Interactive CardioVascular and Thoracic Surgery

http://icvts.oxfordjournals.org

List of Papers (Total 5,415)

Aortic root and proximal aortic arch replacement (performed by a left-handed surgeon)

We present our standard technique of composite graft replacement performed by a left-handed surgeon. This procedure is performed with a 30-day mortality comparable to that of elective isolated aortic valve replacement.

Thoraco-abdominal aortic aneurysm rupture secondary to lymphocytic lymphoma

We present the case of a 60-year old woman with a ruptured thoraco-abdominal aortic aneurysm (TAAA). It was a Type IV TAAA in the Crawford Classification. A mycotic origin was suspected as she had a known history of lymphocytic lymphoma. She underwent thoraco-abdominal aortic replacement with a good surgical result. Histopathological examination revealed destruction of the aortic ...

A pitfall of false lumen embolization in chronic aortic dissection: intimal injury caused by the embolization device edge

We report a case of intimal injury caused by the occluder device in the false lumen (FL) after treatment of refractory chronic aortic dissection with FL embolization. We speculate that the intimal injury was due to the disproportionate stress from the FL. We covered the new entry by an additional stent graft in the true lumen. The deployment of a stent device in both lumens at the ...

Superficial femoral artery access for transcatheter aortic valve replacement

Different vascular accesses have been described for the delivery of a transcatheter aortic bioprosthesis. We report the use of the superficial femoral artery (SFA) as the arterial site of puncture with surgical cut-down. It may be a reasonable access alternative to the other classical routes, especially in the setting of either obese patients with elevated body mass index or in the ...

Haemodynamic improvement of older, previously replaced mechanical mitral valves by removal of the subvalvular pannus in redo cardiac surgery

Patients requiring redo cardiac surgery for diseased heart valves other than mitral valves may show increased pressure gradients and reduced valve areas of previously placed mechanical mitral valves due to subvalvular pannus formation. We treated four women who had mechanical mitral valves inserted greater than or equal to 20 years earlier and who presented with circular pannus ...

Combined endoscopic and transcatheter treatment of native mitral stenosis

This report describes an approach for the treatment of high-risk native mitral valve stenosis. It incorporates the deployment of a transcatheter valve in the mitral position under full endoscopic vision, combined with endoscopic mitral repair techniques that secure valve positioning and reduce the risk of paravalvular leak. This approach could be used as a rescue procedure in ...

A Loeys–Dietz patient with a transatlantic odyssey: repeated aortic root surgery ending with a huge left main coronary aneurysm

We present a patient who required several aortic root procedures. Finally, a huge aneurysm of the left main coronary artery required emergency surgery after a failed transcatheter procedure.

Surgical rescue after left anterior descending catheter entrapment causing cardiogenic shock

Entrapment or device loss during percutaneous coronary intervention is a rare but potentially fatal complication. Percutaneous retrieval is possible but surgery can be required on an emergency basis. We present the case of an entrapped balloon catheter in the left anterior descending coronary artery during an elective percutaneous coronary intervention. The patient developed acute ...

Surgical treatment of a giant left main aneurysm

Coronary artery aneurysms are a rare finding and even more any coronary dilation having a diameter 1.5 times greater than the adjacent artery qualified as giant. No established treatment protocol exists. We report the case of a 75-year old man with a clinical symptom of chest pain on exertion, worsening in the last 6 months, who was diagnosed with a giant left main aneurysm. ...

A successful staged Fontan operation for a right atrial isomerism neonate having major aortopulmonary collateral arteries and extracardiac total anomalous pulmonary venous connection

Right atrial isomerism and pulmonary atresia combined with major aortopulmonary collateral arteries are very rare. Surgical treatment becomes more challenging when an extracardiac total anomalous pulmonary venous connection (TAPVC) requiring surgical repair neonatally is also present. We describe a successful staged Fontan operation for a neonate with a single ventricle, right ...

A novel procedure for reconstructing an extensive hypoplastic aortic arch in older children

Aortic arch reconstruction is the key to successfully repairing an interrupted aortic arch (IAA) with tubular hypoplasia of the aortic arch (THAA), especially in older children. We report a novel reconstruction technique involving aortapulmonary fusion that was used to treat THAA in a 9 year-old patient with IAA. In this procedure, the underside of the aortic arch and the upside of ...

Pulmonary root translocation for borderline complex coarctation of aorta and multiple ventricular septal defects

We describe a case of complex left ventricular outflow tract obstruction, multiple muscular ventricular septal defects, aortic coarctation and a hypoplastic aortic arch, where staged biventricular repair was performed successfully using pulmonary root translocation.

Do novel anticoagulant agents increase the risk of perioperative complications during implantable cardiac rhythm device insertion?

A best evidence topic was written according to a structured protocol. The question addressed was ‘In patients requiring an implanted cardiac rhythm device, do novel oral anticoagulant agents lead to increased rates of peri-procedural complications?’ Altogether 1228 papers were found using the reported search, of which 5 represented the best evidence to answer the clinical question. ...

Is there significance in identification of non-predominant micropapillary or solid components in early-stage lung adenocarcinoma?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘in early-stage lung adenocarcinomas, does the presence of non-predominant micropapillary (MIP) or solid (SOL) growth component influence long-term survival and surgical strategy?’. Altogether, more than 600 papers were found using the reported search, of which 13 ...

Does neoadjuvant chemoradiotherapy increase survival in patients with resectable oesophageal cancer?

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether trimodal therapy [neoadjuvant chemoradiotherapy (nCRT) in addition to surgery] improves survival in patients with resectable oesophageal cancer. Altogether 565 studies were identified using the below-mentioned search. Eleven represented the best ...

Can mitomycin facilitate endoscopic dilatation treatment of benign oesophageal stricture?

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was ‘Can mitomycin facilitate endoscopic dilatation treatment of benign esophageal stricture (mainly including caustic and anastomotic esophageal stricture)?’ Altogether, 115 papers were found using the reported search, of which 6 represented the best evidence to ...

The totally thoracoscopic maze procedure for the treatment of atrial fibrillation

The purpose of this study was to update the current evidence regarding the efficacy and safety of the totally thoracoscopic maze (TT-maze) procedure for the treatment of atrial fibrillation (AF). Fourteen studies published between 2011 and 2016 and comprising 1171 patients were included as follows: 545 (46%) patients had paroxysmal AF (pAF), 268 (23%) persistent AF (persAF) and 358 ...

Surgical revascularization for premature coronary artery disease in second and third decade of life

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 occlusive disease due to unusual causes.

CorMatrix valved conduit in a porcine model: long-term remodelling and biomechanical characterization†

OBJECTIVES Porcine small intestinal submucosa extracellular matrix (CorMatrix; CorMatrix Cardiovascular, Rosewell, GA) is a relatively novel tissue substitute used in cardiovascular applications. We investigated the biological reaction and remodelling of CorMatrix as a tri-leaflet valved conduit in a pig model. We hypothesized that CorMatrix maintains a durable architecture as a ...

The extracellular matrix patch implanted in the right ventricle evaluated with cardiovascular magnetic resonance protocol to assess regional physio-mechanical properties

OBJECTIVES An extracellular matrix patch was implanted in the porcine right ventricle for in situ myocardial regeneration. A newly developed cardiovascular magnetic resonance protocol was utilized to investigate the regional physio-mechanical function of the patch.

Laser lead extraction allows for safe and effective removal of single- and dual-coil implantable cardioverter defibrillator leads: A single-centre experience over 12 years

OBJECTIVES Lead extraction in patients with multiple or old leads of an implantable cardioverter defibrillator (ICD) is challenging. As adhesions are common at the side of the shock coils, we investigated success and procedural complication rates of laser lead extraction procedures in single- and dual-coil leads.

Trends in isolated coronary artery bypass grafting over the last decade

OBJECTIVES The purpose of this study was to assess the impact on hospital mortality and morbidity of extensive myocardial revascularization, using arterial grafts in patients undergoing isolated coronary artery bypass grafting (CABG).

Transcatheter valve-in-valve implantation versus redo surgical aortic valve replacement in patients with failed aortic bioprostheses†

OBJECTIVES Transcatheter aortic valve-in-valve implantation (ViV) is a new treatment for failing bioprostheses (BP) in patients with high surgical risk. However, comparative data, using standard repeat surgical aortic valve replacement (redo-SAVR), are scarce. We compared outcomes after ViV with those after conventional redo-SAVR in two European centres with established ...

Transaortic transcatheter aortic valve implantation: experience from the Kiel study

OBJECTIVES To evaluate the efficacy and safety of Edwards SAPIEN-XT or SAPIEN-3 transcatheter heart valves via transaortic (TAo) access.