Operative Techniques in Thoracic and Cardiovascular Surgery最新文献_第6页

Surgical Technique of Donation after Circulatory Death using Normothermic Regional Perfusion 常温区域灌注循环性死亡后器官捐献的外科技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-08-27 DOI: 10.1053/j.optechstcvs.2024.06.001

Akshay Kumar MD , Syed T. Hussain MD , Michael Dorsey MD , Amit Alam MD , Nader Moazami MD , Deane Smith MD

{"title":"Surgical Technique of Donation after Circulatory Death using Normothermic Regional Perfusion","authors":"Akshay Kumar MD , Syed T. Hussain MD , Michael Dorsey MD , Amit Alam MD , Nader Moazami MD , Deane Smith MD","doi":"10.1053/j.optechstcvs.2024.06.001","DOIUrl":"10.1053/j.optechstcvs.2024.06.001","url":null,"abstract":"<div><div>Heart transplantation (HT) is the gold standard treatment of end-stage heart disease. Waitlist mortality remains high due to a shortage of available donor organs. Donation after circulatory death (DCD) has shown potential to increase transplant volumes by 15%-20%. Resuscitation of the organs after circulatory death can be performed ex vivo using machine perfusion or in situ using either extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (CPB). Thoracoabdominal normothermic regional perfusion (TA-NRP) entails reperfusing the heart in-situ after circulatory death. It also involves total body reperfusion under physiological conditions, correction of metabolic abnormalities, and allows unloading of the left ventricle to facilitate myocardial recovery. After weaning off support, direct visual and hemodynamic assessment of heart function is possible. Safe and expeditious establishment of cardiopulmonary bypass after death is the key to success of this technique. Here, we review the history of donation after circulatory death, our protocol and surgical technique of establishing TA-NRP with cold static preservation, and briefly describe the outcomes after DCD heart transplantation.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 4","pages":"Pages 298-309"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143130409","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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Modified Aortic Arch Reconstruction Combined With Pulmonary Artery Reconstruction in the Comprehensive Stage II Operation Following a Hybrid Stage I for Hypoplastic Left Heart Syndrome 左心发育不全综合征混合Ⅰ期手术后综合Ⅱ期手术中的改良主动脉弓重建术与肺动脉重建术相结合

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2023-11-26 DOI: 10.1053/j.optechstcvs.2023.11.001

Takaaki Suzuki MD, Kentaro Hotoda MD

{"title":"Modified Aortic Arch Reconstruction Combined With Pulmonary Artery Reconstruction in the Comprehensive Stage II Operation Following a Hybrid Stage I for Hypoplastic Left Heart Syndrome","authors":"Takaaki Suzuki MD, Kentaro Hotoda MD","doi":"10.1053/j.optechstcvs.2023.11.001","DOIUrl":"10.1053/j.optechstcvs.2023.11.001","url":null,"abstract":"<div><div>The hybrid approach for hypoplastic left heart syndrome<span><span> is a well-accepted alternative strategy to the conventional staged surgical approach. However, in the typical comprehensive stage II operation, bilateral branch pulmonary artery stenosis is a risk factor for postoperative catheter and/or surgical interventions. In addition to addressing the stenosis from the bands, the branch pulmonary arteries are at risk of compression from the dilated main pulmonary trunk and the resultant large neo-aorta. Here, we present a new </span>aortic arch reconstruction<span> technique combined with the pulmonary artery reconstruction in the comprehensive stage II operation to address these issues. In our experience of 11 patients who underwent hybrid strategy, Fontan completion was achieved in 8 cases (73%) during a median follow-up duration of 84 months (range; 45-161 months), and the 3-year, 5-year, and 10-year survival rates were 73% each. While 6 of 8 cases (75%) required catheter interventions to the branch pulmonary arteries, the Nakata Index was 204 ± 11 before the stage II and 185 ± 19 before Fontan completion, indicating that good pulmonary artery growth. Our modified comprehensive stage II technique optimizes the pulmonary arteries for the Fontan and beyond by addressing both anatomic stenoses and external compression for future growth.</span></span></div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 4","pages":"Pages 336-344"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295594","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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Senning Procedure: Use of a 3D Printed, Silicone Molded Model for Surgical Training Senning程序：使用3D打印，硅胶模塑模型进行外科训练

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-04-01 DOI: 10.1053/j.optechstcvs.2024.02.002

David J. Barron FRCS , Ankavipar Saprungruang MD , Shi-Joon Yoo MD

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Introduction to Winter 2024 2024年冬季简介

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-12-05 DOI: 10.1053/j.optechstcvs.2024.11.001

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Operative management of a difficult problem: Cervical esophagogastric anastomotic stricture 颈部食管胃吻合口狭窄的手术治疗

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1053/j.optechstcvs.2024.06.002

Mai G. Al Khadem MBBCh , Arvind Krishnamurthy MS. MCh , Puja Gaur Khaitan MD, FACS

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Recent Articles in AATS Journals AATS期刊近期文章

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-11-02 DOI: 10.1053/j.optechstcvs.2024.10.001

引用次数: 0

Approach to Severe Mitral Annular Calcification Using Ultrasonic Aspiration 超声抽吸治疗严重二尖瓣环钙化的方法

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-06-24 DOI: 10.1053/j.optechstcvs.2024.05.004

Nicholas J. Goel MD, Mauer Biscotti III MD, Michael A. Catalano MD, Michael A. Acker MD

{"title":"Approach to Severe Mitral Annular Calcification Using Ultrasonic Aspiration","authors":"Nicholas J. Goel MD, Mauer Biscotti III MD, Michael A. Catalano MD, Michael A. Acker MD","doi":"10.1053/j.optechstcvs.2024.05.004","DOIUrl":"10.1053/j.optechstcvs.2024.05.004","url":null,"abstract":"<div><div>Severe mitral annular calcification (MAC) is perhaps the greatest challenge faced in mitral valve surgery. Valve replacement in the setting of severe MAC carries with it the risk of numerous surgical complications and modes of technical failure, including catastrophic atrioventricular (AV) groove disruption. In the face of these challenges, a variety of surgical approaches to severe MAC have been described but without clear consensus. We describe an approach using the Cavitron Ultrasonic Surgical Aspirator (CUSA) emphasizing minimal, focal disruption of annular calcium. Ultrasonic aspiration is applied only when needed and only at the precise site of valve suture placement to aspirate away or merely soften dense calcium such that sutures can be placed through or around the calcified annulus. Our approach is simple and eliminates the need for complete annular decalcification which risks avoidable AV groove destabilization and requires complex annular reconstruction. In our experience of 55 cases of high-risk mitral replacement in the setting of very severe MAC, we report 2 cases of AV groove disruption (4%), 2 cases of coronary injury (4%), and 2 cases of stroke (4%), with no cases of paravalvular leak worse than mild. In-hospital mortality was 16%, due largely to significant underlying cardiac and non-cardiac comorbidity and underscoring the often underestimated nontechnical risks inherent in these cases. While no single approach may be optimal in every case of severe MAC, we feel our technique of limited ultrasonic aspiration is an important tool in the mitral surgeon's armamentarium.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 4","pages":"Pages 310-319"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143130408","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

Modified Aortic Valve Neocuspidization (Ozaki AVNeo) Procedure 改良主动脉瓣新瓣化（Ozaki AVNeo）手术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-08-27 DOI: 10.1053/j.optechstcvs.2024.07.004

Leah Bourgan BS , Teimour Nasirov MD , Olaf Reinhartz MD , Danny Chu MD

{"title":"Modified Aortic Valve Neocuspidization (Ozaki AVNeo) Procedure","authors":"Leah Bourgan BS , Teimour Nasirov MD , Olaf Reinhartz MD , Danny Chu MD","doi":"10.1053/j.optechstcvs.2024.07.004","DOIUrl":"10.1053/j.optechstcvs.2024.07.004","url":null,"abstract":"<div><div>There is a substantial need for interventions to replace or repair diseased aortic valves. As an alternative to conventional replacement with prostheses, we illustrate a modified technique of aortic valve neocuspidization (AVNeo).</div><div>The procedure includes harvesting of autologous pericardium and cutting it into shapes analogous to the patient's aortic valve cusps to create neocusps. The native cusps are then resected and replaced with the neocusps. We highlight details of how to create, size, and attach the autologous cusps to ensure efficacy and durability.</div><div>The AVNeo technique offers abundant advantages to standard aortic valve treatments. The technique is versatile and can be applied in the treatment of essentially all underlying aortic valve pathologies, whether congenital, rheumatic, degenerative, or infectious in etiology. AVNeo appears to be suitable in the growing annuli of children. The technique avoids foreign material and its drawbacks, like stiffness of the annulus and the need for anticoagulation. Though it leads to superior hemodynamic performance and low intervention rates in the short and medium term, long term durability has yet to be proven.</div></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 4","pages":"Pages 320-335"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143130403","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

Modified Starnes Procedure With Patch Occlusion of the Main Pulmonary Artery and Other Technical Modifications to Facilitate Subsequent Biventricular Repair of Ebstein Anomaly 修改后的 Starnes 手术，采用补片闭塞主肺动脉和其他技术修改，以促进随后的双心室埃布斯坦畸形修补术。

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-09-01 Epub Date: 2024-02-21 DOI: 10.1053/j.optechstcvs.2023.12.005

{"title":"Modified Starnes Procedure With Patch Occlusion of the Main Pulmonary Artery and Other Technical Modifications to Facilitate Subsequent Biventricular Repair of Ebstein Anomaly","authors":"","doi":"10.1053/j.optechstcvs.2023.12.005","DOIUrl":"10.1053/j.optechstcvs.2023.12.005","url":null,"abstract":"<div><p><span>The Starnes procedure, introduced in 1991, has been a valuable advancement in the surgical treatment of critically ill neonates with Ebstein's anomaly (EA). However, it used to be followed by the </span>single ventricle<span><span> pathway, which presents long-term outcome limitations. In 2019, this management concept was modified by taking down the Starnes procedure and performing the Cone repair of the tricuspid valve<span>, which resulted in a biventricular reconstruction. This approach rehabilitates the right ventricle<span>, likely improving the patients' long-term outcomes. However, it requires modifications in the classical Starnes operation and observing certain surgical details. In cases of circular shunt, we use a patch to occlude the pulmonary artery instead of dividing and oversewing it, simplifying the succeeding pulmonary artery reconstruction<span>. Regarding the tricuspid valve we use a PTFE fenestrated patch placed in a supra-valvar position, preserving the underneath valve integrity, facilitating the </span></span></span></span>tricuspid valve repair, and decreasing the possibility of heart block.</span></p></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 3","pages":"Pages 249-258"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466016","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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Reply: “Samurai Cannulation for Acute Stanford Type A Aortic Dissection” 回复："Samurai 插管术治疗急性斯坦福 A 型主动脉夹层

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-09-01 Epub Date: 2024-04-04 DOI: 10.1053/j.optechstcvs.2024.03.003

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