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Commentary: The Value Of Great Tools And Strategy
We read with great interest the recent article by Overbey and colleagues.1 Norwood operation is the palliative procedure for patients with hypoplastic left heart syndrome and its variants. Unfortunately, regardless of the improvement of the surgical technique and strategy, patients still face considerable morbidity and mortality. It is well known that, in part, the mortality and morbidity are associated with prolonged periods of myocardial and lower body ischemia, when total all-regional perfusion strategy is not applied, particularly, in patients who had associated intracardiac or extracardiac anomalies that require conco...
Source: Operative Techniques in Cardiac and Thoracic Surgery - February 10, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Igor E. Konstantinov Tags: Congenital - Commentary Source Type: research

Commentary: The value of great tools and strategy.
We read with great interest the recent article by Overbey and colleagues1. Norwood operation is the only palliative procedure for patients with hypoplastic left heart syndrome and its variants. Unfortunately, regardless of Fig. 1 the improvement of the surgical technique and strategy, patients still face considerable morbidity and mortality. It is well known that part of the mortality and morbidity is associated with prolonged periods of myocardial, and lower body ischemia, when total all-regional perfusion strategy is not applied, particularly, in patients who had associated intracardiac or extracardiac anomalies that req...
Source: Operative Techniques in Cardiac and Thoracic Surgery - February 10, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Igor E. Konstantinov, Bosco Moscoso Source Type: research

Per Oral Endoscopic Myotomy: Technique and Tricks for Challenging Anatomy
This article describes the series of steps along with tips and suggested solutions to performing a POEM in patients with achalasia. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 1, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Brian E. Louie Tags: Thoracic Source Type: research

Per Oral Endoscopic Myotomy (POEM): Technique and Tricks for Challenging Anatomy
This article describes the series of steps along with tips and suggested solutions to performing a POEM in patients with achalasia. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 1, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Brian E. Louie Tags: Thoracic Source Type: research

A Novel Approach for Simultaneous Venoarterial Extracorporeal Membrane Oxygenation and Left Ventricular Decompression Therapy with Impella (ECPella)
Percutaneously placed veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is commonly used to support patients with refractory cardiac arrhythmias or arrest and worsening cardiogenic shock (CS). Peripheral VA-ECMO by retrograde flow of blood in the aorta results in a significant increase in left ventricle (LV) afterload. A severely dysfunctional LV may be unable to overcome this afterload to open the aortic valve and unload itself. This may lead to LV distension, increased left ventricular pressure, poor coronary blood circulation, increased left atrial pressures, pulmonary edema, and pulmonary hypertension. (Sourc...
Source: Operative Techniques in Cardiac and Thoracic Surgery - January 1, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Breah Paciotti, Pankaj Garg, James Postier, Amy Lykins, Basar Sareyyupoglu Tags: Adult Source Type: research

Robotic-Assisted Transthoracic Diaphragm Plication
Diaphragm dysfunction, either from congenital eventration or acquired paralysis, impairs the ability of the diaphragm to contract, thereby disrupting normal respiratory mechanics. While a proportion of patients will present with respiratory insufficiency or symptoms of dyspnea, the majority of patients are asymptomatic and most cases are identified incidentally on chest imaging by the presence of an elevated hemidiaphragm. In symptomatic patients, surgical plication of the diaphragm remains the gold standard treatment. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 28, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Anna K Gergen, Christina M Stuart, Brandon M Wojcik, Robert A Meguid, Christopher D. Scott Tags: Thoracic Source Type: research

Transatrial approach to the “Swiss-cheese” ventricular septal defects: re-endocardialization technique
Surgical management of “Swiss-cheese” multiple ventricular septal defects (mVSD) poses significant challenges. Many surgical approaches have been proposed, including staged approach with initial pulmonary artery banding,1 intraoperative or transcatheter device closure,2 definitive surgical repair, or hybrid approach. Conventional surgical technique involves patch closure utilizing a relatively large patch to cover the affected ventricular septum.3 Although intuitive, patch repair carries risk of postoperative septal dyskinesis, and high rate of conduction block,4 particularly in the more severe entity of “Swis s-chee...
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 28, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Osami Honjo, Mimi Xiaoming Deng Tags: Congenital Source Type: research

Simple but Effective Modifications to the Cox Maze Procedure Using Only Cryoablation
We describe an effective and practical approach for concomitant ablation that we use in 100% of mitral surgery patients with a history of atrial fibrillation. There are three steps. First the left atrial appendage is closed with a Clip with is highly effective and electrically isolates it. Second, 3 cryoablation lines are used to recreate the key Cox-Maze III lesion set with a total of 8 minutes of ablation time. In some patients, usually with tricuspid regurgitation, 3 right atrial ablations are placed with 6 minutes of ablation time. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 26, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Patrick M. McCarthy Source Type: research

Commentary: Right Upper Lobe Segmentectomies : A Game of Details
Many factors lead to the current dissemination and adoption of segmentectomy, including the development of dedicated instruments and technical expertise, an evolving understanding of pathologic subtypes and their clinical behavior, advanced concepts in medical imaging such as radiomics, and certainly the increasing proportion of frail and comorbid patients with multiple nodules. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 6, 2023 Category: Cardiovascular & Thoracic Surgery Authors: George Rakovich Tags: Thoracic - Commentary Source Type: research

Commentary: Right upper lobe segmentectomies : a game of details.
Central picture and figures are original artwork by Kathy Hernandez, Technicienne en arts graphiques, DERI, Service des techniques audiovisuelles, CIUSSS de l'Est-de-l' Île-de-Montréal (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 6, 2023 Category: Cardiovascular & Thoracic Surgery Authors: George Rakovich Tags: Thoracic - Commentary Source Type: research

How He Did It – The James S. Tweddell Approach to Single Ventricle Palliation in Patients with Hypoplastic Left Heart Syndrome
Prior to the inception of the single ventricle palliation (SVP), patients born with hypoplastic left heart syndrome (HLHS) accounted for 25% of the congenital cardiac disease deaths occurring within the first week of life [1]. Without treatment, HLHS is uniformly fatal. Dr. Donald Doty and colleagues first reported palliation attempts for patients with HLHS in 1977 [2], followed by Dr. William Norwood and colleagues in 1980 [3]. While the first attempts were unsuccessful, Dr. Norwood first reported successful palliative attempts in 1983 [4] which revolutionized the treatment of patients suffering from HLHS. (Source: Operat...
Source: Operative Techniques in Cardiac and Thoracic Surgery - December 4, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Alan P O'Donnell, David G Lehenbauer Tags: Congenital Source Type: research

Introduction to Winter 2023
Kitamura et al. revives a “forgotten” technique of central cannulation for acute type A aortic dissection. The naming is interesting, coming from Japanese surgeons. Samurai is known to perform “harakiri” or “seppuku”, the ceremonial disembowelment by self-inflicting transection of the belly (and abdominal aorta) with a blade. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - November 29, 2023 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 - November 29, 2023 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 - November 29, 2023 Category: Cardiovascular & Thoracic Surgery Source Type: research

Norwood-Sano procedure with neo-aortic valve repair on the beating heart
Norwood operation for patients with hypoplastic left heart syndrome or its variants may be associated with prolonged period of myocardial ischemia, particularly in those, who may require associated neo-aortic valve repair. Using the myocardial perfusion technique described herein, the heart could remain beating in normal sinus rhythm during the entire procedure, including neo-aortic valve repair and root reconstruction, and the need for cardioplegic heart arrest can be eliminated. (Source: Operative Techniques in Cardiac and Thoracic Surgery)
Source: Operative Techniques in Cardiac and Thoracic Surgery - November 26, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Igor E. Konstantinov, Edward Buratto, Shuta Ishigami, Bosco Moscoso Tags: Congenital Source Type: research