Abstract:
OBJECTIVES:Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. METHODS:A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42.5%) patients in the control group (No-FT). We performed a propensity score analysis, matching 94 pairs. Primary end points were cardiopulmonary bypass and cross-clamp times. Secondary end points were blood product utilization, postoperative ejection fraction, intensive care unit and hospital lengths of stay, the in-hospital mortality rate and the incidence of stroke, sepsis, renal failure, atrial fibrillation, pulmonary embolism, pneumonia and prolonged mechanical ventilator support. RESULTS:The 2 matched groups had similar baseline characteristics. Significant reductions in cardiopulmonary bypass (104 ± 22 vs 118 ± 30 min, P < 0.001) and cross-clamp times (78 ± 17 vs 90 ± 21 min, P < 0.001) were noted in the FT group. Intraoperative red blood cell and cryoprecipitate transfusions (P < 0.001), prolonged mechanical ventilator support (P = 0.013), postoperative renal failure (P = 0.031) and hospital length of stay (P = 0.002) were all significantly decreased. There was insufficient evidence to detect a difference in postoperative ejection fraction, stroke, sepsis, pneumonia, pulmonary embolism or atrial fibrillation (P > 0.49). CONCLUSIONS:FT decreased intraoperative times, intraoperative red blood cell and cryoprecipitate transfusions, the need for prolonged mechanical ventilator support, renal failure and hospital length of stay. Using FT in MIAVR will allow for more reproducible, widespread adoption of minimally invasive approaches for aortic valve replacement.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Plestis K,Orlov O,Shah VN,Wong J,Thomas M,Aharon A,Orlov C,Panagopoulos G,Goldman Sdoi
10.1093/icvts/ivy026subject
Has Abstractpub_date
2018-08-01 00:00:00pages
202-207issue
2eissn
1569-9293issn
1569-9285pii
4934959journal_volume
27pub_type
杂志文章abstract::We aimed to determine the response of the right ventricle (RV) to surgically induced pressure and volume overload in both acute and chronic settings. Four-month-old sheep were operated via left anterior thoracotomy. Pressure overload of the RV was established by banding of the pulmonary trunk. Volume overload was indu...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.221234
更新日期:2010-04-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with hypertrophic and keloid scarring of the sternotomy wound, is surgical excision with or without adjuvant treatment of any benefit in reducing the size of the scar? Altogether, more than ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1510/icvts.2010.264887
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Minimally invasive surgical approaches for aortic valve replacement (AVR) are growing in popularity in an attempt to decrease morbidity from conventional surgery. We have adopted a technique that divides only the manubrium and spares the body of the sternum. We sought to determine whether patients benefit fr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu196
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHO...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx182
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:Aortic valve construction using pericardial tissue has been known since the late 1960s. The procedure was re-introduced by Ozaki in 2010 and is currently used to treat specific aortic valve diseases. The exact sizing of the neo-cusps and the insertion of the commissures remain the keys to success when perfor...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy230
更新日期:2019-02-01 00:00:00
abstract::Coronary artery bypass grafting surgery may be needed in children and young adults for significant premature coronary artery occlusive disease. We report a case series of seven patients who underwent surgical revascularization in their second and third decade of life for significant multivessel coronary artery occlusi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw295
更新日期:2017-01-01 00:00:00
abstract::We introduce a new concept for preoperative planning and surgical education in congenital heart disease: surgical simulation. Recent advances in three-dimensional image acquisition have provided a new means to virtually reconstruct accurate morphological models while computer visualisation hardware now allows simulati...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.132316
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Insertion of a nasogastric tube, though a common clinical procedure, can produce unexpected complications. We sought to analyse the procedure, and explore means to improve its safety. METHODS:We present a case with a thoracic complication. We review the English literature for the range of complications, and...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.109488
更新日期:2005-10-01 00:00:00
abstract::The role of barotrauma in the exaggeration of plastic bronchitis after Fontan circulation has yet to be examined. We aim to describe a case of a 4-year old post-Fontan circulation girl where barotrauma suffered during commercial air travel played a role in the aetiological cascade of plastic bronchitis. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs308
更新日期:2012-10-01 00:00:00
abstract::Venous aneurysms arising from the mediastinal systemic veins are rare. There are only 27 reported cases of such aneurysms. Majority arise from the superior vena cava. We are reporting a saccular aneurysm of superior vena cava in a 58-year-old male. The chest radiogram suggested superior mediastinal mass and the comput...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00076-8
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVES:Dividing the intersegmental planes with a stapler during pulmonary segmentectomy leads to volume loss in the remnant segment. The aim of this study was to assess the influence of segment division methods on preserved lung volume and pulmonary function after segmentectomy. METHODS:Using image analysis softwa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw188
更新日期:2016-10-01 00:00:00
abstract::The aim of the study was to determine the incidence of permanent pacemaker implantation (PPMI) in a cohort of 358 patients undergoing transapical aortic valve implantation (TAVI) using a balloon-expandable prosthesis between April 2008 and March 2011. After excluding patients who had had a previous PPMI (n=36; 10%), t...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.274456
更新日期:2011-10-01 00:00:00
abstract::Serious non-fatal complications of cardiac surgery include deep sternal wound infection (DSWI) and haemorrhage. Understanding the factors associated with these complications (both pre-operatively and intra-operatively) may aid in the prevention and avoidance of such complications. The aim of the current report is to i...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1510/icvts.2006.132191
更新日期:2007-04-01 00:00:00
abstract::We evaluated the impact of major complications on clinical outcome in a series of patients undergoing endovascular repair (EVAR) of descending thoracic aorta. From March 2001 to June 2005, 51 patients underwent EVAR for descending aortic diseases. Thirty-five were treated in emergency (60.7%) and 41 (80.4%) were in II...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.136481
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:Sternal dehiscence and mediastinitis are rare but serious complications following cardiac surgery. The aim of this study was to investigate the influence of the number of sternal wires used for chest closure on sternal complications. METHODS:From May 2003 to April 2007, 4714 adult patients received cardiac ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs293
更新日期:2012-10-01 00:00:00
abstract::This retrospective study investigated whether withdrawal of aprotinin from combined low-dose aprotinin/tranexamic acid (TXA) antifibrinolytic therapy altered postoperative blood loss and transfusion requirements in patients undergoing cardiothoracic surgery employing cardiopulmonary bypass (CPB). The study included da...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.250936
更新日期:2011-02-01 00:00:00
abstract::Indications for transcatheter valve implantation have been extended to treat native valve aortic regurgitation in case of disproportionate risk for open surgery. Transcatheter aortic valves are also an attractive alternative in patients who refuse blood transfusions. We report the successful off-label implantation of ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw180
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:The different aspects of quality of life (QOL) in patients of different sex structure have been examined as well as the presumption that sex structure could be a predictor of QOL changes after coronary artery bypass grafting (CABG). METHODS:The study included 243 consecutive patients who underwent an electi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.208462
更新日期:2010-02-01 00:00:00
abstract::A 60-year-old man complaining of pyrexia and hemoptysis was diagnosed with a squamous cell carcinoma in his right lung. He underwent a right lower lobectomy with lymph node dissection. Following chest tube removal, he suffered from pyrexia and hemoptysis necessitating CT-scans which detected a pulmonary artery pseudoa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.236661
更新日期:2010-09-01 00:00:00
abstract::Six patients with acute Type A aortic dissection were medically treated due to advanced age, patient refusal and comorbidity despite surgical indication. Computed tomography after onset revealed a thrombosed false lumen in 3 patients and a patent false lumen with flap in 3 patients. All patients were stable during adm...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx404
更新日期:2018-04-01 00:00:00
abstract::Coarctation of thoracic aorta is an uncommon diagnosis in adults. Catheter-based intervention consisting of primary ballooning and stenting is becoming one of the methods of choice for the treatment of native coarctation. We describe the case of a young adult with coarctation of the aorta treated unsuccessfully with p...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.265264
更新日期:2011-07-01 00:00:00
abstract::Infective endocarditis is a life threatening disease with high mortality and morbidity, including brain infarction concomitant with intracranial hemorrhage. Generally, patients with a recent intracranial hemorrhage are believed to be a contraindication to undergo cardiac surgery with cardiopulmonary bypass. However, s...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.146209
更新日期:2007-06-01 00:00:00
abstract::Atresia of the left main coronary artery is a rare coronary anomaly. We describe the case of a 5-year-old child presenting in emergency in extremis. Clinical findings of haemodynamic collapse, malignant ventricular tachyarrhythmias and severe mitral regurgitation were indicative of a possible ischaemic aetiology. Surg...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa268
更新日期:2020-11-22 00:00:00
abstract::We describe right coronary translocation as a simplified surgical procedure for right coronary artery arising from the left sinus with an intramural course. At surgery, the right coronary artery was transected, distal to the intramural segment and subsequently anastomosed to the ascending aorta above the right coronar...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.268888
更新日期:2011-08-01 00:00:00
abstract::Prompt controlled reperfusion of a pulmonary allograft in a sequential double lung transplant may correct cellular ischemia prior to exposure to full hydrostatic pressures and minimize organ dysfunction. We reviewed the process of a sequential double lung transplant and describe the technique of controlled antegrade g...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.211730
更新日期:2009-12-01 00:00:00
abstract::We report a case of primary recurrent mediastinal dedifferentiated liposarcoma with unusual long-term survival. A woman who complained of dyspnea showed on imaging features a bulky posterior mediastinal mass which was completely excised and initially misdiagnosed as an angiomyolipoma. She recurred 15 months later and ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.209494
更新日期:2009-10-01 00:00:00
abstract::The radial artery (RA) beside the left internal mammary artery and veins is often used for coronary artery bypass grafting. The aim of this study was to assess arm temperature changes after removal of the radial artery and determine whether there is an effect on hand function. Between April and December 2005, fifty pa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 临床试验,杂志文章
doi:10.1510/icvts.2007.151795
更新日期:2007-10-01 00:00:00
abstract::Platelet dysfunction followed by thromboembolic as well as bleeding complications are severe events in patients with ventricular assist devices (VADs). Microparticles (MP) are cell vesicles with inflammatory and coagulatory potency that are released by cells during activation and can be used as specific cell activatio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.232603
更新日期:2010-08-01 00:00:00
abstract::Embolization of a percutaneous left atrial appendage occlusion device is a rare, but potentially life-threatening, complication. In this report, we present the case of an embolization of such a device into the left ventricular outflow tract causing extensive damage to the mitral subvalvular apparatus and requiring mit...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy290
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:Surgical ventricular reconstruction has been used to treat ischaemic cardiomyopathy with large akinetic or dyskinetic areas. However, application of this approach requires a sternotomy, cardiopulmonary bypass and a left ventriculotomy. This study assessed the feasibility and efficacy of minimally invasive, o...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt387
更新日期:2013-12-01 00:00:00