Operative Techniques in Thoracic and Cardiovascular Surgery最新文献

Technique of Intra-Aortic Balloon Pump Insertion Through Axillary Artery Over a Chimney Graft 经腋动脉经烟囱移植物主动脉内球囊泵置入技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2024.10.002

Nafiye Busra Celik MD, Mohammad Alomari MD, Anthony Pham MS, Pankaj Garg MBBS, Basar Sareyyupoglu MD, Si M. Pham MD

{"title":"Technique of Intra-Aortic Balloon Pump Insertion Through Axillary Artery Over a Chimney Graft","authors":"Nafiye Busra Celik MD, Mohammad Alomari MD, Anthony Pham MS, Pankaj Garg MBBS, Basar Sareyyupoglu MD, Si M. Pham MD","doi":"10.1053/j.optechstcvs.2024.10.002","DOIUrl":"10.1053/j.optechstcvs.2024.10.002","url":null,"abstract":"<div><div>Intra-aortic balloon pump (IABP), which augments coronary blood flow and reduces cardiac afterload, is the most widely used temporary mechanical circulatory support (TMCS) device. It has been used in a various conditions ranging from improving coronary perfusion in acute coronary syndrome and cardiogenic shock, to supporting a failing heart as a bridge to heart transplantation. With recent changes in donor heart allocation policy that favors heart transplant candidates who are on TMCS devices in the United States of America, there is a resurgence in the use of IAPB and a bridge to heart transplant. Herein we present a step-by-step surgical technique of IABP placement through Dacron graft anastomosed to the axillary artery. Under fluoroscopic guidance, the IABP catheter is advanced over the guidewire into the descending thoracic aorta. The axillary artery offers a promising alternative site to the commonly used femoral artery for the insertion of IABP as axillary IABP can be kept in longer and allows greater patient mobility. Studies indicate successful outcomes with axillary IABP, highlighting its potential advantages over femoral insertion, especially in patients awaiting heart transplantation. However, it is a surgical procedure that requires familiarity with axillary anatomy and meticulous attention to details to minimize complications.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 2","pages":"Pages 96-108"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563532","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

Commentary: Melody Mitral Replacement Implantation: The Technique Keeps Evolving 评论：旋律二尖瓣置换术：技术不断发展

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2025.03.004

Sitaram M. Emani MD

引用次数: 0

Reconstruction of the Sternum, Manubrium, and Sternoclavicular Joints With Cadaveric Femur: A Novel Approach 用尸体股骨重建胸骨、柄骨和胸锁关节：一种新方法

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2025.01.001

Sadia Tasnim MD , Nathan W. Mesko MD , Daniel P. Raymond MD

{"title":"Reconstruction of the Sternum, Manubrium, and Sternoclavicular Joints With Cadaveric Femur: A Novel Approach","authors":"Sadia Tasnim MD , Nathan W. Mesko MD , Daniel P. Raymond MD","doi":"10.1053/j.optechstcvs.2025.01.001","DOIUrl":"10.1053/j.optechstcvs.2025.01.001","url":null,"abstract":"<div><div>Objective: To describe a novel sternal and sterno-clavicular joint reconstruction technique using cadaveric femoral allograft. Case Description: A 58-year-old male presented with 14.8 cm Grade 1 sternal chondrosarcoma requiring extensive resection and reconstruction. The goal was to create a semi-rigid reconstruction preserving some mobility of the sternoclavicular joint for optimal patient quality of life. After appropriate oncologic resection, a cadaveric femur was fashioned into a neo-sternal profile and anchored to the clavicles and residual basilar sternum using multiple fixation techniques which are discussed below. The final prosthesis was covered by bilateral pectoralis muscle flaps. The patient had an uneventful postoperative course. On 16 months follow-up, the patient was able to carry out normal activities including work, and self-care, with no evidence of graft failure, fracture, and infections and good cosmetic outcome. Conclusions: We have successfully performed a semi-rigid sternal and sternoclavicular joint reconstruction for large, low-grade chondrosarcoma using bio-prosthesis with good short-term patient outcomes and preservation of functionality. Multidisciplinary care is essential for the performance of such complex chest wall reconstructions. Longer-term follow-up will be necessary to determine the durability of the construct over time.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 2","pages":"Pages 154-179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563534","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

Introduction to Summer 2025 夏季2025简介

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2025.06.001

引用次数: 0

Modified Horizontal Right Mini-Thoracotomy for Pediatric Congenital Heart Surgery 改良水平右小开胸在小儿先心病手术中的应用

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2024.11.003

Hannah E. Neiger MS , Naruhito Watanabe MD , Teimour Nasirov MD, MBA

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Commentary: Breaking Barriers in Sternal Reconstruction With Allograft Innovation 评论：用同种异体骨移植创新打破胸骨重建的障碍

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2025.04.002

Alberto Antonicelli MD , Bryan M. Burt MD, FACS

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Brain First: Carotid Artery Access for Cerebral and Arterial Perfusion in Complex Aortic Surgery 脑优先：颈动脉通路在复杂主动脉手术中的脑和动脉灌注

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2024.09.002

Jaishankar Raman MBBS, MMed, FRACS, PhD , Pankaj Saxena MBBS, MCh, FRACS, PhD , Bashi V. Velayudhan MBBS, MS, MCh , Shiv Choudhary MBBS, MS, MCh

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Aortic Annular Enlargement with Y-Incision/Rectangular Patch: Tips and Pitfalls 用y形切口/矩形补片扩大主动脉环：提示和缺陷

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2024.07.005

Alexander A. Brescia MD, MSc , Sarah A. Chen MD, MA , Katelyn Monaghan BS , Bo Yang MD, PhD

{"title":"Aortic Annular Enlargement with Y-Incision/Rectangular Patch: Tips and Pitfalls","authors":"Alexander A. Brescia MD, MSc , Sarah A. Chen MD, MA , Katelyn Monaghan BS , Bo Yang MD, PhD","doi":"10.1053/j.optechstcvs.2024.07.005","DOIUrl":"10.1053/j.optechstcvs.2024.07.005","url":null,"abstract":"<div><div>The Y-incision/rectangular patch aortic annular enlargement (Y-incision AAE) was developed in August 2020 as a simple, reproducible, and effective approach for annular enlargement. The goal of the Y-incision AAE is to enlarge the crown-shaped surgical aortic annulus and root to accommodate a larger valve with an orifice that matches the diameter of the patient's basal ring. A complete or partial transverse aortotomy is performed 2.0 cm above the sinotubular junction anteriorly. A Y-incision is made through the left-non commissure onto the aortomitral curtain, extending underneath the crown-shaped surgical aortic annulus into the left and right fibrous trigones. A rectangular patch is sewn to the aortomitral curtain from trigone to trigone, and aortic annulus on both sides. A valve sizer touches all 3 nadirs of the aortic annulus to size the prosthesis. Nonpledgetted 2-0 Ethibond valve sutures are placed in a noneverting fashion. The valve sutures are divided by 3 and distributed evenly to each cusp of the sewing ring after aligning 1 valve strut at the left-right commissure. After the prosthesis is tied down, A 2-3 cm longitudinal aortotomy is performed in the posterior side of the proximal ascending aorta. The patch is trimmed to a triangular shape at distal end and incorporated into the longitudinal aortotomy for the aortic closure while enlarging the sinotubular junction and proximal ascending aorta. The simple and reproducible Y-incision AAE technique upsizes 3-4 valve sizes to achieve optimal hemodynamics and durability while also preparing patients for the next intervention in the lifetime management of aortic valve disease.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 2","pages":"Pages 76-86"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557059","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

Surgical Implantation of Melody Valve in Mitral Position in Infants and Small Children: Toronto SickKids Method 婴儿和儿童二尖瓣位置的外科植入：多伦多病童方法

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2024.11.002

Osami Honjo MD, PhD , Mimi X. Deng MD

{"title":"Surgical Implantation of Melody Valve in Mitral Position in Infants and Small Children: Toronto SickKids Method","authors":"Osami Honjo MD, PhD , Mimi X. Deng MD","doi":"10.1053/j.optechstcvs.2024.11.002","DOIUrl":"10.1053/j.optechstcvs.2024.11.002","url":null,"abstract":"<div><div>In infants and small children with critical mitral valve disease nonamenable to repair is a high-risk population with high mortality after mechanical mitral valve replacement (MVR). Placement of the Melody™ valve (Medtronic, Minneapolis, MN, USA) in the mitral position has emerged as a palliative surgical strategy that provides time for somatic growth, until mechanical MVR becomes an appropriate option. Advantages of the Melody valve include its excellent early hemodynamics, no necessary extensive anticoagulation, and relative ease of implantation. Valve sizing is determined by preoperative echocardiography and intraoperative Hegar insertion. Toronto Melody valve modification includes a polytetrafluoroethylene skirt for anchoring to the mitral annulus and a large wedge resection of the stent to prevent left ventricular outflow tract obstruction. Once implanted and tied in standard fashion to conventional MVR, serial balloon dilations are performed to ensure that the valve is well expanded along the length of the stent. Left atrial augmentation may be required to ensure the valve is not obstructing pulmonary vein orifices. Our experience suggests that close surveillance for structural valve deterioration is imperative beyond 2-years post-implantation. In summary, the Melody valve is a safe and efficient temporizing strategy for infants requiring MVR.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 2","pages":"Pages 109-127"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557061","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}

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Adult Articles in AATS Journals 成人文章在AATS期刊

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 DOI: 10.1053/j.optechstcvs.2025.05.001

引用次数: 0