European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Oct 2011
Should we always plan a Fontan completion after a Kawashima procedure?
To determine the late incidence of pulmonary arteriovenous malformations after bidirectional Glenn in patients with azygos continuation of the inferior vena cava (Kawashima operation). ⋯ Unless some hepatic blood flow is directed to both lungs, most, if not all patients with a Kawashima procedure will ultimately develop pulmonary arteriovenous malformations. Elective non-fenestrated Fontan completion in the years following Kawashima procedure should be recommended.
-
Eur J Cardiothorac Surg · Oct 2011
Minimally invasive trans-mediastinal endoscopic approach to insert phrenic stimulation electrodes in the human diaphragm: a preliminary description in cadavers.
Diaphragm pacing by phrenic nerve (PN) stimulation is currently used for patients with central respiratory paralysis to be weaned from mechanical ventilation. Electrodes are inserted either through bilateral thoracotomy or through four ports laparoscopy. The aim of this experimental work is to demonstrate the feasibility of trans-mediastinal bilateral implantation of PN electrodes using a flexible gastroscope introduced through a cervical incision in human cadavers. ⋯ Trans-mediastinal implantation of PN stimulation electrodes is possible using a flexible endoscope. This application of endoscopic surgery could allow a minimally invasive placement of PN electrodes in patients with central respiratory paralysis, for example, at the time of tracheostomy.
-
Eur J Cardiothorac Surg · Oct 2011
Beating-heart implantation of adjustable length mitral valve chordae: acute and chronic experience in an animal model.
This study aimed to determine the acute and chronic performance of a new system designed to conduct beating-heart implantation and off-pump adjustment of neochordal length. ⋯ The V-Chordal system simplifies the process of neochordal implantation and precise off-pump adjustment of the neochordal length to correct MR occurring due to a flail leaflet. This technology may improve the technical feasibility for adoption of chordal repair during open or minimally invasive surgical procedures.
-
Eur J Cardiothorac Surg · Oct 2011
The aortic interleaflet triangles annuloplasty: a multidisciplinary appraisal.
Aortic interleaflets triangles annuloplasty (AITA) reduces interleaflet triangles' circumferential extent through properly placed sutures. To achieve aortic root functional unit (ARFU) stabilization, we aimed at quantifying the effect of suture extent (SE) on aortic valve function and at finding general optimization criteria. ⋯ So far, the AITA seems to be a valuable technique to increase leaflet CL in aortic valve repair and in silico models seem to be able to predict the principles of the phenomena but not the individual complexity.