Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2014
Case ReportsOver 1200-day support with dual Jarvik 2000 biventricular assist device.
We report the successful longest biventricular support using dual Jarvik 2000 biventricular assist device (BVAD; Jarvik Heart, Inc., New York, NY, USA) as a bridge to transplant. A 27-year old woman with arrhythmogenic right ventricular cardiomyopathy underwent implantation of two Jarvik 2000s as a left ventricular assist device and right ventricular assist device. ⋯ Despite advances in continuous-flow ventricular assist devices, their long-term use for biventricular support remains limited. We report a successful case of 1245 days of biventricular support with dual Jarvik 2000 axial flow pumps in a patient with a small body surface area.
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Interact Cardiovasc Thorac Surg · Dec 2014
Observational StudyTriple valve surgery in the modern era: short- and long-term results from a single centre.
Triple valve surgery (TVS) is still a challenge for surgeons because of prolonged cardiopulmonary bypass (CPB) and myocardial ischaemic times. The reported operative mortality rate for TVS ranges between 2.5 and 25%; long-term survival is also diminished, with reported survival rates at 5 and 10 years of 75-82 and 61-75%, respectively. The objective of our study is to define early and late clinical outcomes, reporting the initial experience in the treatment of triple valve disease through a minimally invasive approach. ⋯ TVS offers encouraging short-term and long-term patient survival; these good results after TVS in patients with advanced valvular heart disease justify aggressive surgical therapy in these patients. TVS with a minimally invasive approach is feasible and could be another treatment option.
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Interact Cardiovasc Thorac Surg · Dec 2014
Totally robotic atrial septal defect closure: 7-year single-institution experience and follow-up.
Robotic technology has been applied to atrial septal defect (ASD) repair for more than 10 years, but the number of cases reported is limited and results of long-term follow-up are not clear. This study reports on a large group of patients who underwent totally robotic ASD repair on an arrested or beating heart at a single institution with a 7-year follow-up. ⋯ ASD can be performed safely and effectively on an arrested or beating heart with the assistance of robotic technology. This totally endoscopic approach represents an option for patients seeking a reliable, minimally invasive ASD repair with an excellent long-term result.
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Interact Cardiovasc Thorac Surg · Dec 2014
Case ReportsElephant trunk in a small-calibre true lumen for chronic aortic dissection: cause of haemolytic anaemia?
The elephant trunk technique for aortic dissection is useful for reducing false lumen pressure; however, a folded vascular prosthesis inside the aorta can cause haemolysis. The purpose of this study was to investigate whether an elephant trunk in a small-calibre lumen can cause haemolysis. ⋯ A folded elephant trunk in a small-calibre lumen can cause haemolysis. Therefore, inserting an elephant trunk in a small-calibre true lumen during surgery for chronic aortic dissection should be avoided.
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Interact Cardiovasc Thorac Surg · Dec 2014
The results of a two-stage double switch operation for congenital corrected transposition of the great arteries with a deconditioned morphologically left ventricle.
The purpose of this retrospective study was to evaluate a two-stage double switch operation, morphological left ventricular (mLV) retraining followed by an atrial-arterial switch operation, in the management of patients with congenitally corrected transposition of the great arteries (CCTGA) and a deconditioned mLV. ⋯ For CCTGA children with degraded mLV, the two-stage double switch procedure can be performed with low mortality and morbidity and may be an appealing alternative to conventional repair. mLV retraining should be performed as early as possible. The second-stage atrial-arterial switch procedure showed satisfactory early and mid-term results. More attention should be paid to the long-term function of the mLV and the aortic valve.