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

{"title":"The 10 Commandments for State-of-the-Art Imaging of the Proximal Thoracic Aorta.","authors":"Marko T Boskovski, Elaine E Tseng","doi":"10.1177/15569845241297993","DOIUrl":"10.1177/15569845241297993","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"584-593"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dealing With the Aortic Annulus: Surgical Aortic Annulus Enlargement With a Balloon Catheter.","authors":"Andre Luiz Tyszka, Alexandro Jose Jorge, Harissa El Ghoz","doi":"10.1177/15569845241288550","DOIUrl":"10.1177/15569845241288550","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"677-679"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521835","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}

{"title":"Development and Validation of a Low-Cost, High-Fidelity Simulation Model for Robotic Internal Mammary Artery Harvest Using the da Vinci Xi Robot.","authors":"Syed Faaz Ashraf, Laura Seese, Irsa S Hasan, Ashok N Babu, Husam H Balkhy, Bob B Kiaii, T Sloane Guy, David J Kaczorowski, Johannes Bonatti","doi":"10.1177/15569845241286012","DOIUrl":"10.1177/15569845241286012","url":null,"abstract":"<p><strong>Objective: </strong>We created and validated a low-cost simulation model for robotic internal mammary artery (IMA) takedown.</p><p><strong>Methods: </strong>The simulation model utilized a calf fetus thorax cavity stented open internally and secured to a table. The simulation model was validated at a 2-day robotic cardiac surgery workshop. Each participant harvested one IMA using the da Vinci Xi robot (Intuitive Surgical, Sunnyvale, CA, USA). We compared participant self-reported confidence at robotic IMA harvest before and after using the simulator.</p><p><strong>Results: </strong>Our novel thorax-securing strategy resulted in a stable structure and allowed access to both IMAs from the same 3 ports. The cost to set up the first simulation model was $176 and $133 for every subsequent model. Fifty participants used the simulation model: 42 cardiothoracic surgery attendings and 8 fellows or residents. The feedback form response rate was 78% (<i>n</i> = 39). On the Likert scale, participants rated realism of the calf model to simulate robotic IMA harvesting (0 = <i>not realistic</i>, 10 = <i>highly realistic</i>) with a median of 8 out of 10 (interquartile range [IQR] 7 to 9). Participant confidence (0 = <i>not at all confident</i>, 10 = <i>very confident</i>) in robotic IMA harvesting before and after using the simulator increased (<i>P</i> = 0.001) from a median of 5 (IQR 1 to 7) to 9 (IQR 7 to 10).</p><p><strong>Conclusions: </strong>This robotic IMA harvest simulation model is affordable, realistic, and improved participant confidence in robotic IMA harvest. It may provide a valuable training tool for surgeons learning robotic coronary bypass surgery and allows for training frequency necessary to pass basic learning curves.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"633-639"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545303","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}

{"title":"Innovative Surgical Left Atrial Appendage Closure Technique: Early Experience of Inverted Spiral Closure Technique.","authors":"Eiki Nagaoka, Hirokuni Arai, Tomohiro Mizuno, Keiji Oi, Tatsuki Fujiwara, Kiyotoshi Oishi, Tomoyuki Fujita","doi":"10.1177/15569845241288564","DOIUrl":"10.1177/15569845241288564","url":null,"abstract":"<p><strong>Objective: </strong>Simultaneous closure of the left atrial appendage (LAA) during cardiac procedures has become a common preventive measure against cardiogenic embolic events associated with atrial fibrillation. However, this strategy encounters limitations during minimally invasive mitral valve surgery through a right minithoracotomy because access to the LAA is limited. The use of endocardial sutures for surgical exclusion of the LAA is also well established but has a notable rate of closure failure. We introduced a new surgical LAA closure technique called the inverted spiral closure technique (ISCT).</p><p><strong>Methods: </strong>Between July 2020 and August 2021, 26 patients underwent LAA closure with ISCT concomitant to mitral valve surgery in our hospital. Early postoperative outcomes and any stroke or thromboembolic event during the follow-up were evaluated. Transthoracic or transesophageal echocardiography (TEE) was used to assess LAA patency.</p><p><strong>Results: </strong>The ISCT procedure was performed successfully in all cases. No significant persistent flow between the left atrium and LAA was observed on intraoperative TEE. During a median follow-up of 1.1 years, no patients experienced stroke, myocardial infarction, or death. Postoperative echocardiography showed no significant residual flow within the LAA. One patient was incidentally found to have recanalization between the left atrium and LAA several months after surgery on an enhanced computed tomography scan during coronary evaluation.</p><p><strong>Conclusions: </strong>The ISCT can be performed reliably through the same left atriotomy for mitral valve surgery and is a useful and effective technique for surgical LAA exclusion. There are still not enough patients and modalities for postoperative evaluation.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"656-659"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619451","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}

{"title":"State-of-the-Art Review of Aortic Root Reconstruction: Contemporary Techniques and Challenges.","authors":"Malak Elbatarny, Abby White, Jennifer C Y Chung, Vincent Chauvette, Ming Guo, Munir Boodhwani, Sabin Bozso, Nader S Aboelnazar, Francois Dagenais, Charles Laurin, Mimi Deng, Mark D Peterson, Matthew Valdis, Michael W A Chu","doi":"10.1177/15569845241299804","DOIUrl":"10.1177/15569845241299804","url":null,"abstract":"<p><p>Aortic root reconstruction operations have undergone substantial evolution with technical modifications, expanding indications, and the need for increasingly complex decision-making. The purpose of this state-of-the-art review is to detail our approach to contemporary aortic root reconstruction operations. First, we review the evolution of root reconstruction procedures over the years and discuss the approach to the aortic root patient for lifetime management of aneurysm and valvular disease in the modern context of management options. We also discuss state-of-the art technical considerations of valve-sparing root replacement, variations of the Ross operation, aortic valve repair principles and challenges in special populations, and considerations for complication-free coronary button reconstruction. We also discuss root reconstruction in high-risk subpopulations including acute type A aortic dissection, congenital, and reoperative patients. We briefly highlight future directions in transcatheter root replacement as well as the outlook for the next generation of aortic root surgeons.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"600-610"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally Endoscopic Coronary Artery Bypass Graft: Systematic Review and Meta-Analysis of Reconstructed Patient-Level Data.","authors":"Ioannis Zoupas, Vasiliki Manaki, Panagiotis T Tasoudis, Nina-Rafailia Karela, Dimitrios V Avgerinos, Konstantinos S Mylonas","doi":"10.1177/15569845241296530","DOIUrl":"10.1177/15569845241296530","url":null,"abstract":"<p><strong>Objective: </strong>The standard approach for coronary artery bypass grafting is open surgery. Totally endoscopic coronary artery bypass has emerged as an alternative for selected patients. This meta-analysis sought to evaluate clinical outcomes with this emerging technique.</p><p><strong>Methods: </strong>A PRISMA-compliant search was performed up to December 14, 2022, in PubMed (MEDLINE), Scopus, and Cochrane. Time-to-event data were reconstructed using Kaplan-Meier curves from source literature.</p><p><strong>Results: </strong>A total of 2,774 patients with symptomatic coronary artery disease underwent totally endoscopic coronary artery bypass in 18 eligible studies. The mean patient age was 63.2 ± 12.3 years, and 77.5% (95% confidence interval [CI]: 72.2% to 82.4%) of the included patients were males. The mean operative time was 304.2 ± 155 min, whereas the mean internal mammary artery takedown time was 38.3 ± 18.4 min. Of the patients, 4.7% (95% CI: 1.6% to 9.1%) required conversions to open surgery. The 30-day complication rate was 5.9% (95% CI: 1.2% to 13.1%), whereas late complications developed in 4.8% (95% CI: 1.9% to 8.5%) of the patients. Freedom from major adverse cardiac events was 93.4% (95% CI: 85.3% to 94.8%) and 1-year, 5-year, and 10-year survival rates were 95.2%, 83.2%, and 81.7%, respectively. Reintervention was required in 3.3% (95% CI: 2.3% to 4.4%) of the cohort within a mean follow-up of 42.5 ± 27.8 months.</p><p><strong>Conclusions: </strong>Totally endoscopic coronary artery bypass may be a safe and viable alternative for selected patients with coronary artery disease. Long-term follow-up will help define the place of robotic endoscopic treatment in the armamentarium of myocardial revascularization.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"616-625"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe Training Method for ITA Harvesting via Median Sternotomy in Minimally Invasive Coronary Artery Bypass Surgery Using Harmonic Scalpel.","authors":"Keita Kikuchi, Kunihiko Yoshino, Hiroki Sakai, Yoshun Sai, Kaito Masuda, Joji Ito","doi":"10.1177/15569845241290240","DOIUrl":"https://doi.org/10.1177/15569845241290240","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845241290240"},"PeriodicalIF":1.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545305","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}

{"title":"Program.","authors":"","doi":"10.1177/15569845241271442a","DOIUrl":"https://doi.org/10.1177/15569845241271442a","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":"19 1_suppl","pages":"4S-7S"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545307","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}

{"title":"Message From the President of the Japan MICS Summit 2023.","authors":"Toshihiko Shibata","doi":"10.1177/15569845241271442","DOIUrl":"https://doi.org/10.1177/15569845241271442","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":"19 1_suppl","pages":"3S"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545306","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}

{"title":"Safety and Outcomes of Reoperative Robotic Tricuspid Valve Surgery.","authors":"Panos N Vardas, Brock Daughtry, James Lee West, Rongbing Xie, Gagandip Singh, Lamario Williams, James Davies, Clifton Lewis","doi":"10.1177/15569845241273552","DOIUrl":"10.1177/15569845241273552","url":null,"abstract":"<p><strong>Objective: </strong>Reoperative surgery for isolated tricuspid valve (TV) pathology has been associated with high morbidity and mortality rates; however, the current guidelines recommend intervention for severe, symptomatic TV regurgitation or mild to moderate symptoms with progressive right ventricular dysfunction. There are minimal data regarding reoperative intervention for TV disease. Similarly, there are no large series describing robot-assisted reoperative TV surgery.</p><p><strong>Methods: </strong>Institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database data were used to identify patients with previous cardiac surgery undergoing robot-assisted TV surgery from 2017 to 2022 from 2 tertiary referral hospitals. Patient demographics, preoperative characteristics, disease progression, operative details, and outcomes were analyzed. The primary outcome was 30-day mortality. Secondary outcomes were 30-day readmission, length of stay, and adverse events. Descriptive and summative statistics were used to describe clinical data and examine differences in outcomes of patients with primary versus secondary etiology using bivariate analyses.</p><p><strong>Results: </strong>Twenty-four patients were divided into 2 arms, primary TV pathology and secondary dysfunction due to comorbid cardiac conditions. The overall mortality was 8.3%. Major complications, including respiratory failure, renal failure, and reoperation were 12.5%, 8.3%, and 8.3%, respectively. No permanent pacemakers were required, and the 30-day readmission rate was 4.5%.</p><p><strong>Conclusions: </strong>Reoperative robotic TV surgery is a safe and viable alternative to traditional sternotomy for both primary and secondary TV pathology. TV repair and replacement are possible using the minimally invasive technique. The morbidity and mortality rates are acceptable when compared with traditional approaches with decreased need for pacemaker placement in the minimally invasive approach.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"526-531"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286210","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}