Innovations : technology and techniques in cardiothoracic and vascular surgery
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Innovations (Phila) · Jul 2018
Comparative StudyMini Right Anterior Thoracotomy Approach Versus Sternotomy for Resection of Intracardiac Myxoma.
The standard approach in treating cardiac myxoma is the median full sternotomy. After recent advances in surgical techniques, the mini right anterior thoracotomy has emerged as an alternative method. ⋯ A minimally invasive surgery through mini right anterior thoracotomy is a good alternative technique for treating cardiac myxoma. Despite the small size of the experience, there is a clear diminution in preoperative blood loss and an interesting trend toward a shorter intensive care unit and hospital stay.
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Innovations (Phila) · Jul 2018
Geometric Ring Annuloplasty for Aortic Valve Repair During Aortic Aneurysm Surgery: Two-Year Clinical Trial Results.
An aortic annuloplasty ring could be useful for aortic valve repair. This trial evaluated intermediate-term outcomes of internal geometric ring annuloplasty for repair of trileaflet and bicuspid aortic insufficiency associated with ascending aortic and/or aortic root aneurysms. ⋯ In preliminary regulatory studies, aortic ring annuloplasty seemed safe and effective during aortic aneurysm surgery. This approach could help standardize aortic valve repair.
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Innovations (Phila) · Jul 2018
Silver-Impregnated Dressing Does Not Decrease Incidence of Surgical Site Infection After Adult Cardiac Surgery.
Sternal wound infections complicate 1% to 8% of cardiac surgeries and carry significant morbidity. We investigated the utility of silver-impregnated dressing in decreasing sternal wound infections after sternotomy cases. ⋯ Silver dressings did not reduce sternal wound infection after sternotomy for cardiac surgery in a large-cohort study. We discontinued the routine use of silver dressings for adult cardiac surgery based on these results because traditional gauze likely represents an equally effective and less costly alternative.
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Innovations (Phila) · Jul 2018
Cost and Outcome of Minimally Invasive Techniques for Coronary Surgery Using Robotic Technology.
Totally endoscopic coronary artery bypass (TECAB) with robotic distal anastomosis and robotic-assisted minimally invasive coronary artery bypass (RA-MIDCAB) with robotic internal mammary artery harvest and direct hand-sewn distal anastomosis via an anterior thoracotomy have both been reported as safe and efficacious. We compared hospital cost and short-term outcomes between these techniques. ⋯ Totally endoscopic coronary artery bypass and RA-MIDCAB both demonstrated excellent short-term clinical outcomes. However, TECAB was associated with significantly higher hospital costs. Further comparisons, including long-term outcomes, patient satisfaction, and functional status, are needed to evaluate whether this additional cost is justified.
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Innovations (Phila) · Jul 2018
Intravenous Acetaminophen Improves Outcomes After Transapical Transcatheter Aortic Valve Replacement.
Complications with opioid-based postoperative pain management have led to guideline recommendations for a multimodal analgesia strategy incorporating nonopioid agents. We evaluated the opioid-sparing effect of intravenous acetaminophen in patients undergoing transapical transcatheter aortic valve replacement. ⋯ In patients undergoing transapical transcatheter aortic valve replacement, a multimodal pain management strategy incorporating intravenous acetaminophen was associated with reductions in narcotic use on the day of surgery and overall length of stay.