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

Recent Articles in AATS Journals 最近在 AATS 期刊上发表的文章

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.optechstcvs.2024.05.001

引用次数: 0

Transatrial Approach to the “Swiss-cheese” Ventricular Septal Defects: Re-endocardialization Technique 经心房方法治疗 "瑞士奶酪 "室间隔缺损：再心内膜化技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.optechstcvs.2023.12.002

Osami Honjo MD, PhD , Mimi Xiaoming Deng MD

{"title":"Transatrial Approach to the “Swiss-cheese” Ventricular Septal Defects: Re-endocardialization Technique","authors":"Osami Honjo MD, PhD , Mimi Xiaoming Deng MD","doi":"10.1053/j.optechstcvs.2023.12.002","DOIUrl":"10.1053/j.optechstcvs.2023.12.002","url":null,"abstract":"<div>Transatrial re-endocardialization (TAR) is a technique used to complement conventional patch repair of multiple ventricular septal defects (mVSD). To inform operative strategy, pre-operative imaging is supplemented by pre-cardiopulmonary bypass (CPB) intraoperative epicardial echocardiography to understand the size and location of all VSDs. After standard cannulation and arrest, L-shaped right atriotomy is performed and the superior margin of VSDs are marked. Perimembraneous and moderate-large VSDs with insufficient surrounding trabeculae are closed with patch repair. Remaining small muscular VSDs are addressed by TAR, whereby the defect is closed in 2-layers with fine polypropylene suture for superficial re-approximation of adjacent right ventricular trabeculation. Success of repair is evaluated with high-pressure left ventricular injection and pulmonary-systemic flow ratio after CPB is weaned. Adding TAR to the armamentarium of mVSD repair strategies allows for reduction of patch size, thereby decreasing the risk of ventricular septal dyskinesis and heart block.</div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 2","pages":"Pages 202-215"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193583","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

Three-dimensional printing in the closure of multiple muscular ventricular septal defects 三维打印在多发性肌性室间隔缺损闭合中的应用

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.optechstcvs.2023.04.001

Shalom Andugala MS, MCh (CTh) , Caroline Grant PhD , Jennifer Powell FRANZCR , Supreet Marathe MD, MCh (CTh) , Prem Venugopal FRACS, FRCS (CTh) , Nelson Alphonso FRACS, FRCS (CTh)

{"title":"Three-dimensional printing in the closure of multiple muscular ventricular septal defects","authors":"Shalom Andugala MS, MCh (CTh) , Caroline Grant PhD , Jennifer Powell FRANZCR , Supreet Marathe MD, MCh (CTh) , Prem Venugopal FRACS, FRCS (CTh) , Nelson Alphonso FRACS, FRCS (CTh)","doi":"10.1053/j.optechstcvs.2023.04.001","DOIUrl":"10.1053/j.optechstcvs.2023.04.001","url":null,"abstract":"<div>The closure of multiple muscular ventricular septal defects poses a unique challenge to the surgeon with inherent risks of residual defects, conduction blocks, and ventricular dysfunction. The trabeculations in the right ventricle often make it difficult to identify and visualize the edges of the defects. More recently 3 dimensional (3D) models are increasingly being used in the management of various complex congenital heart defects. We present our technique of closing multiple muscular ventricular septal defects (VSDs) using individualized 3D printed models. The stepwise process requires a multidisciplinary approach between the cardiologist, cardiac surgeon, cardiac radiologist, and 3D engineer. As the 3D model exactly replicates the intracardiac anatomy including that of the trabeculations in the region of the multiple VSDs, this technique facilitates the precise location of the defects and obviates the requirement to ‘search’ for the defects intraoperatively. The defects can be located through a shorter right ventricular incision and the defects can be closed with a shorter myocardial ischemia time. Three-dimensional printing facilitates individualization of surgical management, and we recommend the addition of 3D printing to the armamentarium of surgeons dealing with the challenge of closing multiple muscular VSDs in children.</div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 2","pages":"Pages 184-201"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48698011","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

Implantation Technique for the Aeson Total Artificial Heart Aeson 全人工心脏的植入技术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-06-01 DOI: 10.1053/j.optechstcvs.2024.01.002

André Vincentelli MD, PhD , Yuriy Pya MD , Ivan Netuka MD, PhD , Assad Haneya MD, PhD , Jan Schmitto MD, PhD , Michel Kindo MD, PhD , Peter Wearden MD, PhD , Piet Jansen MD, PhD , Christian Latremouille MD, PhD

{"title":"Implantation Technique for the Aeson Total Artificial Heart","authors":"André Vincentelli MD, PhD , Yuriy Pya MD , Ivan Netuka MD, PhD , Assad Haneya MD, PhD , Jan Schmitto MD, PhD , Michel Kindo MD, PhD , Peter Wearden MD, PhD , Piet Jansen MD, PhD , Christian Latremouille MD, PhD","doi":"10.1053/j.optechstcvs.2024.01.002","DOIUrl":"10.1053/j.optechstcvs.2024.01.002","url":null,"abstract":"<div>The autoregulated, pulsatile Aeson total artificial heart (Carmat SA, Vélizy, France) is a single-unit biventricular device. The central body comprises the 2 blood pumping ventricles and separate technical compartments which house 2 electrohydraulic pumps and control electronics which employ an algorithm informed by pressure sensors and volume detection transducers in each ventricle. The prosthesis is connected by an 8 mm driveline, which exits the skin in the lower right quadrant, to an external routing module and a controller powered by batteries. Since the first implantation took place in 2013, more than 50 patients have been successfully implanted during clinical studies, and commercially after the Aeson obtained its CE mark in 2020, as a bridge to transplant device. The size of the device and the lack of adhesions around the device body have been shown to facilitate relatively easy explanation and subsequent transplantation.With the growing experience, the implant procedure has evolved from experimental to a well-established routine procedure. The purpose of this article is to provide a guide for potential implanters in order to ensure that the advanced design benefits of the Aeson TAH are realized by incorporating optimal surgical techniques.</div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 2","pages":"Pages 149-167"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1522294224000047/pdfft?md5=24bdf33bbcc8b2e7b8976019caf1387c&pid=1-s2.0-S1522294224000047-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139819389","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}

引用次数: 0

Minimally Invasive Complex Segmentectomies of the Right Upper Lobe: Anterior Segmentectomy, Apical Segmentectomy, and Posterior Segmentectomy 右上叶复杂节段的微创切除术:前节段切除术、根尖节段切除术和后节段切除术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.optechstcvs.2023.06.002

Eserval Rocha Júnior MD , Ricardo Mingarini Terra MD, PhD

{"title":"Minimally Invasive Complex Segmentectomies of the Right Upper Lobe: Anterior Segmentectomy, Apical Segmentectomy, and Posterior Segmentectomy","authors":"Eserval Rocha Júnior MD , Ricardo Mingarini Terra MD, PhD","doi":"10.1053/j.optechstcvs.2023.06.002","DOIUrl":"10.1053/j.optechstcvs.2023.06.002","url":null,"abstract":"<div>Anatomic segmentectomy becomes an actual therapeutic option for the thoracic surgeon on lung cancer treatment. Mostly applied for early-stage lung cancer resections, its applications go further passing from localized benign disease and metastatic lung lesions. Due to the anatomic complexity and the vascular anatomic variations of the segments, It is usually more technically challenging than a standard lobectomy. This complexity is noted mainly in single-segment resections where there is a need to treat more than 1 intersegmental plane. The great anatomical variation and the high occurrence of lesions in the upper lobes make it important to study sublobar resections of the right upper lobe. Performing it with minimally invasive access requires a great knowledge of the technique to standardize the approach avoid pitfalls and optimize the procedure outcomes. This paper aims to describe the anatomic segmental resections of the right upper lobe performed by minimally invasive access, anticipating instructions for video thoracoscopic and robotic approaches.</div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 1","pages":"Pages 118-128"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43720917","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

Norwood-Sano Procedure With Neo-aortic Valve Repair on the Beating Heart 诺伍德-萨诺手术，在跳动的心脏上进行新主动脉瓣修复术

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.optechstcvs.2023.11.002

Igor E. Konstantinov MD, PhD, FRACS , Edward Buratto MBBS, PhD, FRACS , Shuta Ishigami MD, PhD , Bosco Moscoso MD

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How I Do the Norwood Operation 我如何进行诺伍德操作

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.optechstcvs.2023.09.007

Douglas M. Overbey MD, MPH , Nicholas D. Andersen MD , Joseph W. Turek MD, PhD, MBA

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A Novel Approach for Simultaneous Venoarterial Extracorporeal Membrane Oxygenation and Left Ventricular Decompression Therapy With Impella (ECPella) 体外膜肺氧合与左心室减压疗法（ECPella）同时进行的新方法

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.optechstcvs.2023.11.004

Breah Paciotti MPH, PA-C , Pankaj Garg MBBS , James Postier , Amy Lykins APRN, DNP , Basar Sareyyupoglu MD

{"title":"A Novel Approach for Simultaneous Venoarterial Extracorporeal Membrane Oxygenation and Left Ventricular Decompression Therapy With Impella (ECPella)","authors":"Breah Paciotti MPH, PA-C , Pankaj Garg MBBS , James Postier , Amy Lykins APRN, DNP , Basar Sareyyupoglu MD","doi":"10.1053/j.optechstcvs.2023.11.004","DOIUrl":"10.1053/j.optechstcvs.2023.11.004","url":null,"abstract":"<div>Percutaneously placed veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is commonly used to support patients with refractory cardiac arrhythmias or arrest and worsening cardiogenic shock. Peripheral VA-ECMO by retrograde flow of blood in the aorta results in a significant increase in left ventricle (LV) afterload. A severely dysfunctional LV may be unable to overcome this afterload to open the aortic valve and unload itself. This may lead to LV distension, increased LV pressure, poor coronary blood circulation, increased left atrial pressures, pulmonary edema, and pulmonary hypertension. Moreover, it jeopardizes ventricular recovery, particularly in the presence of ischemia-induced myocardial impairment. Furthermore, if the aortic valve remains closed during the cardiac cycle, stasis of blood in the LV and aortic root may increase the risk of thrombus formation. These complications may preclude cardiac recovery and the patient from being a heart transplant candidate. In patients with cardiogenic shock, utilizing Impella with VA-ECMO, commonly referred to as ECPella, has consistently been shown to reduce mortality and improve outcomes. Patients who need prolonged ECPella support as a bridge to recovery or transplant may remain bed-bound since ambulation of patients with 2 mechanical circulatory support devices is challenging. We present the technique of ECPella placement through Y chimney graft anastomosis on the axillary artery for arterial cannula and Impella insertion and percutaneous cannulation of the right internal Jugular vein for venous cannula. This technique gives the ease of ambulation and decannulation of VA-ECMO under local anesthesia without requiring intubation or a trip to the operating room.</div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 1","pages":"Pages 2-24"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126143","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 Spring 2024 2024 年春季介绍

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.optechstcvs.2024.03.001

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Valved Conduit for Norwood-Sano Procedure 用于诺伍德-萨诺程序的阀式导管

Operative Techniques in Thoracic and Cardiovascular Surgery Pub Date : 2024-03-01 DOI: 10.1053/j.optechstcvs.2023.09.005

David Kalfa MD, PhD, Edward Buratto MD, PhD, Andrew Goldstone MD, PhD, Emile Bacha MD

{"title":"Valved Conduit for Norwood-Sano Procedure","authors":"David Kalfa MD, PhD, Edward Buratto MD, PhD, Andrew Goldstone MD, PhD, Emile Bacha MD","doi":"10.1053/j.optechstcvs.2023.09.005","DOIUrl":"10.1053/j.optechstcvs.2023.09.005","url":null,"abstract":"<div>Use of a valved Sano (VS) during the Norwood procedure has been reported previously, but is not widely used and its impact on clinical outcomes needs to be further elucidated. Our institution shifted practice to the VS operation entirely in 2019, using a valved femoral venous homograft. We describe our technique in the present report. The VS technique is well codified and highly reproducible. Pre-Glenn echocardiograms showed competent conduit valves in two-thirds of the VS patients (n = 16/25, 66.7%). We retrospectively reviewed 25 consecutive HLHS neonates who underwent a Norwood procedure with a VS conduit using a femoral venous homograft and 25 consecutive HLHS neonates who underwent a Norwood procedure with a non-valved Sano (NVS) conduit between 2013 and 2022. Hospital survival for the VS group was 96%. Postoperatively, VS patients had significantly lower peak and postoperative day 1 lactate levels (p = 0.033 and p = 0.025 respectively), shorter time to diuresis (p = 0.043), and shorter time to enteral feeds (p = 0.038). The VS group had significantly fewer PA reinterventions until the Glenn (n = 1 vs 8; p = 0.044). The VS group showed significant improvement in ventricular function from the immediate postoperative period to discharge (p < 0.001). From preoperative to pre-Glenn time points, analysis of ventricular function showed sustained ventricular function within the VS group, but a significant reduction of ventricular function in the NVS group (p = 0.003). The use of a valved conduit for Norwood-Sano procedure is a reproducible technique, associated with improved multi-organ recovery, ventricular function recovery and fewer PA reinterventions.</div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":"29 1","pages":"Pages 25-36"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135406755","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