Journal of cardiac surgery
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Transcatheter valve-in-valve (VIV) procedures are an alternative to standard surgical valve replacement in high risk patients. ⋯ Transcatheter VIV implantation in the nonaortic position for dysfunctional bioprostheses can be performed safely with favorable clinical outcomes using a balloon expandable TAVR device. doi: 10.1111/jocs.12745 (J Card Surg 2016;31:282-288).
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Different "hybrid" techniques that combine open debranching of the supra-aortic vessels with endografting of the aortic arch have emerged as alternatives to the open arch repair in high-risk patients. This study aims to review the early and mid-term results of single-stage hybrid arch repair with ascending aorta stent graft deployment for aortic arch aneurysms and dissections. ⋯ Hybrid arch repair with endograft landing in zone 0 may decrease mortality and morbidity in high-risk patients. doi: 10.1111/jocs.12735 (J Card Surg 2016;31:341-347).
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We describe the use of the Sapien XT, placed in the mitral position using a totally endoscopic robotic approach in a 76-year-old man with extensive circumferential mitral calcifications and severe stenosis. The patient was at high risk for traditional open surgery and a large mitral valve annulus prevented safe transcatheter deployment due to size mismatch. Our novel approach offered a minimally invasive technique for native mitral valve replacement in a high-risk patient with anatomical constraints prohibitive to conventional approaches. doi: 10.1111/jocs.12737 (J Card Surg 2016;31:303-305).
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A number of intraoperative tools are used for brain monitoring in aortic arch surgery. We rely on intraoperative electroencephalogram (EEG) to guide deep hypothermic circulatory arrest. ⋯ Intraoperative EEG is a reliable monitoring tool for safe circulatory arrest.
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Veno-venous extracorporeal membrane oxygenation (V V ECMO) has been used for refractory respiratory failure. We describe the indications, technical aspects, and outcomes of placing V V ECMO in adults using a dual-lumen, single-cannula catheter.