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

{"title":"The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts.","authors":"Massimo Baudo, Gianluca Torregrossa, John D Puskas","doi":"10.1177/15569845241279249","DOIUrl":"10.1177/15569845241279249","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"464-470"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286211","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":"Endoscopic Robotic Mitral Operating Room as a Microsystem for Safety and Sustainability.","authors":"Douglas A Murphy, Sergey Psarev, Amalia A Jonnson, Michael E Halkos","doi":"10.1177/15569845241278605","DOIUrl":"10.1177/15569845241278605","url":null,"abstract":"<p><strong>Objective: </strong>Safety and sustainability are key elements of a robotic mitral valve (MV) program at any stage of development. Challenges include the positioning of the surgeon at the robotic console, increasing patient complexity, and upstream administrative staffing difficulties. We instituted a systems approach to maximize patient safety and maintain robotic service viability.</p><p><strong>Methods: </strong>A single dedicated robotic operating room (OR) was equipped as a microsystem with team training in the operative steps, ergonomics, digital tools, and an explicit culture of safety. Outcomes of all robotic mitral procedures including concomitant procedures in the microsystem OR by a single surgeon were retrospectively reviewed.</p><p><strong>Results: </strong>From January 2014 through December 2023, 1,529 consecutive MV patients were operated with an endoscopic robotic approach. Ten patients (0.65%) were converted to conventional approaches. Overall, 1,300 MV repairs (85%) were performed with residual MV regurgitation of none to trace in 1,205 patients (92.7%), mild in 92 patients (7.1%), and moderate in 3 patients (0.23%). MV replacements were performed in 229 patients (15%) with no paravalvular leaks. Mortality was 0.08% in the repair group and 0.87% in the replacement group. No deaths have occurred in the last 38 months. Stroke occurred in 0.31% of repair patients and 1.3% of replacement patients. One patient developed transient renal failure.</p><p><strong>Conclusions: </strong>Organization of the robotic OR as a microsystem is associated with surgical efficacy and very low morbidity and mortality. A comparable microsystem approach using all or select components may promote safety and sustainability for robotic MV programs at all levels.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"485-493"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286134","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":"Hybrid Biatrial Ablation Versus Catheter Ablation for Patients With Nonparoxysmal Atrial Fibrillation and Enlarged Left Atrium.","authors":"Chunyu Yu, Haojie Li, Zhiwei Zeng, Lihui Zheng, Lingmin Wu, Ligang Ding, Yan Yao, Zhe Zheng","doi":"10.1177/15569845241275161","DOIUrl":"10.1177/15569845241275161","url":null,"abstract":"<p><strong>Objective: </strong>There is no consensus on the optimal ablation strategy for nonparoxysmal atrial fibrillation (NPAF) with enlarged left atrium. We aimed to explore whether hybrid ablation (HA) of combined thoracoscopic surgical ablation with catheter ablation (CA) was superior to CA alone in these patients.</p><p><strong>Methods: </strong>Patients with NPAF and left atrial diameter (LAD) ≥45 mm who underwent hybrid biatrial ablation or CA procedure from June 2014 to July 2021 were included in this study. Propensity score matching was applied to select patients in each group. The primary endpoint was freedom from atrial tachyarrhythmias after procedures.</p><p><strong>Results: </strong>After propensity score matching, 52 patients with enlarged left atrium (median LAD = 51 mm) were enrolled in each group. The median follow-up was 36 months. The probability of freedom from atrial tachyarrhythmias at 12, 24, and 36 months on antiarrhythmic drugs (AADs) was 70.1%, 65.4%, and 62.6% in the HA group and 34.3%, 29.4%, and 22.0% in the CA group, respectively (<i>P</i> < 0.001); off AADs was 57.1%, 52.7%, and 50.0% in the HA group and 25.0%, 16.2%, and 11.5% in the CA group (<i>P</i> < 0.001); on AADs after redo CA was 76.2%, 73.7%, and 73.7% in the HA group and 43.6%, 43.6%, and 38.2% in the CA group, respectively (<i>P</i> < 0.001); off AADs after redo CA was 62.5%, 60.1%, and 60.1% in the HA group and 30.4%, 25.1%, and 20.9% in the CA group, respectively (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>For patients with NPAF and enlarged left atrium, hybrid biatrial ablation was superior to CA in sinus rhythm maintenance even if redo CA was performed.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"511-519"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286198","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":"The 10 Commandments for Transesophageal Assessment Following Epicardial Surgical Ligation of the Left Atrial Appendage.","authors":"Atizazul H Mansoor","doi":"10.1177/15569845241273660","DOIUrl":"10.1177/15569845241273660","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"471-476"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286212","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":"The 7 Pillars of Techniques to Treat and Repair Tricuspid Endocarditis.","authors":"Michele Gallo, Jaimin R Trivedi, Mark S Slaughter","doi":"10.1177/15569845241282662","DOIUrl":"10.1177/15569845241282662","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"477-479"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390250","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":"Long-Term Outcomes of Minimally Invasive Endoscopic Versus Sternotomy Surgical Resection of Primary Cardiac Tumors.","authors":"Nader S Aboelnazar, Brandon R Loshusan, Michael W A Chu","doi":"10.1177/15569845241289132","DOIUrl":"10.1177/15569845241289132","url":null,"abstract":"<p><strong>Objective: </strong>Primary cardiac tumors are uncommon, often benign, but can be potentially life threatening. Minimally invasive endoscopic (ENDO) techniques have been shown to be a feasible alternative for tumor resection compared with conventional sternotomy (CS). This study compared the clinical and surgical outcomes of a small series of patients undergoing cardiac tumor resection operations.</p><p><strong>Methods: </strong>Between November 2009 and December 2022, 34 consecutive patients underwent cardiac tumor resection using either ENDO (<i>n</i> = 21) or CS (<i>n</i> = 13) techniques. We compared early perioperative outcomes, echocardiographic outcomes, and long-term clinical and tumor recurrence outcomes.</p><p><strong>Results: </strong>Baseline characteristics were similar between groups; however, the ENDO group included younger patients (56 ± 16 vs 62 ± 17 years) and more female patients (83% vs 53%). The tumor was located in the left atrium (<i>n</i> = 19, 56%), right atrium (<i>n</i> = 5, 15%), or either ventricle (<i>n</i> = 4, 12%). In-hospital mortality and stroke frequency were similar for both groups (<i>n</i> = 0). There was no significant difference in cardiopulmonary bypass or cross-clamp times, respiratory or renal failure, or intensive care unit or hospital lengths of stay. At follow-up (ENDO, 42 [2 to 131] months vs CS, 54 [1 to 156] months), there were no deaths in the ENDO group and 2 patients died in the CS group (<i>P</i> = 0.21). No patients in either group experienced tumor recurrence.</p><p><strong>Conclusions: </strong>In selected patients, both ENDO and CS approaches to primary cardiac tumor resection were safe, effective, durable, and associated with similarly good early and late results.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"550-555"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545304","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":"Left Thoracoscopic Robot-Assisted Excision of a Left Lower Paratracheal Parathyroid Adenoma for Cure of Primary Hyperparathyroidism.","authors":"Matthew L Inra, Dominick Guerrero, Adin Reisner, Subroto Paul, Brett A Miles","doi":"10.1177/15569845241277529","DOIUrl":"10.1177/15569845241277529","url":null,"abstract":"<p><p>We present a case of a 38-year-old male patient with symptomatic hypercalcemia secondary to primary hyperparathyroidism. After evaluation, the source of the excess parathyroid hormone was found to be an adenoma localized to the middle mediastinum. Specifically, it was located in the left paratracheal space along the lesser curve of the aortic arch. We discuss this case with a corresponding video to demonstrate the necessary equipment and setup as well as the 5 operative steps recommended to access this paratracheal subaortic location from a minimally invasive transthoracic approach. The pitfalls for this operation are also discussed. The purpose is to make this operation more reproducible for other surgeons.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"556-560"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286200","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":"Barriers to Multiarterial Coronary Artery Bypass Grafting.","authors":"Stephen D Waterford","doi":"10.1177/15569845241272266","DOIUrl":"10.1177/15569845241272266","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"345-350"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286131","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":"Capsular Fibrosis as a Suggested Cause of Failure of Magnetic Sphincter Augmentation.","authors":"Pamela Emengo, Daniel Nicastri, John Jacob","doi":"10.1177/15569845241266245","DOIUrl":"10.1177/15569845241266245","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"443-445"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286132","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":"Impella 5.5: A Systematic Review of the Current Literature.","authors":"Carlos Alberto Valdes, Ahmet Bilgili, Akshay Reddy, Omar Sharaf, Fabian Jimenez-Contreras, Griffin Stinson, Mustafa Ahmed, Juan Vilaro, Alex M Parker, Mohammad Az Al-Ani, Daniel Demos, Juan Aranda, Mark Bleiweis, Thomas M Beaver, Eric I Jeng","doi":"10.1177/15569845241266527","DOIUrl":"10.1177/15569845241266527","url":null,"abstract":"<p><strong>Objective: </strong>Impella 5.5 (Abiomed, Danvers, MA, USA) is a temporary mechanical circulatory support device used for patients in cardiogenic shock. This review provides a comprehensive overview of the device's clinical effectiveness, safety profile, patient outcomes, and relevant procedural considerations.</p><p><strong>Methods: </strong>We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed/MEDLINE database. The search query included articles available from October 6, 2022, through January 13, 2023. Our initial search identified 75 studies. All records were screened by 2 independent reviewers using the Covidence software for adherence to our inclusion criteria, and 8 retrospective cohort studies were identified as appropriate for inclusion.</p><p><strong>Results: </strong>Across the included studies, the sample size ranged from 4 to 275, with predominantly male cohorts. Indications for Impella support varied, and the duration of support ranged from 9.8 to 70 days. Overall, Impella support appeared to be associated with favorable survival rates and manageable complications in various patient populations. Complications associated with Impella use included bleeding, stroke, and device malfunctions. Two studies compared prolonged and Food and Drug Administration-approved Impella support, showing similar outcomes and adverse events.</p><p><strong>Conclusions: </strong>Impella 5.5 continues to be an attractive option for bridging patients to definitive therapy. Survival during and after Impella 5.5 was favorable for patients regardless of initial indication. However, device use was associated with several important complications, which calls for judicious use and a precontemplated exit strategy. Limitations of this literature review include biases inherent to the retrospective studies included, such as selection and publication bias.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"380-389"},"PeriodicalIF":16.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286199","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}