspid Valve Replacement: Promising Alternative to Repair but More Unknowns than Knowns
The tricuspid valve (TV) is now no longer a forgotten valve, with significant advances in the understanding of anatomy and morphology, imaging and less invasive alternatives to surgery to treat severe tricuspid regurgitation (TR). Given secondary TR accounts for a majority of cases, tricuspid repair is the mainstay therapy in surgery, most commonly in the form of a ring annuloplasty.1 The procedure is straightforward, can be done on a beating heart, and typically takes only 10-15 additional minutes of operating time. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 2, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Gilbert H.L. Tang Tags: Adult - Commentary Source Type: research

Commentary: The Ross Renaissance
In 1967, Donald Ross reported the first replacement of a diseased aortic valve with a pulmonary autograft in humans.1 More than half a century later, the Ross procedure remains the only replacement operation that allows for long-term viability of the neo-aortic root. After an initial wave of enthusiasm, the operation was largely abandoned due to its surgical complexity and concerns over durability.2, 3 By 2010, the Ross procedure had all but disappeared from the surgical menu in North America.2 The operation was kept alive by a small number of dedicated surgeons who remained faithful to the promise of a durable living subs...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 2, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Amine Mazine, Michael W.A. Chu, Mark D. Peterson, Maral Ouzounian, Canadian Thoracic Aortic Collaborative (CTAC) Tags: Adult - Commentary Source Type: research

Commentary: PEARS – Good Fruit for the Congenital Heart Surgeon?
Robicsek et al. introduced the concept of aortic wrapping in 1971 using synthetic vascular grafts.1 In 2014, Treasure reported their first cohort of 30 patients with connective tissue disease and the use of a personalized external aortic root support (PEARS).2 Unlike vascular grafts, PEARS is personalized to each patient's anatomy and has interstices that provide flexibility and importantly prevent entrapment of fluid between the graft and the aortic wall. Kenny et al. in the current report describe PEARS to stabilize the post arterial switch (ASO) aneurysmal neo-aortic root. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 2, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Ronald K. Woods Tags: Congenital - Commentary Source Type: research

Commentary: Transcarotid TAVR - Keeping It Simple!
McKiernan and colleagues1 have provided readers with a beautifully illustrated manuscript describing important technical aspects of performing transcarotid transcatheter aortic valve replacement (TAVR) which closely mimics our own experience with this technique.2,3,4 While the need for non-femoral access is declining, it remains relevant for the heart team to be comfortable with at least one non-thoracic, alternate access option. Like politics, alternate access decisions are made based on the local experience and composition of the heart team; while head-to-head trials comparing alternate access options such as transapical...
Source: Operative Techniques in Cardiac and Thoracic Surgery - July 2, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Keith B. Allen Tags: Adult - Commentary Source Type: research

Aortic sinus pouch technique for dextro-transposition of the great arteries with a single or intramural coronary artery
The clinical results of the arterial switch operation (ASO) for dextro-transposition of the great arteries (d-TGA) are less than ideal when the anomaly is associated with an unusual coronary artery pattern, such as a single coronary artery or intramural coronary artery course. We developed a novel technique to deal with d-TGA with a single coronary pattern, including variations in which all the coronary arteries arise from a single aortic sinus. In this procedure, the coronary cuff is trimmed from the aorta together with the adjacent non-coronary sinus wall and is formed into a tubular pouch, which is then anastomosed with...
Source: Operative Techniques in Cardiac and Thoracic Surgery - June 26, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yusuke Yamamoto, Koji Nomura, Sho Isobe, Fumiaki Murayama Tags: Congenital Source Type: research