Operative Techniques in Thoracic and Cardiovascular Surgery最新文献_第5页

The Ventricular Switch Procedure Atlas: Adopting the Right Ventricle for the Systemic Circulation 心室开关程序图集：采用右心室进行体循环

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-06-01 Epub Date: 2025-02-27 DOI: 10.1053/j.optechstcvs.2024.07.007

Hani K. Najm MD, MSc, Munir Ahmad MD, John P. Costello MD, Tara Karamlou MD, MSc

{"title":"The Ventricular Switch Procedure Atlas: Adopting the Right Ventricle for the Systemic Circulation","authors":"Hani K. Najm MD, MSc, Munir Ahmad MD, John P. Costello MD, Tara Karamlou MD, MSc","doi":"10.1053/j.optechstcvs.2024.07.007","DOIUrl":"10.1053/j.optechstcvs.2024.07.007","url":null,"abstract":"<div><div>Patients born with complex heterotaxy syndromes and patients with complex intra-cardiac connections are generally routed to univentricular pathways. This subgroup of patients typically carries poor long-term prognosis due to the frequent presence of unpartitioned atrioventricular valve and other morphological determinants that are associated with univentricular failure. Adopting the left ventricle in the systemic circulation would be the ideal choice if achievable. However, the presence of complex venous or arterial connections may make this infeasible. To overcome these limitations, we have introduced the concept of the “Ventricular Switch Procedure” (VSP) wherein the right ventricle is harnessed to serve as the systemic ventricle, while utilizing the left ventricle for the subpulmonary ventricle. The VSP paradigm offers prospect of a either a one-and-a-half or biventricular circulation for these patients. Here, we present 4 examples of complex congenital cardiac malformations and their surgical management to exemplify the principles of this surgical concept and illustrate how different techniques may be employed to achieve a right ventricle-based biventricular circulation.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 2","pages":"Pages 144-153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557063","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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Comprehensive surgical technique for the neonatal and infant Ross Konno procedure – technical pearls 新生儿和婴儿罗斯科诺手术的综合外科技术-技术珍珠

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-10-16 DOI: 10.1053/j.optechstcvs.2024.07.006

Yishay Orr MBBS BSc (med) PhD FRACS , Richard B. Chard MBBS FRACS

{"title":"Comprehensive surgical technique for the neonatal and infant Ross Konno procedure – technical pearls","authors":"Yishay Orr MBBS BSc (med) PhD FRACS , Richard B. Chard MBBS FRACS","doi":"10.1053/j.optechstcvs.2024.07.006","DOIUrl":"10.1053/j.optechstcvs.2024.07.006","url":null,"abstract":"<div><div>The Ross Konno procedure is a technically demanding operation in neonates and infants, particularly in small babies and those with significant aortic annular and left ventricular outflow tract hypoplasia. There are several key technical considerations for harvesting the pulmonary autograft with care to preserve the left main coronary artery and the septal perforating arteries in addition to ensuring an optimal muscle cuff on the base of the autograft. Accommodation of the autograft deep within the native aortic valve annulus by performing an appropriate Konno incision and ensuring correct suture placement is essential. Adequate epicardial mobilisation and subsequent reimplantation of the coronary arteries into the autograft neo-aortic root is also a key consideration given the significant radial displacement of the coronary arteries required to accommodate the often much larger autograft into the space of a previously very small aortic root. Although the overall technical details of the Ross Konno procedure have previously been described by others the specific granular technical detail and meticulous approach required for a successful procedural outcome in neonates and infants remains to be fully elucidated. Key technical considerations such as suture spacing, positioning of the autograft with in the Konno incision and management of the coronary arteries require detailed description. We describe our institutional approach to the Ross Konno procedure in neonates and infants to clarify these important technical considerations.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 1","pages":"Pages 46-66"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642917","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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Commentary: The more the merrier. Another technique to treat left ventricular outflow tract obstruction 评论：人越多越好。另一种治疗左心室流出道阻塞的技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1053/j.optechstcvs.2024.09.001

Nicholas G. Smedira MD

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Commentary: Avoid Flying Blind During TEVAR for Acute Type B Aortic Dissection 评论：急性B型主动脉夹层患者在TEVAR期间避免盲目飞行

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2025-02-03 DOI: 10.1053/j.optechstcvs.2025.01.003

Alexander P. Nissen MD, Bradley G. Leshnower MD

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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 : 2025-03-01 Epub Date: 2025-03-04 DOI: 10.1053/j.optechstcvs.2025.03.001

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Beating Heart Pulmonary Valve Replacement: Technique of Pulmonary Valve Replacement with a Biological Valve 跳动心脏肺动脉瓣置换：生物瓣膜置换肺动脉瓣技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-08-03 DOI: 10.1053/j.optechstcvs.2024.07.002

Liranne Bitton BSc , Rohan Suresh Daniel BSc , Mariana Flaifel BSc , Christian A. Than PhD , George Shiakos MD , Ioannis Tzanavaros MD

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Posterior Leaflet Mitral Valve Repair with Septal Myectomy For Hypertrophic Cardiomyopathy 肥厚性心肌病的后小叶二尖瓣修复术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-08-03 DOI: 10.1053/j.optechstcvs.2024.07.003

David A. Heimansohn MD, James Hermiller MD, Peter A. Walts MD, Giorgio Zanotti MD

{"title":"Posterior Leaflet Mitral Valve Repair with Septal Myectomy For Hypertrophic Cardiomyopathy","authors":"David A. Heimansohn MD, James Hermiller MD, Peter A. Walts MD, Giorgio Zanotti MD","doi":"10.1053/j.optechstcvs.2024.07.003","DOIUrl":"10.1053/j.optechstcvs.2024.07.003","url":null,"abstract":"<div><div>Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy, and presents with left ventricular hypertrophy resulting in left ventricular outflow tract (LVOT) obstruction in 60% of patients. Standard surgical therapy for the relief of outflow tract obstruction is septal myectomy which can effectively reduce the outflow tract gradient to normal levels.</div><div>Several challenges exist when performing septal myectomy, especially in the cases of less basilar septal hypertrophy and elongated mitral leaflets. These include creation of a ventricular septal defect, injury to the conduction system requiring a permanent pacemaker, and failure to completely relieve the obstruction. In patients with elongated mitral leaflets, as is common in HCM, septal myectomy alone may be ineffective in completely relieving outflow tract obstruction. Mitral valve repair may be necessary to effectively eliminate any residual outflow tract gradient. Shortening the posterior leaflet with neochords is a repair technique that can move the mitral valve coaptation line posteriorly away from the septum and prevent anterior leaflet systolic motion into the outflow tract, thus relieving the outflow tract gradient. This can be achieved simply by placing neochords to the posterior leaflet through the aortic root and securing them to half the length of the existing cords. The posterior leaflet height is reduced, allowing the coaptation line to move away from the septum, and prevent systolic anterior motion of the anterior leaflet of the mitral valve. The obstruction is prevented, and normal mitral valve function is achieved. This repair technique is especially helpful when the basil ventricular septal thickness is less than 2 cm and the mitral valve leaflets are elongated.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 1","pages":"Pages 2-10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642914","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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Endovascular Therapy for Acute Type B Aortic Dissection 急性B型主动脉夹层的血管内治疗

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-12-09 DOI: 10.1053/j.optechstcvs.2024.08.002

Giacomo Murana MD, PhD , Francesco Campanini MD , Silvia Snaidero MD , Valentina Orioli MD , Francesco Buia MD , Luca Di Marco MD, PhD , Davide Pacini MD, PhD

{"title":"Endovascular Therapy for Acute Type B Aortic Dissection","authors":"Giacomo Murana MD, PhD , Francesco Campanini MD , Silvia Snaidero MD , Valentina Orioli MD , Francesco Buia MD , Luca Di Marco MD, PhD , Davide Pacini MD, PhD","doi":"10.1053/j.optechstcvs.2024.08.002","DOIUrl":"10.1053/j.optechstcvs.2024.08.002","url":null,"abstract":"<div><div>Type B acute aortic dissection (TBAAD) is a severe condition that requires urgent intervention to minimize complications and improve outcomes. Endovascular treatment has emerged as an effective approach for managing this challenging condition in acute complicated type B dissections or in case of high-risk features for later adverse event. This involves placing stent grafts to seal the tear, redirect blood flow, and promote clot formation. Endovascular treatment reduces mortality and complication rates, allowing for a faster recovery.</div><div>The benefits of endovascular repair in complicated TBAAD have been extensively demonstrated, showing lower morbidity and in-hospital mortality (5%-8% vs 15%-30%) rates compared to traditional open surgery. This technique offers better control over the extent of the dissection, leading to improved patient outcomes and shorter hospital stays.</div><div>It is essential to optimize antihypertensive therapy and provide proper patient<del>s</del> education. Regular angio-CT scans should be done to monitor disease progression and ensure long-term success.</div><div>Endovascular treatment has revolutionized the management of TBAAD by providing a less invasive, more effective approach, enhancing patient care and prognosis.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 1","pages":"Pages 26-43"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642910","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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Emergency Conversion From Robotic Thoracoscopy to Thoracotomy: A Safe, Reproducible, and Effective Technique 从机器人胸腔镜急诊转换到开胸术：一种安全、可重复和有效的技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2024-11-30 DOI: 10.1053/j.optechstcvs.2024.10.005

Ammara A. Watkins MD, MPH , Caroline Ricard MD , Darian Hoagland MD , Dena Shehata MBChB , Melyssa Price PAC , Christopher J. Trant CST , Elizabeth A. Preston BSN, RN , Cameron T. Stock MD , Susan Moffatt-Bruce MD, PhD , Elliot L. Servais MD

{"title":"Emergency Conversion From Robotic Thoracoscopy to Thoracotomy: A Safe, Reproducible, and Effective Technique","authors":"Ammara A. Watkins MD, MPH , Caroline Ricard MD , Darian Hoagland MD , Dena Shehata MBChB , Melyssa Price PAC , Christopher J. Trant CST , Elizabeth A. Preston BSN, RN , Cameron T. Stock MD , Susan Moffatt-Bruce MD, PhD , Elliot L. Servais MD","doi":"10.1053/j.optechstcvs.2024.10.005","DOIUrl":"10.1053/j.optechstcvs.2024.10.005","url":null,"abstract":"<div><div>Robotic thoracoscopic surgical operations are increasingly performed worldwide. Current lung resection trends indicate that the robotic approach has now surpassed conventional VATS (video assisted thoracoscopy surgery) in the United States. Emergency conversion to an open thoracotomy is an uncommon occurrence; however, preparedness for this infrequent but potentially catastrophic event is paramount. There is a paucity of step-by-step instruction available on how to convert from robotic thoracoscopy safely and reliably to thoracotomy. Herein, we present our conversion method which has been refined in an iterative fashion based on real-life experience and testing in a simulated environment. This method ensures pressure control of bleeding either by the surgeon or bedside assist while also maintaining vision of the operative field throughout the conversion process. At no point is bleeding control maintained by an unmanned robotic instrument. This technical report aims to provide thoracic surgery teams a safe and reliable option for emergency conversion during robotic thoracoscopy.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"30 1","pages":"Pages 67-74"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642918","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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Introduction to Spring 2025 2025年春季简介

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2025-03-01 Epub Date: 2025-03-17 DOI: 10.1053/j.optechstcvs.2025.03.002

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