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1.
Indian J Thorac Cardiovasc Surg ; 40(2): 159-170, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38389777

RESUMO

Introduction: In the context of double-valve surgery for elderly high-risk patients involving both the aortic and mitral valves, a clinically significant problem has been that no clear criteria or surgical strategies have been reported for the selection of mitral valve plasty (MVP) or mitral valve replacement (MVR) for mitral valve disease management during surgical aortic valve replacement (SAVR) to achieve better clinical outcomes. This study investigated valve durability and survival using our surgical strategy for mitral valve disease with concomitant SAVR in elderly patients. Methods: Eighty-six patients aged > 65 years (mean 75 years) who underwent a double-valve procedure for mitral valve surgery with concomitant SAVR from 2010 to 2022 were reviewed. Our surgical strategy for mitral valve disease with concomitant SAVR for the elderly patients was as follows: MVP was selected for patients in whom mitral valve disease was expected to be controlled with simple surgical procedures (n = 47), otherwise MVR was selected (n = 39). Results: The hospital mortality rate was 8% (n = 7). The mean follow-up was 4.9 (0-12.3) years. And the 10-year survival rate was 62%. The 10-year freedom from aortic valve reoperation rate was 95%. No mitral valve reintervention was performed during follow-up. Echocardiographic follow-up demonstrated freedom from at least moderate mitral regurgitation in 86% of cases at 10 years. Conclusion: In double-valve surgery for elderly high-risk patients, appropriate selection of the mitral valve procedure with concomitant SAVR provided better early and long-term survival and valve durability. This surgical strategy may be beneficial in elderly patients with combined aortic and mitral valve disease.

2.
Eur J Cardiothorac Surg ; 62(3)2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35904768

RESUMO

Our goal was to describe a novel technique for reconstructing the aortomitral curtain using autologous tissue. This technique was performed on a patient who required replacement of both the aortic and mitral valves and the aortic root due to recurrent prosthetic valve infection and aortic root abscess. The aortomitral curtain was reconstructed without using any artificial patches. Instead, surrounding autologous tissues were used, including the residual healthy left atrial and aortic basal tissues. This patch-sparing technique may occasionally be feasible to perform and may serve as a secure anchor for subsequent aortic root replacement.


Assuntos
Endocardite Bacteriana , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Abscesso/cirurgia , Aorta/diagnóstico por imagem , Aorta/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Endocardite Bacteriana/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia
3.
Ann Vasc Surg ; 82: 294-302, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34788707

RESUMO

BACKGROUND: This study was aimed to evaluate the outcomes of performing open repair or thoracic endovascular aortic repair for chronic type B dissecting aortic aneurysm. METHODS: From July 2004 to February 2019, 52 patients underwent surgery as open repair (n = 32) or endovascular repair (n = 20) for chronic type B dissecting aortic aneurysm. Replacement of the aorta was limited to the aneurysmal portion with or without reconstructing the visceral arteries or the segmental arteries. Stent grafts were deployed in the true lumen above the celiac artery to cover the primary entry for even DeBakey IIIb dissection. RESULTS: Operative mortality and morbidity rates, including spinal cord ischemia incidence, did not differ between the groups. Operative mortality and morbidity rates, including spinal cord ischemia incidence, did not differ between the groups. In the endovascular repair group, 3 patients died due to rupture of residual false lumen in the early, and late postoperative follow-up. The 5-year rate of freedom from all-cause death, aorta-related death, and aorta-related event were 84% ± 6%, 94% ± 3% and 84% ± 6%. The endovascular repair was independently associated with all-cause death (hazard ratio [HR], 5.7; confidence interval [CI], 1.02-31.6; P = 0.04) and aorta-related event (HR, 30.9; CI 4.9-195.0; P < 0.001). In the open group, postoperative residual aortic diameter was an independent predictor of aorta-related events, and the threshold was 41 mm. CONCLUSIONS: Open repair remains a better option than simple endovascular repair alone in DeBakey IIIb dissection, but the distal un-resected aortic portion over 41 mm was associated with late aortic events.


Assuntos
Aneurisma da Aorta Torácica , Aneurisma Aórtico , Dissecção Aórtica , Implante de Prótese Vascular , Procedimentos Endovasculares , Isquemia do Cordão Espinal , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/cirurgia , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Progressão da Doença , Procedimentos Endovasculares/efeitos adversos , Humanos , Estudos Retrospectivos , Isquemia do Cordão Espinal/cirurgia , Stents , Fatores de Tempo , Resultado do Tratamento
4.
J Cardiol Cases ; 24(6): 307-309, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34917217

RESUMO

Cardiac perforation is a rare but serious and life-threatening complication of permanent pacemaker implantation, with an incidence of 0.1-6%. Surgery is usually performed through a median sternotomy; however, sternotomy-related morbidity remains a concern. Herein, we report a case of surgical repair performed via a left mini-thoracotomy for a right ventricular perforation caused by implantation of a permanent pacemaker lead in a 56-year-old woman. Through the left fifth intercostal space, the pacemaker lead was observed to have penetrated the left ventricular myocardium, reaching the pericardium. The lead had passed through the right ventricle and the inferior ventricular septum and protruded from the left ventricular myocardium. After pacemaker lead removal, a dark blow-out type hemorrhage occurred; hence, repair was performed using a pair of pledgeted Mattress sutures. In conclusion, left mini-thoracotomy provides an adequate surgical field and has less impact on hemodynamics when operating at the cardiac apex. .

5.
Clin Case Rep ; 9(12): e05126, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34917364

RESUMO

In patients with a narrow sinotubular junction, small sinus of Valsalva, or extensibility loss in the aortic root, aortic valve replacement (AVR) with a standard valve is challenging due to limited surgical field. Detailed preoperative measurements of the aortic root render performing AVR using the Perceval valve easy.

6.
Ann Thorac Surg ; 112(2): e119-e121, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33444579

RESUMO

A 25-year-old man presented with palpitations and subsequently received a diagnosis of a large epicardial cyst (6.8 × 3.8 cm) originating from the left ventricle. The cyst compressed the left atrium and ventricle and led to left ventricular diastolic dysfunction. Contrast-enhanced chest computed tomography revealed that the circumflex artery passed over or through the cyst. We successfully resected the cyst without using cardiopulmonary bypass through a left mini-thoracotomy with thoracoscopic assistance. The diastolic dysfunction improved after the procedure. Most epicardial cysts may be treated in this fashion if the cyst is located in the left side of the heart.


Assuntos
Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Cistos/cirurgia , Neoplasias Cardíacas/cirurgia , Adulto , Cistos/diagnóstico , Neoplasias Cardíacas/diagnóstico , Humanos , Masculino , Pericárdio , Tomografia Computadorizada por Raios X
7.
J Card Surg ; 36(3): 971-977, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33428267

RESUMO

BACKGROUND AND AIM: Leaflet resection and chordal reconstruction are established repair techniques for posterior mitral valve (MV) prolapse. This study aimed to compare the clinical results of the resect and respect approaches, with a particular focus on MV hemodynamics. METHODS: Overall, 291 patients who underwent elective MV repair for isolated posterior leaflet prolapse between 2012 and 2020 were enrolled. Patients who underwent leaflet resection alone were classified as the "resection" group (n = 166), while patients who underwent neochordal replacement with/without limited leaflet resection were classified as the "respect" group (n = 125). Early postoperative MV hemodynamics and midterm repair durability were compared between the groups. RESULTS: The annuloplasty ring size was significantly larger in the respect group than in the resection group (31.0 ± 2.1 vs. 30.4 ± 2.0 mm, p = .028). The respect group showed significantly lower mean MV gradient (2.6 ± 1.1 vs. 3.0 ± 1.4 mmHg, p = .03) and larger effective orifice area (EOA) (1.86 ± 0.48 vs. 1.66 ± 0.47 cm2 , p < .001) than the resection group. Multivariable analysis identified the respect approach, younger age, female sex, larger ring size, and partial band as independent determinants of larger EOA. The rate of freedom from moderate or greater recurrent mitral regurgitation 5 years postoperatively was 90.9% in both groups. CONCLUSIONS: The respect approach allowed for a lower MV gradient and a larger EOA than the resection approach, which is possibly due to the capability of implanting a larger annuloplasty ring.


Assuntos
Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral , Prolapso da Valva Mitral , Cordas Tendinosas/cirurgia , Feminino , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Prolapso da Valva Mitral/cirurgia , Prolapso , Respeito , Resultado do Tratamento
8.
Ann Thorac Surg ; 111(6): e415-e417, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33352177

RESUMO

We admitted a 76-year-old woman for treatment of an ascending aortic aneurysm with left ventricular outflow tract (LVOT) obstruction and systolic anterior motion (SAM) of the mitral valve. Echocardiography showed an elevated velocity of the LVOT flow with a sigmoid septum. Mild mitral regurgitation was also detected due to SAM. We performed a graft replacement of the ascending aorta, after which the LVOT obstruction and SAM were resolved. We report a case in which the traction of a graft likely released the compression on the aortic root and ventricular septum.


Assuntos
Obstrução do Fluxo Ventricular Externo/cirurgia , Idoso , Aorta/cirurgia , Prótese Vascular , Procedimentos Cirúrgicos Cardíacos/métodos , Feminino , Humanos , Obstrução do Fluxo Ventricular Externo/complicações
10.
J Artif Organs ; 24(2): 293-295, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32959119

RESUMO

Hypo-attenuated leaflet thickening (HALT) is gaining attention as a relatively common issue after surgical or transcatheter aortic valve replacement (AVR). However, only a few reports have described HALT in sutureless bioprosthesis, which has emerged as a promising tool with excellent hemodynamics and enhanced implantability. We herein report a 75-year-old woman who underwent quintuple coronary artery bypass grafting and sutureless AVR with a Perceval S bioprosthesis (LivaNova PLC, London, UK). Despite an uneventful perioperative course, her recovery was slow with persistent pleural effusion. Echocardiography revealed an increased transvalvular pressure gradient, and HALT was confirmed by computed tomography. The patient received aggressive anticoagulation therapy with resolution of the HALT and made an uneventful recovery. Current guidelines provide no specific recommendations for peri-procedural antithrombotic therapy for sutureless AVR. However, HALT is not rare after sutureless AVR and can lead to significant clinical consequences. In this case, aggressive anticoagulation therapy with systemic heparinization was effective as HALT treatment following early post-sutureless AVR. Further investigation is required to determine the optimal antithrombotic strategy for sutureless AVR.


Assuntos
Estenose da Valva Aórtica/etiologia , Valva Aórtica/fisiopatologia , Bioprótese/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Próteses Valvulares Cardíacas/efeitos adversos , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Estenose da Valva Aórtica/diagnóstico , Estenose da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/cirurgia , Ecocardiografia , Feminino , Implante de Prótese de Valva Cardíaca/instrumentação , Implante de Prótese de Valva Cardíaca/métodos , Hemodinâmica/fisiologia , Humanos , Movimento (Física) , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Derrame Pleural/fisiopatologia , Procedimentos Cirúrgicos sem Sutura/efeitos adversos , Procedimentos Cirúrgicos sem Sutura/instrumentação , Procedimentos Cirúrgicos sem Sutura/métodos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/instrumentação , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
11.
J Cardiol Cases ; 24(4): 186-189, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35059053

RESUMO

Optimal timing of open-heart surgery for the treatment of patients with cerebral hemorrhage remains controversial because systemic heparinization may lead to catastrophic bleeding. Several recent reports have shown that patients who undergo open-heart surgery .within a few weeks of cerebral hemorrhage have a much lower risk of exacerbated bleeding than previously considered. Herein, we report a case of left atrial myxoma and large hemorrhagic embolic stroke, which was successfully operated on with no exacerbation of cerebral hemorrhage. Careful assessment of time-course changes in cerebral hemorrhage by neurological imaging and adjustment of anticoagulation can help prevent the exacerbation of postoperative cerebral hemorrhage and neurological deterioration. .

12.
Ann Thorac Surg ; 111(4): e305-e307, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33159860

RESUMO

Systolic anterior motion (SAM) of the mitral valve is a well-known complication in mitral valve repair. Because excessive leaflet tissue is an important mechanism, surgical correction is sometimes required to reduce leaflet height or mobility. However, a different approach may be necessary in cases of normal leaflet height. Herein, we describe papillary muscle reorientation for treating SAM after isolated anterior leaflet repair. The papillary muscle heads were approximated and fixed to the posterior ventricular wall, relocating them away from the ventricular septum. This technique is useful for treating postrepair SAM, without addressing the leaflet, in patients with degenerative mitral disease.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Músculos Papilares/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Função Ventricular Esquerda/fisiologia , Ecocardiografia Transesofagiana , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/fisiopatologia , Músculos Papilares/diagnóstico por imagem , Sístole
13.
Gen Thorac Cardiovasc Surg ; 69(2): 353-355, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32712755

RESUMO

A 78-year-old woman diagnosed with an infected descending aortic aneurysm underwent graft replacement through a left rib-cross thoracotomy. She developed shock suddenly on the postoperative day 3 owing to cardiac tamponade. We performed emergent surgery and identified a small myocardial laceration in the left ventricular obtuse marginal area and a small perforation on the pericardium. One of the claws used to fix the titanium plate in the cross-rib repair caused this complication. This is a cautionary note regarding this type of titanium plate, which is used in many procedures.


Assuntos
Tamponamento Cardíaco , Titânio , Idoso , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/cirurgia , Feminino , Humanos , Pericárdio , Costelas , Toracotomia
14.
Gen Thorac Cardiovasc Surg ; 69(5): 790-795, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33113115

RESUMO

OBJECTIVE: The aim of this study was to compare outcomes of the full maze procedure with left atrial appendage closure (LAAc) as concomitant procedures for atrial fibrillation (AF) in patients undergoing cardiovascular surgery. METHODS: A total of 151 patients (88 men, 62 women) underwent elective AF surgery concomitantly with cardiovascular surgery from April 2005 to December 2019. The mean age at time of operation was 70 years and the mean follow-up period was 5.2 ± 3.8 years. Patients were divided into two groups according to the procedure performed: the maze group (n = 87) and the LAAc group (n = 63). RESULTS: Patients in the LAAc group were significantly older and had more comorbidities than those in the maze group. The operative mortality rate was significantly higher in the LAAc group. There was no difference in the rate of freedom from cardiac-related death between the groups (p = 0.86). Furthermore, there was no difference in the 5-year rate of freedom from thromboembolic stroke between the maze group and the LAAc group (p = 0.17). However, the 5-year rate of freedom from heart failure was significantly higher in the maze group compared with the LAAc group (100% vs. 86% ± 6%, respectively; p = 0.006). CONCLUSIONS: Patients undergoing the maze procedure had good operative and long-term results, suggesting that this procedure should be performed if indicated. Concomitant LAAc may be effective for preventing thromboembolic stroke in patients with AF if they have no indication for the maze procedure.


Assuntos
Apêndice Atrial , Fibrilação Atrial , Procedimentos Cirúrgicos Cardíacos , Acidente Vascular Cerebral , Apêndice Atrial/cirurgia , Fibrilação Atrial/cirurgia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Feminino , Humanos , Masculino , Procedimento do Labirinto , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Resultado do Tratamento
15.
Kyobu Geka ; 73(10): 744-748, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-33130759

RESUMO

Severe atherosclerosis of the ascending aorta frequently causes difficulties during heart operations, hindering surgical maneuvers and potentially leading to systemic embolism. There have been several methods to solve these problems but the best way to treat patients requiring aortic valve replacement (AVR) has not been established yet. Surgical techniques for AVR in these patients include AVR under deep hypothermic circulatory arrest with or without endarterectomy of the ascending aorta or replacement of the ascending aorta. Endovascular clamping using a balloon is another approach but require manipulation of the heavily calcified aorta that may result in a certain risk for stroke. Another option to avoid the ascending aorta and cross-clamping is the apico-aortic conduit. Trans-catheter AVR( TAVR),especially trans-apical AVR, has been shown to be feasible in such patients. Large studies and longer follow-up will be required to scientifically prove the superiority of trans-apical AVR over conventional surgical strategies in patients with porcelain aorta requiring AVR.


Assuntos
Doenças da Aorta , Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Aorta/diagnóstico por imagem , Aorta/cirurgia , Doenças da Aorta/complicações , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Humanos
17.
J Artif Organs ; 23(4): 401-404, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32508003

RESUMO

Sutureless aortic valve replacement (AVR) offers an alternative approach to the standard AVR in aortic valve disease. We herein report a case of an 82-year-old woman with severe aortic insufficiency and a persistent type 1 endoleak following a thoracic endovascular aortic repair, who underwent successful combined aortic arch reconstruction and sutureless AVR. The bioprosthesis, Perceval (LivaNova PLC, London, UK), a self-anchoring, self-expanding, sutureless valve, which can be implanted in selected patients with aortic insufficiency was used. Although the patient was frail and at a high risk of open-heart surgery, she had an uneventful postoperative course. Hence, Perceval may be a useful option for combined aortic arch reconstruction and aortic valve surgery in high-risk elderly patients.


Assuntos
Insuficiência da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Idoso de 80 Anos ou mais , Aorta Torácica/cirurgia , Bioprótese , Feminino , Humanos , Desenho de Prótese , Procedimentos de Cirurgia Plástica , Resultado do Tratamento
18.
J Card Surg ; 35(7): 1471-1476, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32383283

RESUMO

BACKGROUND AND AIM: Mitral regurgitation (MR) in Barlow's disease is complicated because of its mixed pathophysiology, leaflet billowing with or without organic prolapse, and abnormal annular dynamics that cause functional prolapse. Complex repair techniques, including aggressive leaflet resection and implantation of multiple artificial chordae, are conventionally performed; nevertheless, these are technically demanding, especially when performed using a minimally invasive approach. We aimed to standardize the repair technique for Barlow's disease and developed stepwise repair techniques. METHODS: Of 292 patients who underwent isolated minimally invasive mitral valve repair for MR, 29 patients (seven females, age 49 ± 10 years) were found to have Barlow's disease. Our repair technique consists of the following three steps: (a) stabilization of the mitral annulus by placing annuloplasty ring sutures; (b) distinction between organic and functional prolapse by a saline injection test; and (c) targeted repair for organic prolapse by leaflet resection or chordal replacement. RESULTS: Surgical techniques included leaflet resection in 22 patients, chordal replacement in 19 patients, and ring annuloplasty only in one patient. These procedures were applied to the anterior leaflet in one, posterior leaflet in eight, and both leaflets in 19 patients. The median annuloplasty ring size was 34 mm. The repair success rate was 100%. No patients developed moderate or greater MR during a mean follow-up period of 36 ± 21 months. CONCLUSIONS: A stepwise repair strategy facilitates mitral valve repair in patients with Barlow's disease and provides excellent outcomes even via a minimally invasive approach.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Anuloplastia da Valva Mitral/métodos , Prolapso da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Adulto , Idoso , Feminino , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Gen Thorac Cardiovasc Surg ; 68(10): 1128-1133, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32212032

RESUMO

OBJECTIVES: The safety and feasibility of minimally invasive coronary artery bypass grafting (MICS CABG) were evaluated. METHODS: From December 2012 to March 2019, 122 consecutive patients underwent MICS CABG via a left mini-thoracotomy under direct vision. The internal thoracic artery (ITA) was harvested from all, while bilateral ITAs (BITAs) were used in 36 patients, with the second ITA as an in situ (n = 18) or free (n = 18) graft. Proximal anastomosis of the free graft (ITA, radial artery, or saphenous vein segments) was performed directly onto the ascending aorta, or from the ITA as a Y- or I-composite graft. RESULTS: Patient ages ranged from 38 to 89 years (mean 66.9 ± 9.6 years) and 102 were males. MICS CABG was completed without conversion in 116 patients (95.1%), of whom 76 underwent multivessel bypass grafting, with 2 grafts used in 52 and 3 or more in 24 patients. A cardiopulmonary bypass was performed in 17 patients. Perioperative mortality occurred in 1 patient who died of advanced cancer. There were no cases of reoperation for bleeding, stroke, or chest wound infection. The perioperative transfusion rate was 11.2%. Early graft patency was noted in 97.1%. The rate of freedom from major adverse cardiac and cerebrovascular events (all-cause death, myocardial infarction, stroke, and repeated revascularization) was 89.7% at 5 years. CONCLUSIONS: MICS CABG is feasible and showed good mid-term outcomes. BITAs can be harvested with this approach; thus, allowing for various graft designs. We recommend this as a useful option for coronary revascularization in selected cases.


Assuntos
Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/cirurgia , Artéria Torácica Interna/transplante , Procedimentos Cirúrgicos Minimamente Invasivos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ponte de Artéria Coronária sem Circulação Extracorpórea , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Artéria Radial/transplante , Reoperação , Toracotomia
20.
Ann Thorac Surg ; 109(1): e63-e65, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31518590

RESUMO

Proper positioning of the heart through a small left thoracotomy is the main challenge during off-pump minimally invasive cardiac coronary artery bypass grafting. Here we report a novel technique for target vessel exposure using the Tentacles NEO (Sumitomo Bakelite, Co Ltd, Tokyo, Japan) multisuction heart positioner, a device with 3 independent small suction cups that can be applied to various surfaces of the heart and pulled toward any direction using attached traction cords. The armless design of the device enables the use of flexible exposure techniques and contributes to the safety and feasibility of minimally invasive coronary artery bypass grafting.


Assuntos
Ponte de Artéria Coronária sem Circulação Extracorpórea/instrumentação , Toracotomia , Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Desenho de Equipamento , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Sucção/instrumentação , Toracotomia/métodos
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