Innovations : technology and techniques in cardiothoracic and vascular surgery
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Innovations (Phila) · Sep 2014
Outcomes of aortic valve and concomitant ascending aorta replacement performed via a minimally invasive right thoracotomy approach.
Replacement of the aortic valve with concomitant replacement of the ascending aorta performed via a minimally invasive right anterior thoracotomy approach has not been reported. We evaluated the feasibility and safety of this procedure. ⋯ Minimally invasive AVR with concomitant replacement of the ascending aorta, via a right anterior thoracotomy approach, can be performed with low morbidity and mortality.
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Innovations (Phila) · Jul 2014
Comparative StudyPerformance increase in venous drainage for mini-invasive heart surgery: superiority of self-expanding cannulas.
Originally, the Smartcanula principle (collapsed insertion and expansion in situ) was developed for venous drainage by gravity. However, in minimally invasive surgery, augmentation with either constrained force vortex pumps or vacuum is often used. The current study was set up to assess whether smaller diameters of self-expanding venous cannulas are sufficient in conjunction with venous drainage augmentation resulting in smaller access orifices. ⋯ Our experimental evaluation demonstrated the superior performance of the Smartcanula with its self-expanding design in comparison with the reference commercially available standard cannulas. The Smartcanula with its small diameter is particularly welcome for minimally invasive surgery.
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Innovations (Phila) · Jul 2014
Nonintubated thoracoscopic pulmonary nodule resection under spontaneous breathing anesthesia with laryngeal mask.
During the past 20 years, the use of video-assisted thoracoscopic surgery has increased as an important minimally invasive tool. To further reduce its invasiveness, after a preliminary experience, we decided to use a nonintubated spontaneous breathing general anesthesia, for video-assisted thoracoscopic surgery resection of lung nodule, using a laryngeal mask (LMA). This study aimed to verify the safety and the feasibility of this technique. ⋯ Our experience suggests that thoracoscopic wedge resection of lung nodule is safe and feasible under spontaneous breathing anesthesia with LMA. This technique permits a confident manipulation of lung parenchyma and a safe stapler positioning, without cough, pain, or panic attack described for awake epidural anesthesia, avoiding the risks related to tracheal intubation and mechanical ventilation.