Journals Multimedia Manual of Cardiotho...

Multimedia Manual of Cardiothoracic Surgery : MMCTS
Eduard Charchyan, Denis Breshenkov, Boris Tivelev, Yuriy Belov
Single-stage total aortic replacement represents a comprehensive approach for patients at high risk of aorta-related complications between procedures. It not only avoids staged surgical treatment but also facilitates quicker rehabilitation. Opting for a radical surgery in such cases can yield superior outcomes compared with a staged approach, making it particularly suitable for young patients with aorta-related risk factors. Moreover, a single-stage aorta repair reduces the likelihood of subsequent aortic interventions...
June 13, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Kenta Zaikokuji, Hayoung Lee, Chen Ken, Yosuke Mukae, Tomohiro Iwakura, Junichi Shimamura
Aortic root reconstruction during aortic root replacement for a patient with prosthetic valve endocarditis and aortic root abscess can be a difficult procedure with many possible complications. In this video case report, we describe our novel technique using a single bovine pericardial patch that avoids deep stitches or external sutures to support the friable annulus. Compared with more standard methods, this approach has shorter cross-clamp and cardiopulmonary bypass times and is less demanding technically...
May 24, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Tetsuto Takeda, Yui Watanabe, Kosuke Sato, Tadahisa Numakura, Ken Onodera, Hirotsugu Notsuda, Hiromichi Niikawa, Yoshinori Okada
Pleuroperitoneal communication occurs when ascites moves from the abdominal cavity to the pleural cavity via a diaphragmatic fistula. Managing large pleural fluid volumes is challenging, often requiring an operation. Identifying small diaphragmatic fistulas during the operation can be problematic, but ensuring their detection improves outcomes. This video tutorial presents a recent empirical case in which we successfully identified and closed a pleuroperitoneal contact using a thoracoscopic surgical procedure aided by indocyanine green fluorescence imaging...
May 23, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Igor E Konstantinov, Bosco Moscoso, Tyson A Fricke, Alexey Zubritskiy, Regina Marliau Lijanto
The arterial switch operation has evolved to become the treatment of choice for transposition of the great arteries and is one of the greatest success stories in congenital heart surgery. The most crucial step of the operation is the coronary artery translocation; therefore, it is of paramount importance for surgeons to know every single detail about the morphology and spatial relationships of the coronary arteries and the roots of the great vessels. However, sometimes the surgeon may face unfavourable scenarios such as major commissural malalignment and anomalous coronary artery patterns and need to be prepared to carry out a successful coronary artery translocation...
May 22, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Naveen Srinivasan, Ranjith Chandran, Jahnavi Narayanan, Divya Kadavanoor Sasikumar, Vijayakumar Raju
We describe a surgical technique for a half-turned truncal switch operation in a 5-year-old child with dextro-transposition of the great arteries (D-TGA), a ventricular septal defect, a left ventricular outflow tract obstruction and a complex coronary pattern. The benefit of the half-turned truncal switch is the creation of haemodynamically superior biventricular outflow tracts and the maximal use of an autologous pulmonary valve in the right ventricular outflow tract, thereby avoiding the right ventricular-pulmonary artery conduit...
May 16, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Nestor Ivan Quiroga, Leandro Ezequiel Grando, Xavier Michavila Oller, Pablo Luis Paglialunga, Ángela Guirao Montes, David Sanchez-Lorente
The current treatment for mesothelioma, in selected cases, consists of extended pleurodecortication and intrathoracic hyperthermic chemotherapy. This technique is laborious and detailed and must be followed step by step to achieve good results. We present the case of a patient with epithelioid mesothelioma meeting surgical criteria who underwent the mentioned technique, experiencing an adequate postoperative period and an early discharge. This experience demonstrates that the technique is safe when performed in centres with experience and the means to address this complex pathology...
May 15, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Yuriy Stukov, Mark Bleiweis, Werviston De Faria, Thiago Beduschi, Giles J Peek, Jeffrey P Jacobs
A combined heart+liver transplant is the only option for survival in some patients with end-stage combined cardiac and hepatic disease. These patients may suffer from congenital or acquired cardiac disease. The potential aetiologies of the associated hepatic disease are heterogeneous and include systemic disease that impacts the liver as well as venous congestion in patients with functionally univentricular circulation. In the latter scenario, patients with functionally univentricular circulation often require complex cardiac reconstruction in the setting of a cardiac transplant after staged palliation...
May 10, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Fabian A Kari, Jürgen Hörer, Sebastian Michel
Preoperative calculations showed that the 9-mm inlet, 6-mm outlet, 25-cc pump chambers and 65-73 bpm would be optimal for a 5-year-old patient suffering from restrictive cardiomyopathy, with a body surface area of 0.59 m2 (1.5 L/min flow for a cardiac index of 2.5). After re-sternotomy and standard bicaval cannulation for cardiopulmonary bypass, the procedure was performed under normothermic conditions and on the beating heart. Biventricular support was established with the Berlin Heart Excor using biatrial cannulation...
May 10, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Joshua R Chen, John Kelly, Jason J Han
A video can help highlight the real-time steps, anatomy and the technical aspects of a case that may be difficult to convey with text or static images alone. Editing with a regimented workflow allows for the transmission of only essential information to the viewer while maximizing efficiency by going through the editing process. This video tutorial breaks down the fundamentals of surgical video editing with tips and pointers to simplify the workflow.
May 8, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Yuriy Stukov, Mindaugas Rackauskas
In this video tutorial, we present a comprehensive step-by-step operative technique for a bilateral orthotopic lung transplant using a bilateral transverse thoracosternotomy in a patient with idiopathic pulmonary fibrosis lung disease. The donor lungs were exposed to extended cold static ischaemic storage at 10° C for the semi-elective operation.
May 8, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Antonia Van Kampen, Thoralf M Sundt Rd, Serguei Melnitchouk
In a 39-year-old male with mitral valve endocarditis, after 6 weeks of intravenous antibiotics, echocardiography confirmed multiple vegetations on both leaflets, a flail posterior leaflet flail and contained perforation of the anterior leaflet in a windsock-like morphology. All vegetations, diseased and ruptured chords and the windsock-like contained rupture of the anterior leaflet were carefully resected via a right minithoracotomy and with femoral cannulation. Three repair techniques were blended to reconstruct the valve: (1) A large, infected portion of the prolapsing posterior leaflet was resected in a triangular fashion, and the edges were re-approximated using continuous 5-0 polypropylene sutures...
May 7, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Yuriy Stukov, Marc O Maybauer, William Ricks, Mindaugas Rackauskas
In this video tutorial, we present the cannulation technique for venopulmonary extracorporeal membrane oxygenation using the ProtekDuo dual-lumen cannula in a patient with acute respiratory distress syndrome.
May 2, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Suguru Ohira, Vasiliki Gregory, David Spielvogel
A 72-year-old male with a history of a triple-vessel coronary artery bypass graft years ago presented with a DeBakey type 2 aortic dissection and an aorto-left atrial fistula with patent bypass grafts (left internal mammary artery and saphenous vein grafts). He developed pulmonary oedema and required intubation. The right axillary artery was cannulated. After the ascending aorta and left internal mammary artery were clamped, the aorta was transected, leaving aortic tissue around two saphenous vein grafts as two separate patches...
May 2, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Akio Hara, Hideoki Yokouchi
Segmentectomies involving the posterior basal segment (S10) of the lower lobe present a challenging surgical procedure due to anatomical complexities, especially when lesions extend towards the lateral basal segment (S9). We introduce a combined subsegmentectomy technique via a posterior approach for a lesion situated between S9b and S10b, which preserves subsegmental branches that do not affect the resection margin of the tumour and facilitates intersegmental division without extending dissection into the interlobar region...
May 1, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Aishah Z Mughal, Ahmed El-Zeki, Ahmed Oliemy, Ahmed M Habib
Bone metastasis is the most common form of distant metastasis encountered within the breast cancer population. Surgical resection of bone metastases is a curative treatment option in patients who present with an isolated solitary lesion and no other associated disease. This decision is typically made following a multidisciplinary discussion. Patients can also be put forward for surgical excision of bone metastases following inadequate response to chemotherapy or radiotherapy.  With tumours located in the manubrium of the sternum, surgery serves not only to resect the bone metastasis but to provide suitable chest wall reconstruction...
May 1, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Mina Estafanos, Amir J Rose, Sameh M Said
The patient is a 15-year-old girl who was diagnosed with hypertrophic cardiomyopathy and has been symptomatic due to severe left ventricular outflow tract obstruction. Combined transaortic and transapical left ventricular septal myectomy was performed to relieve the left ventricular outflow tract obstruction and address both subaortic and midventricular gradients.
March 26, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Farhad Bakhtiary, Saad Salamate, Ali El-Sayed Ahmad
Micro-invasive totally endoscopic aortic valve replacement surgery is a minimally invasive cardiac procedure that can be performed with the help of several techniques and technologies that employ the latest innovations in instrumentation and technological advances in the field, thereby greatly limiting the overall invasiveness of the procedure. With the help of a 3-dimensional camera, long instruments, a very small thoracotomy and a soft-tissue retractor without any rib retractor, the aortic valve can be easily and safely accessed for replacement...
March 26, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Fabian A Kari, Sebastian Michel, Jürgen Hörer
A 12-month-old girl (8.4 kg) with absent pulmonary valve syndrome and enlarged bilateral pulmonary arteries underwent trans-tricuspid ventricular septal defect closure, placement of a right ventricular-to-pulmonary artery conduit and hilum-to-hilum internal pulmonary artery plication plasty.
March 26, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Tarisai Mandishona, Nicole Asemota, Obadah Alqudah, Haisam Saad, Joanna Fuentes-Warr, Lydia Rhodes, Vasileios Kouritas
We describe a rare procedure involving near-total robotic-assisted thoracoscopic surgery resection of a right posterior Pancoast tumour. Four ports and an assistant port were used. The DaVinci X system was used. The lobectomy was performed first to allow for adequate exposure to the apex and spine. The lateral aspect of ribs 1 to 4 was resected next, and the extrathoracic space was entered. Dissection proceeded through this space superiorly up to the level of the scapula and then posteriorly towards the spine...
March 25, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Mehar Bijral, Mannat Rana, Ignacio Guillermo Berra, Georgi Christov, Nikolaos Charokopos, Zsolt Lorant Prodan, Martin Kostolny, Georgios Belitsis
Aortic valve repair has emerged as the treatment of choice for congenital aortic valvular disease, avoiding the need for a reoperation associated with stented prosthesis overgrowth. The introduction of a leaflet implant represents a recent advancement in a field that originated early techniques, such as simple commissurotomies. In our experimental approach, we assessed two established leaflet-sizing techniques by analysing their resultant coaptation areas. Although both techniques produced competent valves, the large coaptation areas differed significantly from the native aortic valve...
February 27, 2024: Multimedia Manual of Cardiothoracic Surgery: MMCTS
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