The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Autogenous rib grafts for reconstruction of the manubrium after resection: technical refinements and outcomes.
Sternal reconstruction after resection is essential for restoring the rigidity of the chest cavity. However, no consensus has been reached regarding the most physiologic or efficacious material for this procedure. We present our clinical experience with autogenous rib grafts for reconstruction of the manubrium after resection and discuss the refinements in this procedure. ⋯ This case series demonstrates the successful use of autogenous rib grafts in the reconstruction of the manubrium after resection. We consider that the reconstruction technique is a safe and effective alternative to a complex problem.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Observational StudyMinimally invasive right thoracotomy approach for mitral valve surgery in patients with previous sternotomy: a single institution experience with 173 patients.
This study presents a review of our experience with minimally invasive mitral valve surgery (MIMVS) in patients with a previous cardiac procedure performed through a sternotomy over a 10-year period. ⋯ Reoperative mitral valve surgery can be safely performed through a right minithoracotomy with good early and late outcomes. The avoidance of extensive surgical dissection, optimal valve exposure, and low blood transfusion are the main advantages of this technique.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Embolic capture with updated intra-aortic filter during coronary artery bypass grafting and transaortic transcatheter aortic valve implantation: first-in-human experience.
We report our first-in-human clinical experience in the use of the new version of the EMBOL-X intra-aortic filter (Edwards Lifesciences Corporation, Irvine, Calif) to capture embolic material during transaortic transcatheter aortic valve implantation and cardiac surgery. ⋯ This first-in-human clinical experience has demonstrated the safety and feasibility of using the new version of the EMBOL-X intra-aortic filter during either cardiac surgery or transaortic transcatheter aortic valve implantation. We believe that the combination of the transaortic approach without aortic arch manipulation and the use of the EMBOL-X filter with a high capture rate is a promising strategy to reduce the incidence of embolic complications during transcatheter aortic valve implantation.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
Observational StudyMitral durability after robotic mitral valve repair: analysis of 200 consecutive mitral regurgitation repairs.
The study objective was to review a single-center experience on robotic mitral valve repair to treat mitral regurgitation, with a specific focus on midterm echocardiographic mitral durability. No data assessing the quality or durability of repaired mitral valves are currently available. ⋯ Robotic mitral regurgitation repair is technically feasible and efficacious, demonstrating favorable midterm mitral durability and improved procedural times as experience increases.
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J. Thorac. Cardiovasc. Surg. · Dec 2014
A stepwise model for delivering medical humanitarian aid requiring complex interventions.
Cardiothoracic surgeons and practitioners of cardiovascular medicine have a long history of humanitarian aid. Although this is worthwhile at multiple levels and occasionally described in some detail, few efforts have a proven algorithm with demonstrable outcomes that suggest effective educational methodology or clinical results approaching accepted standards in developed countries. ⋯ The positive results of our program model indicate that these methodologies may be helpful to others attempting to address the worldwide shortage of cardiovascular care and particularly the complex interventions required in the management of congenital cardiovascular disease.