Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery最新文献

Three-Dimensional Heart Modeling of Hypertrophic Obstructive Cardiomyopathy for In Situ Patient-Specific Simulation to Optimize Septal Myectomy. 肥厚型梗阻性心肌病的三维心脏建模，用于原位患者特异性模拟，以优化房间隔切除术。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-09-02 DOI: 10.1177/15569845241273538

Karin C Smits, Ron G H Speekenbrink, Edsko E G Hekman, Maaike A Koenrades, Tijn J P Heeringa, Jutta Arens, Frank R Halfwerk

{"title":"Three-Dimensional Heart Modeling of Hypertrophic Obstructive Cardiomyopathy for In Situ Patient-Specific Simulation to Optimize Septal Myectomy.","authors":"Karin C Smits, Ron G H Speekenbrink, Edsko E G Hekman, Maaike A Koenrades, Tijn J P Heeringa, Jutta Arens, Frank R Halfwerk","doi":"10.1177/15569845241273538","DOIUrl":"https://doi.org/10.1177/15569845241273538","url":null,"abstract":"Objective: Hypertrophic obstructive cardiomyopathy (HOCM) develops in at least 1 out of 715 young adults. Patients who are refractory to medical therapy qualify for septal myectomy. Due to anatomy, serious complications such as ventricular septal defect and heart block may occur. Establishing cardiovascular magnetic resonance (CMR)-based 3-dimensional (3D) models as part of preoperative planning and training has the potential to decrease procedure-related complications and improve results.Methods: CMR images were used to segment cardiac structures. Left ventricular wall thickness was calculated and projected on top of the in silico model. A 3D model was printed with a red layer indicating a wall thickness exceeding 15 mm and used for preoperative resection planning and patient counseling. To provide preoperative patient-specific in situ simulation, the planned resection volume was replaced with silicone in a second model. For perioperative quality control, resected silicone was compared with resected myocardial tissue. The impact of the models was evaluated descriptively through consultation of both the cardiothoracic surgeon and patients and through patient outcomes.Results: Three-dimensional in silico and 3D-printed heart models of 5 patients were established preoperatively. Since the introduction of the models in October 2020, the surgeon feels better prepared, more confident, and less difficulty with making decisions. In addition, patients feel better informed preoperatively.Conclusions: Using 3D heart models optimized preoperative planning and training, intraoperative quality control, and patient consultation. Reduction of procedure-related complications and clinical outcome should be studied in larger cohorts.","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot-Assisted Right S3 Segmentectomy of a Neuroendocrine Tumor. 机器人辅助下的神经内分泌肿瘤右S3节段切除术。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-08-31 DOI: 10.1177/15569845241272237

Purab D Kothari, Olugbenga T Okusanya, Tyler R Grenda, Nathaniel R Evans, John D Jacob

引用次数: 0

Maximizing Minimally Invasive Cardiac Surgery With Enhanced Recovery (ERAS). 最大限度地提高微创心脏手术的康复效果（ERAS）。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-08-29 DOI: 10.1177/15569845241264565

Rawn Salenger, Niv Ad, Michael C Grant, Faisal Bakaeen, Husam H Balkhy, Stephanie L Mick, Peyman Sardari Nia, Jörg Kempfert, Nikolaos Bonaros, Vinayak Bapat, Moritz C Wyler von Ballmoos, Marc Gerdisch, Douglas R Johnston, Daniel T Engelman

{"title":"Maximizing Minimally Invasive Cardiac Surgery With Enhanced Recovery (ERAS).","authors":"Rawn Salenger, Niv Ad, Michael C Grant, Faisal Bakaeen, Husam H Balkhy, Stephanie L Mick, Peyman Sardari Nia, Jörg Kempfert, Nikolaos Bonaros, Vinayak Bapat, Moritz C Wyler von Ballmoos, Marc Gerdisch, Douglas R Johnston, Daniel T Engelman","doi":"10.1177/15569845241264565","DOIUrl":"https://doi.org/10.1177/15569845241264565","url":null,"abstract":"We convened a group of cardiac surgeons, intensivists, and anesthesiologists with extensive experience in minimally invasive cardiac surgery (MICS) and perioperative care to identify the essential elements of a MICS program and the relationship with Enhanced Recovery After Surgery (ERAS). The MICS incision should minimize tissue invasion without compromising surgical goals. MICS also requires safe management of hemodynamics and preservation of cardiac function, which we have termed myocardial management. Finally, comprehensive perioperative care through an ERAS program should be provided to allow patients to achieve optimal recovery. Therefore, we propose that MICS requires 3 elements: (1) a less invasive surgical incision (non-full sternotomy), (2) optimized myocardial management, and (3) ERAS. We contend that the full benefit of MICS can be achieved only by also utilizing an ERAS platform.","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimally Invasive Surgical Repair of Simple Congenital Heart Defects Using the Right Vertical Infra-Axillary Thoracotomy Approach. 使用右侧垂直腋下胸廓切开术微创手术修复单纯先天性心脏缺损

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-08-26 DOI: 10.1177/15569845241273650

Dien Minh Tran, Vinh Quang Tran, Mai Tuan Nguyen, Duyen Dinh Mai, Anh Vuong Doan, Son Thanh Hoang, Yasuhiro Kotani, Truong Ly-Thinh Nguyen

{"title":"Minimally Invasive Surgical Repair of Simple Congenital Heart Defects Using the Right Vertical Infra-Axillary Thoracotomy Approach.","authors":"Dien Minh Tran, Vinh Quang Tran, Mai Tuan Nguyen, Duyen Dinh Mai, Anh Vuong Doan, Son Thanh Hoang, Yasuhiro Kotani, Truong Ly-Thinh Nguyen","doi":"10.1177/15569845241273650","DOIUrl":"https://doi.org/10.1177/15569845241273650","url":null,"abstract":"Objective: To evaluate the safety and efficacy of surgical repair for patients diagnosed with simple congenital heart defects (CHD) using the minimally invasive right vertical infra-axillary minithoracotomy (RVIAT) approach.Methods: We retrospectively reviewed the clinical data of consecutive patients who underwent minimally invasive RVIAT for repair of CHD between August 2019 and August 2022. There were 382 patients who underwent 8 primary procedures and were included in this study.Results: The median age of the patients was 16.2 (interquartile range [IQR], 7.2 to 41.9) months, and the median weight of the patients was 8.8 (IQR, 6.5 to 14) kg. The preoperative diagnoses were as follows: ventricular septal defect, atrial septal defect, partial anomalous pulmonary venous return, partial atrioventricular septal defect, cor triatriatum, complete atrioventricular septal defect, and myxoma. The mean aortic cross-clamp time, bypass time, and operation time were 45.4 ± 19.3 min, 65.6 ± 23.1 min, and 154.5 ± 29.7 min, respectively. There was no in-hospital mortality or conversion to median sternotomy. Two patients (0.5%) required early reoperation; 1 due to postoperative bleeding and 1 for permanent pacemaker implantation. Other complications included trivial residual shunts (23 of 382, 6%), pleural effusion (3 of 382, 0.8%), pneumothorax (0.8%), and wound infection (4 of 382, 1%). There were 2 late noncardiac deaths. Late reoperation was performed on 1 patient with progressive aortic valve regurgitation who required aortic valvuloplasty.Conclusions: RVIAT is a minimally invasive approach that can be safely performed on patients with simple CHDs. RVIAT may be a good alternative approach for median sternotomy and cardiac intervention.","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The 10 Commandments of Less Invasive CABG: How to Increase Adoption. 微创 CABG 十诫：如何提高采用率。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-08-26 DOI: 10.1177/15569845241272159

Marc Ruel

引用次数: 0

Robotic Totally Endoscopic Transmitral Septal Myectomy and Secondary Chord Resection for Hypertrophic Obstructive Cardiomyopathy. 机器人全内镜经房间隔髓质切除术和继发性脊髓切除术治疗肥厚型梗阻性心肌病。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-08-09 DOI: 10.1177/15569845241256382

Hiroto Kitahara, Kaitlin Grady, Dinesh Kurian, Husam H Balkhy

引用次数: 0

Single Additional Stitch During Rapid Deployment Aortic Valve Replacement to Reduce Postimplant Pacemaker Needs. 在快速展开主动脉瓣置换术中进行单次额外缝合，以减少植入起搏器后的需求。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-08-09 DOI: 10.1177/15569845241258973

Akira Shiose, Tomoki Ushijima

引用次数: 0

Induced Moderate Hypothermia in Aortic Rupture With Retroperitoneal Bleeding: A Randomized Porcine Study. 主动脉破裂伴腹膜后出血时的中度低温诱导：一项随机猪研究。

IF 1.5

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-06-03 DOI: 10.1177/15569845241253234

Artai Pirouzram, Maria Wikström, Thomas Larzon, Éva Tamás, Kristofer F Nilsson

{"title":"Induced Moderate Hypothermia in Aortic Rupture With Retroperitoneal Bleeding: A Randomized Porcine Study.","authors":"Artai Pirouzram, Maria Wikström, Thomas Larzon, Éva Tamás, Kristofer F Nilsson","doi":"10.1177/15569845241253234","DOIUrl":"https://doi.org/10.1177/15569845241253234","url":null,"abstract":"Objective: Induced hypothermia improves outcome in aortic arch surgery, neonatal neurointensive care, and transplant surgery for example. In contrast, spontaneous hypothermia has been associated with worse outcomes in patients suffering from hemorrhagic shock, mostly explained by its adverse effects on the coagulation system. We investigated if induced hypothermia would impair short-term survival in experimental aortic rupture with retroperitoneal bleeding.Methods: Anesthetized pigs were randomized into 2 groups: hypothermia by peritoneal lavage of ice-cold Ringer's acetate and external cooling (n = 10) and normothermia (n = 10). Aortic rupture with retroperitoneal bleeding was induced by endovascular means creating a 6 mm hole in the retroperitoneal portion of abdominal aorta. Survival (primary outcome), hemodynamics, and arterial blood gases including lactate were collected and analyzed up to 180 min after aortic rupture.Results: The body temperature (mean ± standard deviation) in the hypothermic group was 31.5 ± 1.0 °C and 38.7 ± 0.4 °C in the normothermic group at the time for aortic rupture. Survival up to 180 min after the retroperitoneal bleeding was significantly higher in the hypothermic compared with the normothermic group (P = 0.023).Conclusions: Induced hypothermia did not impair survival in this experimental retroperitoneal aortic bleeding model in anesthetized pigs. This finding may indicate a minor role for the coagulation system in this type of bleeding.","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous Coronary Artery Dissection, Takotsubo Cardiomyopathy, and Venoarterial Extracorporeal Membrane Oxygenation in Pregnancy. 妊娠期自发性冠状动脉夹层、Takotsubo 心肌病和静脉体外膜氧合。

IF 1.5

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-06-03 DOI: 10.1177/15569845241252443

Jake L Cotton, James Makinen, Sarah Y Park, Alison Halpern Mungo, Muhammad Aftab, Jordan R H Hoffman, Michael T Cain

引用次数: 0

Practice Patterns in Sternal Closure and Evaluation of Adoption of a Novel Sternal Closure Device. 胸骨闭合术的实践模式以及对采用新型胸骨闭合设备的评估。

IF 1.6

Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery Pub Date : 2024-05-01 Epub Date: 2024-05-09 DOI: 10.1177/15569845241247792

Gardner Yost, Thomas Marten, Jeffrey Plott, Jonathan W Haft

{"title":"Practice Patterns in Sternal Closure and Evaluation of Adoption of a Novel Sternal Closure Device.","authors":"Gardner Yost, Thomas Marten, Jeffrey Plott, Jonathan W Haft","doi":"10.1177/15569845241247792","DOIUrl":"10.1177/15569845241247792","url":null,"abstract":"Objective: The technique for sternal closure has remained largely unchanged owing to the efficacy, simplicity, and low cost of stainless-steel sternal wires. Despite their ubiquity, several other closure devices designed to address the complications associated with sternal wires such as sternal bleeding and dehiscence have become popular. We have developed a novel sternal closure device that reduces sternal bleeding and dehiscence. This study quantifies the use of currently available sternal closure devices and determines predicted uptake of the novel device.Methods: An electronic survey, designed to determine practice patterns for sternal closure, was distributed to 70 US cardiac surgeons. The survey included a discrete choice section in which surgeons evaluated relative value of device attributes including cost, ease of emergent sternal reentry, and dehiscence risk.Results: There were 70 surgeons from 30 states who completed the survey. The most frequent means of sternal closure was straight sternal wires (35.8%), followed by straight sternal wires plus figure-of-8 sternal wires (18.1%), double wires (10.9%), plates (10.2%), and other (25%). The relative utilization shifted from sternal wires to sternal plates as the risk for dehiscence increased. The adoption of the novel closure device was estimated at 34.6%.Conclusions: The standard stainless-steel sternal wire remains the most common means of sternal reapproximation, but its utilization is lower in patients at high risk for sternal dehiscence. Based on this survey, there is acceptance in the community for a novel sternal closure device designed to address the limitations of traditional sternal closure methods.","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0