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Non-circulatory arrest aortic arch replacement. 非循环停止主动脉弓置换术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-21 DOI: 10.1510/mmcts.2024.023
Stephen M Spindel, Manuel Giraldo-Grueso
{"title":"Non-circulatory arrest aortic arch replacement.","authors":"Stephen M Spindel, Manuel Giraldo-Grueso","doi":"10.1510/mmcts.2024.023","DOIUrl":"https://doi.org/10.1510/mmcts.2024.023","url":null,"abstract":"<p><p>The definitive management of combined aortic arch and descending aortic pathologies such as aneurysms and dissections is either a single or staged operation associated with high morbidity and mortality. Stroke, kidney dysfunction, coagulopathy and high blood transfusion requirements are all affiliated with hypothermic circulatory arrest and prolonged cardiopulmonary bypass times. Considering the perilous nature of these operations, the authors describe a step-by-step zone 2 arch replacement as a staged frozen elephant trunk procedure, which provides an adequate landing zone for a later-placed endovascular stent yet maintains a short cardiopulmonary bypass time and no circulatory arrest.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114725","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
The Commando procedure for mechanical double valve prosthesis endocarditis with destruction of the aortomitral continuity. 突击队手术治疗伴有主动脉连续性破坏的机械双瓣人工心内膜炎。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-14 DOI: 10.1510/mmcts.2024.052
Sami Mouritane, Birgit Zirngast, Melanie Arnreiter, Günther Laufer, Daniel Zimpfer
{"title":"The Commando procedure for mechanical double valve prosthesis endocarditis with destruction of the aortomitral continuity.","authors":"Sami Mouritane, Birgit Zirngast, Melanie Arnreiter, Günther Laufer, Daniel Zimpfer","doi":"10.1510/mmcts.2024.052","DOIUrl":"https://doi.org/10.1510/mmcts.2024.052","url":null,"abstract":"<p><p>Infective endocarditis, particularly after implanting valve prostheses, poses significant surgical challenges, often requiring complex interventions. We describe a case of a 37-year-old male with Staphylococcus aureus endocarditis, unsuccessfully treated with mechanical valve prostheses. Continued infection led to the destruction of the intervalvular fibrous body, necessitating a Commando procedure involving radical debridement and replacement of both aortic and mitral valves with complex patch reconstruction. Prosthesis selection remains contentious, considering recurrence risk and long-term prognosis. Our case underscores timely intervention and meticulous technique in managing such complex situations. It highlights successful strategies for treating infective endocarditis with destruction of aortomitral continuity, emphasizing the pivotal role of the Commando procedure.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977172","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
A robotic left S6 and S1/2c segmentectomy using the lung-inverted approach. 采用肺倒置方法的机器人左侧 S6 和 S1/2c 节段切除术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-07 DOI: 10.1510/mmcts.2024.051
Hitoshi Igai, Akinobu Ida, Kazuki Numajiri, Kazuhito Nii, Mitsuhiro Kamiyoshihara
{"title":"A robotic left S6 and S1/2c segmentectomy using the lung-inverted approach.","authors":"Hitoshi Igai, Akinobu Ida, Kazuki Numajiri, Kazuhito Nii, Mitsuhiro Kamiyoshihara","doi":"10.1510/mmcts.2024.051","DOIUrl":"10.1510/mmcts.2024.051","url":null,"abstract":"<p><p>In pulmonary segmentectomy, the dominant pulmonary arteries are traditionally divided at the fissure. However, this approach sometimes leads to inadvertent injury to the pulmonary artery and prolonged air leak when the fissure is fused. To overcome these problems, by taking advantage of the good visualization provided by robotic surgery, we have adopted the lung-inverted approach without fissure dissection for segmentectomy. We have successfully performed a robotic left S6 and S1+2c segmentectomy using the lung-inverted approach. In addition to a good postoperative course, the console time was 57 minutes, which was considered relatively short. This approach may have contributed to the short operating time because it did not require repeated rotation of the lung. A clear understanding of the anatomy was required to perform this approach properly, because each branch of the pulmonary vessels and bronchi was treated inverted at the hilum. A preoperative 3-dimensional computed tomography broncho-angiographic scan was considered useful because it allowed us to recognize the relative positions of the dominant pulmonary vessels, the bronchi and other structures that were preserved.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898882","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 intrapericardial bilobectomy with stapler on the atrium and pericardial reconstruction. 机器人心包内双腔切除术，在心房上用订书机订书，并重建心包。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-05 DOI: 10.1510/mmcts.2024.032
Haisam Saad, Nicole Asemota, Obadah Alqudah, Ahmad Asqalan, Joanna Fuentes-Warr, Stephen Wilson, May Thu Han, Vasileios Kouritas
{"title":"Robotic intrapericardial bilobectomy with stapler on the atrium and pericardial reconstruction.","authors":"Haisam Saad, Nicole Asemota, Obadah Alqudah, Ahmad Asqalan, Joanna Fuentes-Warr, Stephen Wilson, May Thu Han, Vasileios Kouritas","doi":"10.1510/mmcts.2024.032","DOIUrl":"https://doi.org/10.1510/mmcts.2024.032","url":null,"abstract":"<p><p>Few intrapericardial robotic lung resection cases have been reported in the literature because of the perceived complexity of the procedure, with most surgeons embarking on an open resection via a thoracotomy. We present the case of a right middle and lower lobe tumour involving the pericardium and the origin of the right middle lobe vein. An intrapericardial lower bilobectomy was performed, with pericardial resection, pre-pericardial fat resection and mesh reconstruction. The vascular stapler for the right middle lobe vein was fired on the atrium. The resection was completed via a retrograde and fissureless approach, dividing the bronchus intermedius first, because it was impossible to open the fissure, leaving the division of the pulmonary artery until last. The case was performed solely robotically, with no complications and excellent postoperative recovery. Robotic resection can be performed successfully when pericardial lung tumours are involved.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890921","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
A heart transplant and concomitant hemiarch repair in a patient with a large ascending aortic aneurysm and a challenging sternal re-entry. 一名患有巨大升主动脉瘤和胸骨再入路的患者接受了心脏移植手术并同时进行了半弓修补术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-05 DOI: 10.1510/mmcts.2024.025
Junichi Shimamura, David Spielvogel, Stephen Pan, Hayoung Lee, Suguru Ohira
{"title":"A heart transplant and concomitant hemiarch repair in a patient with a large ascending aortic aneurysm and a challenging sternal re-entry.","authors":"Junichi Shimamura, David Spielvogel, Stephen Pan, Hayoung Lee, Suguru Ohira","doi":"10.1510/mmcts.2024.025","DOIUrl":"https://doi.org/10.1510/mmcts.2024.025","url":null,"abstract":"<p><p>An orthotopic heart transplant and an aortic operation can be done concomitantly at centres that are experienced in both aortic operations and heart transplants with meticulous surgical strategy.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890920","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
Re-sternotomy in complex aortic surgery: careful individualized planning for a safe opening. 复杂主动脉手术中的再司脉切开术：为安全开腹而进行的个体化精心规划。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-01 DOI: 10.1510/mmcts.2023.106
Ignacio Morales-Rey, Eduard Quintana, Jorge Alcocer, Daniel Pereda, María Ascaso
{"title":"Re-sternotomy in complex aortic surgery: careful individualized planning for a safe opening.","authors":"Ignacio Morales-Rey, Eduard Quintana, Jorge Alcocer, Daniel Pereda, María Ascaso","doi":"10.1510/mmcts.2023.106","DOIUrl":"https://doi.org/10.1510/mmcts.2023.106","url":null,"abstract":"<p><p>An increasing number of patients have required cardiac reoperations in recent decades, and this trend is expected to continue. Hence, re-sternotomy is and will be a common practice in high-volume centres. Re-sternotomy in complex aortic reinterventions carries a high risk of injuring major vascular and heart structures. To avoid catastrophic injuries, preoperative planning and case individualization are essential to minimize complications. Designing a safe and tailored strategy for each patient is believed to have an impact on postoperative outcomes. The arterial cannulation site, the need for hypothermia, left ventricle decompression and the use of an aortic occlusion balloon catheter are some of the preoperative decisions that must be made on a case-by-case basis to ensure adequate brain and visceral perfusion and to minimize major bleeding and circulatory interruption in case of re-entry injury.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861643","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
Thoracoscopic S1 segmentectomy, right upper lobe: alternative posterior approach. 胸腔镜 S1 区段切除术（右上叶）：另一种后入路。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-08-01 DOI: 10.1510/mmcts.2024.019
George Rakovich
{"title":"Thoracoscopic S1 segmentectomy, right upper lobe: alternative posterior approach.","authors":"George Rakovich","doi":"10.1510/mmcts.2024.019","DOIUrl":"https://doi.org/10.1510/mmcts.2024.019","url":null,"abstract":"<p><p>Minimally invasive pulmonary segmentectomy allows adequate oncological treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. Although several variations of minimally invasive pulmonary segmentectomy have been described, a fully thoracoscopic multiport approach that allows direct access to the segmental structures, is straightforward and is versatile enough to allow adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy in the case of positive margins) is preferable. The S1 (apical) segment of the right upper lobe has some unique features that may make a conventional anterior approach challenging. The presence of multiple vascular structures bearing complex anatomical relationships and the requirement for preserving these structures may make identification of and access to the apical artery, and subsequent access to the segmental bronchus, challenging. In contradistinction, a posterior approach may obviate some of these challenges by allowing direct access to the segmental bronchus. Once the bronchus is divided, the apical artery is in direct alignment with the operating instruments, without encroachment from other troublesome vascular structures. This situation, however, remains contingent on individual anatomy, which may vary.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861644","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
Redo aortic root and arch replacement with 3 different homografts. 用 3 种不同的同种移植物重做主动脉根和弓置换术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-07-17 DOI: 10.1510/mmcts.2024.044
Andrey Protopopov, Alexey Limansky, Dmitry Khvan, Dmitry Sirota, Maxim Zhulkov, Alexander Bogachev-Prokophiev, Maxim Nikitin, Alexander Zheravin, Khava Agaeva
{"title":"Redo aortic root and arch replacement with 3 different homografts.","authors":"Andrey Protopopov, Alexey Limansky, Dmitry Khvan, Dmitry Sirota, Maxim Zhulkov, Alexander Bogachev-Prokophiev, Maxim Nikitin, Alexander Zheravin, Khava Agaeva","doi":"10.1510/mmcts.2024.044","DOIUrl":"10.1510/mmcts.2024.044","url":null,"abstract":"<p><p>A 74-year-old male entered the hospital with a medical history of an aortic arch and a descending thoracic aneurysm. To prevent arm ischaemia after the frozen elephant trunk procedure, a left subclavian artery to left common carotid artery anastomosis was performed. The postoperative period was complicated by sepsissternal infection and mediastinitis. We decided to perform a combined total aortic root and aortic arch replacement with 3 cryopreserved homografts. In addition, the \"reverse arch technique\" was applied to adapt the distal anastomosis. The operation is associated with a high risk of mortality in the postoperative period.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629227","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
Minimally invasive off-pump bypass grafting-positioning the right posterior descending coronary artery. 微创离泵旁路移植术--右冠后降支动脉定位。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-07-15 DOI: 10.1510/mmcts.2024.012
Ferdi Akca
{"title":"Minimally invasive off-pump bypass grafting-positioning the right posterior descending coronary artery.","authors":"Ferdi Akca","doi":"10.1510/mmcts.2024.012","DOIUrl":"https://doi.org/10.1510/mmcts.2024.012","url":null,"abstract":"<p><p>Minimally invasive coronary surgery offers benefits to the patient. Besides the anterior wall, the lateral and inferior walls can be reached through a small thoracotomy with off-pump techniques. Thoracoscopic coronary identification can be very useful in these multivessel procedures. Positioning the heart without cardiopulmonary bypass can be challenging. We describe our technique for off-pump positioning and for grafting the right posterior descending coronary artery.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749752","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
Right uniportal video-assisted thoracoscopic surgery lung-sparing sleeve resection of the bronchus intermedius 右侧单孔视频辅助胸腔镜手术--中间气道支气管袖式保肺切除术。
Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2024-07-10 DOI: 10.1510/mmcts.2024.054
Rihards Mikilps-Mikgelbs, Helmuts Bināns, Marina Gaidukova, Ints Siliņš
{"title":"Right uniportal video-assisted thoracoscopic surgery lung-sparing sleeve resection of the bronchus intermedius","authors":"Rihards Mikilps-Mikgelbs, Helmuts Bināns, Marina Gaidukova, Ints Siliņš","doi":"10.1510/mmcts.2024.054","DOIUrl":"10.1510/mmcts.2024.054","url":null,"abstract":"<p><p>Complete surgical resection has been the main treatment modality for pulmonary neoplasms without locoregional or distant spread of the disease. Sleeve resections were developed to minimize unnecessary loss of pulmonary parenchyma mainly in the case of centrally located tumours. Experience with sleeve resections and recent technological advancements made minimally invasive resection possible for selected patients. We present a case report of the totally thoracoscopic uniportal sleeve resection of the bronchus intermedius without any resection of pulmonary parenchyma. The operation was performed successfully, and the patient did not experience any postoperative complications. In this case report, we describe our surgical approach and short-term results.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565099","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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