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Multimedia Manual of Cardiothoracic Surgery: MMCTS

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https://read.qxmd.com/read/31099504/non-fasting-tubeless-minimally-invasive-esophagectomy-a-simplified-procedure
#1
Yin Li, Ahmed Daoud, Xiankai Chen, Jianjun Qin, Zhen Wang, Jiagen Li
Recent advances in minimally invasive techniques have made thoracoscopic and laparoscopic esophagectomy a real alternative to open 3-field esophagectomy, with better results in terms of reduction of morbidity and mortality.  In this video tutorial we demonstrate our technique of minimally invasive esophagectomy with cervical anastomosis, which is summarized briefly as follows: The patient is placed in a left lateral decubitus position. Four ports are used for thoracoscopic mobilization of the thoracic esophagus and for mediastinal lymph node dissection...
May 13, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990578/the-david-procedure-for-surgical-management-of-neo-aortic-root-dilatation-following-the-arterial-switch-operation-technical-aspects
#2
Markus Liebrich, Nicolas Doll, Wolfgang Hemmer, Ioannis Tzanavaros
Progressive neo-aortic/pulmonary root dilatation and associated valve regurgitation if translocated into the aortic position, remains a major drawback and serious late complication following the arterial switch operation. This video tutorial presents the technical aspects and a step-by-step illustration of the valve-sparing reimplantation technique, which  allows the neo-aortic valve to be maintained late after the arterial switch operation.
April 16, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990582/robotic-assisted-minimally-invasive-direct-coronary-artery-bypass-grafting-in-single-vessel-disease
#3
Anas Boulemden, Matteo Pettinari
This video tutorial presents a case of robotic-assisted minimally invasive direct coronary artery bypass grafting in a patient who presented with stable angina and significant stenosis of the proximal left anterior descending artery.   The patient was intubated using a double lumen tube to allow for single lung ventilation, then positioned supine with the left chest slightly tilted up. Defibrillation pads were applied, and the patient draped. A small port incision was made in the left 3rd intercostal space for camera scope insertion; 2 further port incisions were made in the 5th and 7th intercostal spaces under direct vision...
April 12, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990580/outflow-graft-tunneling-through-the-transverse-sinus-for-heartware-hvad-implantation-as-bridge-to-heart-transplantation-strategy
#4
Antonio Loforte, Gregorio Gliozzi, Giuditta Coppola, Mariafrancesca Fiorentino, Sofia Martin Suarez, Davide Pacini
Left ventricular assist device graft protection and its intraoperative orientation continues to be a major concern in bridge-to-transplant strategy. Different techniques have been described, including the adoption of a standard full sternotomy approach. We describe our institutional experience of placement of the with HeartWare HVAD® implantable continuous flow pump, with outflow graft tunnelling through the transverse sinus to prepare patients in need of eventual re-sternotomy. Surgical tips are provided in the tutorial videos both for HVAD® placement, and for explantation at the time of heart transplantation...
April 12, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990577/endoscopic-saphenous-vein-harvesting-with-a-non-sealed-approach
#5
Daniyal Mahmood, Fabrizio Rosati, Dimitri Petsikas, Darrin Payne, Lawrence Torkan, Gianluigi Bisleri
Endoscopic saphenous vein harvesting is considered a safe and effective approach for graft procurement during coronary artery bypass graft surgery. As an alternative to open techniques, minimally invasive approaches are associated with superior outcomes in terms of morbidity and patients' discomfort, without affecting graft quality, patency rate, and long-term outcomes.  Both sealed and non-sealed systems are available for endoscopic conduit harvesting. Sealed systems require carbon dioxide gas insufflation, which may have a damaging impact on the endothelium...
April 9, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990576/endoscopic-radial-artery-harvesting-with-a-non-sealed-approach
#6
Daniyal Mahmood, Fabrizio Rosati, Dimitri Petsikas, Darrin Payne, Lawrence Torkan, Gianluigi Bisleri
Endoscopic radial artery harvesting is considered a safe and effective approach for graft procurement during coronary artery bypass graft surgery. As an alternative to open techniques, minimally invasive approaches are associated with superior outcomes in terms of morbidity and patients' discomfort, without affecting graft quality, patency rate, and long-term outcomes.  Both sealed and non-sealed systems are available for endoscopic conduit harvesting. Sealed systems require carbon dioxide gas insufflation, which may have a damaging impact on the endothelium...
April 9, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990581/biventricular-fibroma-resection-in-an-adult
#7
María Ascaso, Eduardo Astrosa, Bosco Moscoso, Alejandro Fernandez, Clemente Barriuso, Manel Castella
Cardiac fibromas are the second most common primary cardiac tumors in childhood. They only rarely present in adults. They are mainly located in the free wall of the ventricles and attached to the interventricular septum. Despite their benign pathology, fibromas in some locations can cause significant complications. This video tutorial illustrates the resection of a septo-apical cardiac fibroma in an asymptomatic 26-year-old woman, diagnosed with transthoracic echocardiography and cardiac magnetic resonance imaging after an abnormal ECG on an occupational medical examination...
March 12, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30990579/surgical-correction-of-anomalous-origin-of-the-right-coronary-artery-from-the-left-sinus-of-valsalva-how-where-and-when
#8
Igor Belluschi, Andrea Blasio, Alberto Pozzoli, Luca Vicentini, Ottavio Alfieri
Anomalous origin of the right coronary artery from the left sinus of Valsalva has a very low prevalence in the general population. Although the vast majority of patients are asymptomatic, the clinical consequence of this heart disorder can be sudden death. In many of these sudden death cases the right coronary artery is running between the anterior aspect of the aorta and behind the common trunk of the pulmonary artery, where systolic compression may have an impact on myocardial perfusion. Asymptomatic patients with this malignant course present the surgeon with a difficult decision, and they should be carefully evaluated in order to facilitate a tailored surgical approach...
March 5, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30767439/how-to-construct-and-use-a-low-fidelity-coronary-anastomosis-simulator
#9
Andras Durko, Daniel Thuijs, Edris Mahtab, Jos Bekkers
This Core Skills tutorial shows how a low-fidelity coronary anastomosis simulator can be constructed out of materials available in a normal hospital environment and used to practice various peripheral coronary anastomoses in a realistic-depth environment with limited working space.
February 1, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30767438/external-stent-vest-for-saphenous-vein-grafts-in-coronary-artery-bypass-grafting
#10
Sigrid Sandner, Philipp Angleitner, Günther Laufer, Daniel Zimpfer
This video tutorial is a guide to the application of the only currently available external stent for saphenous vein grafts, the VEST (Vascular Graft Solutions, Tel Aviv, Israel). We describe the preparation of the vein graft, selection of the appropriate VEST model, and the application procedure itself. We also present angiograms 2 years after coronary artery bypass grafting of unsupported versus VEST-supported saphenous vein grafts.
February 1, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30667184/left-systematic-mediastinal-lymph-node-dissection
#11
Charalambos Zisis, Nikolaos Papakonstantinou, Evangelia Liverakou
Sampling, or systematic mediastinal lymph node dissection, is the standard-of-care surgical treatment for early stage non-small cell lung cancer, according to guidelines from the European Society of Thoracic Surgeons. Lymph node status defines disease status and patients' prognosis. In this  video tutorial, a radical ipsilateral mediastinal lymph node dissection in a man suffering from a left, centrally located lung adenocarcinoma is presented. Systematic mediastinal lymph node dissection constitutes a high-quality metric for the efficacy of the surgical procedure and is essential to achieving adequate staging and treatment...
January 2, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30667182/thoracoscopic-anterior-segmentectomy-right-upper-lobe
#12
George Rakovich
Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. Most lung segments may be resected as segmentectomies or as part of bisegmentectomies (as is the case for the lingula). Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that allows direct access to the segmental structures, and is straightforward and versatile enough to allow for adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy in the case of positive margins)...
January 2, 2019: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30667183/composite-lita-rita-y-lima-rima-y-graft-configuration-for-coronary-artery-bypass-grafting
#13
Daniel Thuijs, Andras Durko, Edris Mahtab, Ad Bogers
This Core Skills tutorial elucidates the principal surgical techniques of constructing a composite Y-graft, using the left internal thoracic artery and the right internal thoracic artery, for on-pump coronary artery bypass grafting.
December 21, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30667185/double-arterial-cannulation-during-aortic-arch-reconstruction-in-pediatric-patients
#14
Michaela Kreuzer, Eva Sames-Dolzer, Peter Benedikt, Roland Mair, Rudolf Mair
Aortic arch reconstruction is a highly demanding procedure in congenital heart surgery. The 2 conventional options for cardiopulmonary bypass - deep hypothermic circulatory arrest or antegrade cerebral perfusion - both result in lack of perfusion of the entire or lower body.  In 2003, the Children's Heart Center Linz started to use a double-arterial cannulation technique for aortic arch reconstructions in order to provide whole body perfusion during the entire operation. Our technique, demonstrated in this video tutorial, is as follows: After inserting an arterial cannula into the innominate artery, followed by venous cannulation, the cardiopulmonary bypass is started...
December 17, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30549511/hybrid-ablation-under-intraoperative-3d-voltage-mapping-guidance
#15
Malak Elbatarny, Benedict Glover, Jason Baley, Sanoj Chacko, Nasser Alhammad, Gianluigi Bisleri
Long-standing persistent atrial fibrillation remains a significant therapeutic challenge, often proving to be resistant to treatment with antiarrhythmic medications and transcatheter ablation. Hybrid ablation, which combines a minimally invasive surgical and transcatheter approach, is emerging as a promising treatment option. In this video tutorial, we demonstrate our method of hybrid ablation for long-standing persistent atrial fibrillation using advanced 3D electro-anatomical voltage mapping to guide the ablation process and thereby improve the ultimate effectiveness of the procedure...
December 10, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30549515/exercises-in-anatomy-ventricular-septal-defect
#16
Robert Anderson, Diane E Spicer, Jessica Saavedra, Carl L Backer
The phenotypic features of the heart with ventricular septal defects will be shown in this video tutorial. There is still no agreement as to whether it's best to categorize lesions on the basis of their geography or their borders. Both geography and borders are features that are of importance. I hope this video will persuade you that the borders are the most significant because they display the phenotypic variance and give added information about the heart regarding the location of the atrioventricular conduction axis...
December 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30549514/repair-of-tricuspid-papillary-muscle-rupture-after-percutaneous-coronary-intervention
#17
Shinji Kanemitsu
Papillary muscle rupture is a rare complication after myocardial infarction and almost all cases occur in the mitral valve papillary muscle. Tricuspid regurgitation development after right ventricular myocardial infarction caused by papillary muscle rupture is extremely rare.  In this video tutorial we present a 70-year-old man with massive tricuspid regurgitation caused by papillary muscle rupture after percutaneous stenting of the right coronary artery. We performed tricuspid valve repair with reimplanted papillary muscle in situ using neither artificial chordae nor a prosthetic valve...
December 6, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30549509/thoracoscopic-left-apical-bisegmentectomy
#18
George Rakovich
Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. It may also be ideal for removing benign obstructive lesions. Most lung segments may be resected as segmentectomies or as partial bisegmentectomies (as is the case for the lingula). Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that generally allows direct access to the segmental structures, is usually straightforward, and is versatile enough to allow adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy if positive margins are found)...
December 5, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30549513/minimally-invasive-triple-valve-surgery-the-rome-approach
#19
Francesco Musumeci, Antonio Lio, Marcello Bergonzini, Antonio Cammardella, Francesca Nicolò, Federico Ranocchi
Although the benefits of minimally invasive cardiac surgery are well recognized, most surgeons have little experience in the treatment of triple valve disease through a minithoracotomy approach. In this video tutorial, we present a case of concomitant aortic valve replacement with mitral and tricuspid valve repair through a lateral minithoracotomy.
December 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/30549512/one-stage-transmediastinal-surgical-approach-for-extensive-aortic-pathology
#20
Corrado Cavozza, Antonio Campanella, Andrea Audo
"One-stage" transmediastinal replacement of the thoracic aorta provides an alternative treatment to single or multiple stage hybrid procedures for patients with ascending, arch, and descending thoracic aorta aneurysm. The patient is placed on bypass and cooled. During circulatory arrest, after surgical treatment of the aortic valve and root where appropriate, the entire ascending aorta is excised and the transverse arch is opened longitudinally. The heart is retracted cephalad and the left pleural cavity is entered longitudinally...
December 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
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