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Bicuspid aortic valve repair with external annuloplasty. 外环成形术修复二尖瓣主动脉瓣。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-23 DOI: 10.1510/mmcts.2025.117
Maksym Rzhanyi, Polina Danchenko, Kostiantyn Rudenko, Liliana Hrubiak, Mykhailo Ischenko, Vladyslav Stepanov, Dmytro Vichev, Anna Bei
{"title":"Bicuspid aortic valve repair with external annuloplasty.","authors":"Maksym Rzhanyi, Polina Danchenko, Kostiantyn Rudenko, Liliana Hrubiak, Mykhailo Ischenko, Vladyslav Stepanov, Dmytro Vichev, Anna Bei","doi":"10.1510/mmcts.2025.117","DOIUrl":"https://doi.org/10.1510/mmcts.2025.117","url":null,"abstract":"<p><p>This video tutorial demonstrates the surgical repair of a bicuspid aortic valve in a 45-year-old male patient with severe aortic regurgitation due to annular dilatation and prolapse of the fused cusp. The procedure included external annuloplasty to stabilize and downsize the annulus, and cusp plication to restore effective height and durable coaptation. The repair resulted in a competent native valve with preserved geometry. It highlights reconstructive strategies as a durable alternative to valve replacement.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350035","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
Extra-anatomical ascending-to-descending aortic bypass in an adult patient with aortic coarctation. 成人主动脉缩窄患者的解剖外升降主动脉搭桥术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-20 DOI: 10.1510/mmcts.2025.090
Gvido Varpins, Eduard Quintana, Nikola Caune, Gunars Davis Bahs, Peteris Stradins, Carlos A Mestres
{"title":"Extra-anatomical ascending-to-descending aortic bypass in an adult patient with aortic coarctation.","authors":"Gvido Varpins, Eduard Quintana, Nikola Caune, Gunars Davis Bahs, Peteris Stradins, Carlos A Mestres","doi":"10.1510/mmcts.2025.090","DOIUrl":"https://doi.org/10.1510/mmcts.2025.090","url":null,"abstract":"<p><p>Aortic coarctation is typically diagnosed in infancy, but some cases present in adulthood, posing significant risks including aortic dissection, myocardial infarction and heart failure. In adults requiring complex aortic or cardiac interventions, extra-anatomical ascending-to-descending aortic bypass via median sternotomy is a preferred surgical option due to its reduced risk of spinal cord ischaemia and recurrent laryngeal nerve injury. We present the case of a 55-year-old woman with lifelong hypertension and severe headaches. Transthoracic echocardiography revealed a significant narrowing at the aortic isthmus with elevated peak velocity and pressure gradients. Contrast-enhanced computed tomography confirmed 80% narrowing without aneurysmal changes. The patient underwent an extra-anatomical bypass using a 16mm interposition graft via median sternotomy. The graft was routed behind the left ventricle and over the left pulmonary artery to connect the ascending and descending aorta. Intra-operative haemodynamic improvement was immediate, with normalization of upper and lower body pressures. Post-operative imaging confirmed correct graft positioning without stenosis or kinking. The patient recovered uneventfully and was discharged on post-operative Day 12. This case demonstrates the safety and effectiveness of extra-anatomical bypass via sternotomy in adult coarctation, offering a viable alternative to thoracotomy in anatomically and surgically complex scenarios.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330808","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 two-patch repair with left atrioventricular valve augmentation for complete atrioventricular septal defect: a novel modification to an older concept. 改良双补片修复左房室瓣膜增强治疗完全性房室间隔缺损：对旧概念的新改良。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-20 DOI: 10.1510/mmcts.2025.111
Sameh M Said, Ali H Mashadi
{"title":"Modified two-patch repair with left atrioventricular valve augmentation for complete atrioventricular septal defect: a novel modification to an older concept.","authors":"Sameh M Said, Ali H Mashadi","doi":"10.1510/mmcts.2025.111","DOIUrl":"https://doi.org/10.1510/mmcts.2025.111","url":null,"abstract":"<p><p>Repair of complete atrioventricular septal defects continues to be a challenge. Several techniques have been described such as the single-patch, the modified single-patch and the two-patch technique. Each has its own pros and cons, and no technique is free from reoperation. Routine augmentation of the left atrioventricular valve during the repair has also been proposed; however, a repeat operation for recurrent left atrioventricular regurgitation continues to be a major concern. In this report, we describe a new strategy for the repair of a complete atrioventricular septal defect that combines the basics of several of the previously described techniques, eliminates some of the anatomical factors behind future left ventricular outflow tract obstruction and may improve competence of the left atrioventricular valve, and has the potential of decreasing the reoperation rate on both the left atrioventricular valve and the left ventricular outflow tract.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337861","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
Robotic folding plasty for repair of posterior mitral leaflet prolapse. 机器人折叠成形术修复二尖瓣后小叶脱垂。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-17 DOI: 10.1510/mmcts.2025.112
Paul Cullen, Tarek Malas, Marc Gillinov
{"title":"Robotic folding plasty for repair of posterior mitral leaflet prolapse.","authors":"Paul Cullen, Tarek Malas, Marc Gillinov","doi":"10.1510/mmcts.2025.112","DOIUrl":"https://doi.org/10.1510/mmcts.2025.112","url":null,"abstract":"<p><p>Folding plasty is a valuable technique for reducing excessive posterior leaflet height and mitigating the risk of systolic anterior motion. It offers a simpler alternative to the classic quadrangular resection with sliding plasty and has demonstrated comparable long-term durability when applied in appropriate settings. We have adopted this technique widely and employ it frequently in both open and robotic mitral valve repair.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309869","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
Pectus Up: a new technique for the correction of pectus excavatum. 上胸：一种矫正漏斗胸的新技术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-16 DOI: 10.1510/mmcts.2025.073
Giulia Pagliarini, Vincenzo Verzeletti, Alessandro Bonis, Marco Schiavon, Samuele Nicotra, Andrea Dell'Amore, Federico Rea
{"title":"Pectus Up: a new technique for the correction of pectus excavatum.","authors":"Giulia Pagliarini, Vincenzo Verzeletti, Alessandro Bonis, Marco Schiavon, Samuele Nicotra, Andrea Dell'Amore, Federico Rea","doi":"10.1510/mmcts.2025.073","DOIUrl":"https://doi.org/10.1510/mmcts.2025.073","url":null,"abstract":"<p><p>The treatment of pectus excavatum has historically been based on two main surgical techniques: the Ravitch procedure and the minimally invasive Nuss procedure. Both have demonstrated effectiveness over the years and have become well-established options in clinical practice. However, in recent years, a new approach known as the Pectus Up technique has emerged as an innovative and less invasive alternative for the correction of this congenital chest wall deformity. In this video tutorial, we present the case of a young male patient treated using the Pectus Up system, highlighting the surgical steps, clinical outcomes and potential advantages of this novel method compared to traditional techniques.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330745","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
Open aortic root in a porcelain aorta when TAVR is not feasible. 当TAVR不可行时，打开瓷主动脉的主动脉根部。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-16 DOI: 10.1510/mmcts.2025.119
Alexandra Murillo Solera, Vaishnavi Karanam, Lindsey Brinkley, Ryan Azarrafiy, Anna Adams, Anjali Khanna, Giselle Leon, Oscar Holmvard, Yuriy Stukov, Jeffrey P Jacobs, Thomas M Beaver
{"title":"Open aortic root in a porcelain aorta when TAVR is not feasible.","authors":"Alexandra Murillo Solera, Vaishnavi Karanam, Lindsey Brinkley, Ryan Azarrafiy, Anna Adams, Anjali Khanna, Giselle Leon, Oscar Holmvard, Yuriy Stukov, Jeffrey P Jacobs, Thomas M Beaver","doi":"10.1510/mmcts.2025.119","DOIUrl":"https://doi.org/10.1510/mmcts.2025.119","url":null,"abstract":"<p><p>Porcelain aorta, though rare, is often considered a contraindication for open surgery due to the risk of associated neurological complications due to calcium embolization. We present the case of a 70-year-old female with a prior 19mm bioprosthetic aortic valve replacement who, during routine follow-up, was found to have significant aortic valve stenosis, severely reduced leaflet mobility and a mean gradient of 40mmHg. Pre-operative computed tomography angiography revealed a calcified 'porcelain aorta'. Transcatheter aortic valve-in-valve replacement was not possible due to the small 19mm valve and small aortic sinuses, leading to referral for open aortic surgery.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330779","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
Robotic commissuroplasty for mitral valve repair. 二尖瓣修复的机器人融合成形术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-16 DOI: 10.1510/mmcts.2025.115
Paul Cullen, Tarek Malas, Marc Gillinov
{"title":"Robotic commissuroplasty for mitral valve repair.","authors":"Paul Cullen, Tarek Malas, Marc Gillinov","doi":"10.1510/mmcts.2025.115","DOIUrl":"https://doi.org/10.1510/mmcts.2025.115","url":null,"abstract":"<p><p>Commissuroplasty is a simple yet highly effective technique to address prolapse involving the mitral commissures, which can otherwise be technically challenging to repair using traditional resection or neochordae. We demonstrate our robotic approach and highlight key technical nuances, indications and expected outcomes relevant to mitral surgeons.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330827","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
Robotic mitral valve repair: quadrangular resection and bidirectional sliding valvuloplasty. 机器人二尖瓣修复：四边形切除和双向滑动瓣成形术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-16 DOI: 10.1510/mmcts.2025.114
Paul Cullen, Tarek Malas, Marc Gillinov
{"title":"Robotic mitral valve repair: quadrangular resection and bidirectional sliding valvuloplasty.","authors":"Paul Cullen, Tarek Malas, Marc Gillinov","doi":"10.1510/mmcts.2025.114","DOIUrl":"https://doi.org/10.1510/mmcts.2025.114","url":null,"abstract":"<p><p>Systolic anterior motion remains a recognized complication of mitral valve repair, for which sliding valvuloplasty was originally developed as a preventive strategy. This technique is used in patients with a broad area of posterior leaflet prolapse and excessive leaflet height. We demonstrate our modification of the classic sliding plasty, including further adaptations to enable its reliable and efficient application via a minimally invasive robotic approach.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330886","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
Stepwise surgical approach to left ventricular fibroma. 渐进式手术治疗左心室纤维瘤。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-13 DOI: 10.1510/mmcts.2025.102
Chellasamy Rajeev Thilak, Wahi Pritja, Rezaei Mohammad, Cusimano Robert, Ansari Bilal
{"title":"Stepwise surgical approach to left ventricular fibroma.","authors":"Chellasamy Rajeev Thilak, Wahi Pritja, Rezaei Mohammad, Cusimano Robert, Ansari Bilal","doi":"10.1510/mmcts.2025.102","DOIUrl":"https://doi.org/10.1510/mmcts.2025.102","url":null,"abstract":"<p><p>Cardiac fibromas are rare benign myocardial tumours, most commonly detected in infants and children. Presentations in adolescents are uncommon but clinically significant due to the associated arrhythmic risk. We report a case of a young female who presented with syncope and was subsequently diagnosed with a left ventricular fibroma on cardiac magnetic resonance imaging (MRI). The tumour was located near the papillary muscles. Surgical excision was performed via a left ventriculotomy, carefully avoiding distortion of the mitral valve. This video tutorial demonstrates the surgical approach to an left ventricular fibroma, a definitive treatment aimed at mitigating the life-threatening arrhythmogenic risks associated with these tumours, while preserving the mitral valve.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330867","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
Carbon fibre-enforced stabilization system for ministernotomy resynthesis. 用于椎板切开再合成的碳纤维强化稳定系统。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-10-13 DOI: 10.1510/mmcts.2025.058
Bruno Chiarello, Sherif Negm, Lorena Mujica, Brayan Rubio, Gustavo Woll, Manuel Castellà
{"title":"Carbon fibre-enforced stabilization system for ministernotomy resynthesis.","authors":"Bruno Chiarello, Sherif Negm, Lorena Mujica, Brayan Rubio, Gustavo Woll, Manuel Castellà","doi":"10.1510/mmcts.2025.058","DOIUrl":"https://doi.org/10.1510/mmcts.2025.058","url":null,"abstract":"<p><p>Sternal dehiscence incidence ranges from 0.2% to 5%]. Risk factors include obesity, advanced age, use of bilateral internal thoracic arteries, diabetes mellitus and chronic obstructive pulmonary disease [1]. Traditional techniques with steel wires have been associated with dehiscence rates of up to 11.8% [2]. Utilizing titanium plates, the incidence of sternal dehiscence has reduced to 1.5% [3]. The STERN FIX Sternal Stabilization System is a biocompatible carbon-fibre reinforced poly-ether-ether-ketone tool constituting two components, both with a curved arm that embraces the sternum at the level of an intercostal space and does not perforate the intercostal fascia, reducing the retrosternal bleeding [4]. The sternal closure is performed following five steps: sizing using a gauger (device available for sternal bone thicknesses between 9.5 and 17mm); marking the selected intercostal space bilaterally to allow the passage of the device; placement of both device parts; closure of the device; and cutting the excess segment. The sternal closure is complemented with cerclage wire. The first results are very satisfactory, with 0% sternal dehiscence at 6 months on 30 patients [5], comparable to those achieved by adopting the Robicsek technique [6]. We present a video tutorial case of ministernotomy closure using the STERN FIX system.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330744","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
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