Pulmonary function may decrease significantly after
|
|
- Evelyn Malone
- 6 years ago
- Views:
Transcription
1 Effects of Minimal Invasive Coronary Artery Bypass on ulmonary Function and ostoperative ain Artur Lichtenberg, MD, Christian Hagl, MD, Wolfgang Harringer, MD, Uwe Klima, MD, and Axel Haverich, MD Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany Background. Minimally invasive direct coronary artery bypass () requires substantially smaller incisions than conventional coronary artery bypass grafting (). We investigated whether this fact may lead to less postoperative pain and improved pulmonary function. Methods. reoperative and postoperative (days 1, 3, and 5) pulmonary function and postoperative pain were assessed in 15 patients undergoing (group A) by using a standardized score and were compared with 15 patients admitted for (group B). Results. Total operation time (140 minutes versus 189 minutes; p < 0.001) and duration of mechanical ventilation (300 minutes versus 840 minutes; p < 0.001) were significantly less in group A. ulmonary function was comparable between the 2 groups on postoperative day 1 (OD 1). Vital capacity was significantly greater in group A on OD 3 (59.7% versus 40.6%; p < 0.001) and on OD 5 (74.4% versus 53.9%; p < 0.001). Similar results were found for forced expiratory volume in 1 second (group A versus B on OD 3: 56.3% versus 42.2%; p < 0.05; and on OD 5: 68.4% versus 55.5%; p < 0.01). ostoperative pain was significantly higher in group A (OD 1: score 5.5 versus 3.6; OD 3: 4.0 versus 2.9; p < 0.01). Conclusions. procedures lead to better preservation of pulmonary function compared with conventional despite greater postoperative pain. (Ann Thorac Surg 2000;70:461 5) 2000 by The Society of Thoracic Surgeons ulmonary function may decrease significantly after myocardial revascularization using cardiopulmonary bypass (CB). Impairment of pulmonary function after coronary artery bypass grafting () is one of the most common complications in the early postoperative period [1 3]. Sternotomy [1], pleurotomy with opening of the pleural space, harvest of internal mammary artery [4, 5], and pain [4, 6] may lead to deterioration of postoperative pulmonary function. Additionally, CB may cause pathomorphologic and functional pulmonary changes called postperfusion syndrome [7 10]. With a minimally invasive direct coronary artery bypass () technique using a lateral minithoracotomy, and surgery on the beating heart without CB, some of the disadvantages of can be avoided. The purpose of our study was to investigate how this new technique affects postoperative pulmonary function as well as postoperative pain when compared with standard. Material and Methods was composed of 15 men (aged years) who underwent without CB. consisted of 15 men (aged years) who underwent conventional using CB. Inclusion criteria for both groups were male sex, normal cardiac function Accepted for publication Mar 24, Address reprint requests to Dr Lichtenberg, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany; lichtenberg@thg.mh-hannover. (ejection fraction 55%), New York Heart Association (NYHA) classification I or II and absence of pulmonary or chest wall diseases. ulmonary Function Test and ostoperative ain reoperatively, lung function parameters (vital capacity [VC] and forced expiratory volume in 1 second [FEV 1 ]) were evaluated using a transportable spirometer unit (LA2, Allied Healthcare, St. Louis, MO). Each test was performed three times and the best results were selected for analysis. Tests were then repeated on postoperative day (OD) 1, 3 and 5 by a respiratory therapist. Arterial blood gas analyses (po 2 and pco 2 ) were determined when breathing room air preoperatively and on OD 1, 3 and 5. atients quantified their pain at rest and at forced inspiration during spirometry using a verbal numerical pain scale from 0 (no pain whatever) to 10 (the worst imaginable pain). This standardized test was used previously by us and other investigators [11 13]. The postoperative pain regimen was equal in both groups. The amount of used pain drugs was comparable between the groups. Standard analgetic medication with diclofenac 1.5 mg/kg was administered to all patients postoperatively 1 to 2 hours before spirometry. Anesthesiologic Management For group A, anesthesiologic management included the use of a single-lumen tube for intubation. A bronchial blocker (6 charriere; Rüsch, Kerner, Germany) was placed in the tube to allow selective ventilation of the 2000 by The Society of Thoracic Surgeons /00/$20.00 ublished by Elsevier Science Inc II S (00)
2 462 LICHTENBERG ET AL Ann Thorac Surg ULMONARY FUNCTION AND AIN AFTER 2000;70:461 5 right lung. Anesthesia was usually achieved by the use of etomidate, fentanyl, pancuronium bromide, and sodium thiopental. Before performing the anastomosis, heparin was administered at a dosage of 100 IU/kg body weight. Depending on the intraoperative bleeding tendency, protamine was given at a dosage to antagonize either half or all of the administered heparin. In selected cases pharmacologic reduction of the heart rate was necessary and accomplished with -blockers (esmolol hydrochloride 0.5 to 2.0 mg/kg). All patients received prophylactic antibiotics (ceftriaxon sodium 2 g) at induction of anesthesia and for 12 hours after operation. For group B, the differences from group A were singlelumen intubation without using a bronchial blocker. Heparin was given at a dose of 300 IU/kg. On bypass, heparin was administered additionally to keep the activated clotting time longer than 400 seconds. After CB, heparin was antagonized completely with protamine. Operative Technique For group A, the patient was placed in a 30-degree right lateral decubitus position, and the left hemithorax was entered through the fourth or fifth intercostal space [14]. The usual length of incision was 8 cm. The pedicle of the left internal thoracic artery (ITA) was dissected from the caudal part of the sixth rib up to the cranial origin of the ITA. Exposure was obtained by a Thora-LIFT Retractor (Auto Suture; U.S. Surgical Corp, Norwalk, CT). Side branches were cut by electrocautery or clipped. After ITA preparation, diluted papaverine was applied externally. Then the pericardium was opened and formed a cradle to lift the heart. A mechanical U-shaped stabilizer (Cardio- Thoracic Systems, Inc, Cupertino, CA) was placed parallel to the left anterior descending artery (LAD). The LAD was then surrounded by a 4/0 polypropylene tourniquet proximal to the chosen site for the anastomosis and also distally in case of significant bleeding. The artery was opened longitudinally, and the left ITA to LAD anastomosis was performed with a running 8/0 polypropylene suture. After the anastomosis one pleural chest drain was placed through the sixth or seventh intercostal space. The wound was closed in layers. No intercostal pain catheter was used. For group B, coronary bypass grafting was carried out through a midline sternotomy. The left ITA pedicle was mobilized after wide opening of the left pleura. Cardiopulmonary bypass was established using a single venous and arterial cannula. Moderate systemic hypothermia (32 C to 34 C) was applied and CB was carried out with a disposable membrane oxygenator (Sorin-Biomedica; Saluggia, VC, Italy). Myocardial preservation was achieved by using cold crystalloid cardioplegia (St. Thomas Solution) every 20 minutes during the crossclamp period. The distal coronary anastomosis were performed in standard technique. The chest was closed using six to eight steel wires (Sherwood Medical, St. Louis, MO) after one left pleural chest drain as well as a subxiphoid mediastinal drainage tube were placed through the sixth or seventh intercostal space. Fluid drainage in both groups was monitored hourly. Table 1. reoperative, Intraoperative, and erioperative atient Characteristics in Both Groups Daily chest roentgenograms and ultrasonographic examinations were done to evaluate diaphragmatic motion, retention of intrapleural fluid, and atelectasis. On OD 1 the subxiphoid tube was removed in all patients in group B. The pleural tube was removed in all patients of groups A and B on OD 2. Statistical Analysis Data are expressed as mean SD. atient variables were analyzed by Student s t test for unpaired data when appropriate. Results of pain scores and blood gas analysis as well as pulmonary function parameters were analyzed with repeated measures of analysis of variance. Multiple pairwise comparisons were done using the Bonferroni t test. robability values less than 0.05 were considered significant. Results Age (years) NS Weight (kg) NS Number of bypass grafts Aortic clamp time (min) Time of CB (min) Time of operation (min) Time of intubation (min) minimally invasive direct artery bypass; coronary artery bypass grafting; CB cardiopulmonary bypass; NS not significant. There were no significant differences in demographic data. The operation time, number of bypass grafts, and the duration of mechanical ventilation in the intensive care unit were significantly greater in group B (p 0.001; Table 1). All patients in both groups had no pulmonary complications postoperatively. No patient had inappropriate drainage with fluid retention or diaphragmatic immobility because of phrenic nerve injury. Table 2 shows the results of pulmonary function preoperatively and on OD 1, 3, and 5. reoperative VC and FEV 1 were comparable between groups. The decrease in VC and FEV 1 on OD 1 were slightly less in group A, but the differences observed were not statistically significant. The decreases in VC were significantly greater in group B on OD 3 (40.6% versus 59.7%; p 0.001) and OD 5 (53.9% versus 74.4%; p 0.001) compared with group A. Similar results were found for FEV 1 (OD 3: 42.2% versus 56.3%; OD 5: 55.5% versus 68.4%; group B versus A; p 0.01; Fig 1). Arterial blood gas analyses showed no significant differences in the postoperative period between groups A and B (Table 3). In group A, patients showed significantly higher pain scores on OD 1 (5.5 versus 3.6; p 0.001) and OD 3 (4.0
3 Ann Thorac Surg LICHTENBERG ET AL 2000;70:461 5 ULMONARY FUNCTION AND AIN AFTER 463 Table 2. Comparison of reoperative and ostoperative ulmonary Function of atients Undergoing () and () Variable reoperative VC NS redicted % NS reoperative FEV NS redicted % NS ostoperative VC (OD 1) NS redicted % NS ostoperative FEV 1 (OD 1) NS redicted % NS ostoperative VC (OD 3) redicted % ostoperative FEV 1 (OD 3) redicted % ostoperative VC (OD 5) redicted % ostoperative FEV 1 (OD 5) redicted % coronary artery bypass grafting; FEV 1 forced expiratory volume in one second; minimally invasive direct artery bypass; NS not significant; OD postoperative day; VC vital capacity. versus 2.9; p 0.01) than in group B during forced inspiration (Fig 2). ain score was comparable between groups at rest (Table 4). Table 3. Comparison of Arterial Blood Gases reoperatively and ostoperatively Comment reoperative day po 2 (mm Hg) NS pco 2 (mm Hg) NS ostoperative day 1 po 2 (mm Hg) NS pco 2 (mm Hg) NS ostoperative day 3 po 2 (mm Hg) NS pco 2 (mm Hg) NS ostoperative day 5 po 2 (mm Hg) NS pco 2 (mm Hg) NS coronary artery bypass grafting; minimally invasive direct artery bypass; NS not significant. The aim of minimal surgical trauma is revolutionizing many surgical subspecialties, including cardiac surgery. Cardiac surgery has entered the era of minimal access surgical trauma through the introduction of these surgical approaches to coronary artery disease. is an evolving strategy for treating limited Fig 1. Vital capacity and FEV 1 preoperatively and for the first 5 postoperative days in the (group A) and (group B) groups. Data are shown as the mean SD. ( minimally invasive direct coronary artery bypass; coronary artery bypass grafting; VC vital capacity; FEV 1 forced expiratory volume in 1 second; OD postoperative day.) Fig 2. ain level for the first postoperative 5 days in group A (MID- CAB) and group B (). ain score: 0 no pain whatsoever; 10 the worst imaginable pain. Data are shown as the mean SD. ( minimally invasive direct artery bypass; coronary artery bypass grafting; OD postoperative day.)
4 464 LICHTENBERG ET AL Ann Thorac Surg ULMONARY FUNCTION AND AIN AFTER 2000;70:461 5 Table 4. Subjective ain Score After Removal of Chest Drains At Rest and During Forced Inspiration Variable ostoperative pain level (OD 1) At rest NS Forced inspiration ostoperative pain level (OD 3) At rest NS Forced inspiration ostoperative pain level (OD 5) At rest NS Forced inspiration NS coronary artery bypass grafting; minimally invasive direct artery bypass; NS not significant; OD postoperative day. coronary disease using techniques designed to minimize incisions, avoid cardiopulmonary bypass, and reduce perioperative complications as well as length of postoperative hospital stay. Anesthesia recovery times and intensive care unit and hospital stays were very similar to those reported by others after [14] and were shorter than after conventional [16]. ulmonary impairment in postoperative cardiac surgical patients with CB has been reported previously [1 6, 10, 11, 17]. Many authors found a significant reduction of the lung function in patients having sternotomies [1] for coronary artery bypass procedure with the ITA used as conduit [4, 5, 17]. ain, pleurotomy, and impaired pulmonary mechanics may lead to deterioration of pulmonary function in the postoperative period. The pathologic effects of extracorporeal circulatory support on the lungs have been extensively examined and described [2, 7, 9, 10, 18]. They lead to functional changes that have been designated by Baer and Osborn as postperfusion pulmonary congestion syndrome [7]. Complement activation [18], thrombotic occlusion of pulmonary capillaries, and insufficient coverage of the metabolic demands of lung tissue [2] lead to an increase of extravascular lung fluids as well as atelectasis and ventilation disruptions [3, 9]. These changes are responsible for degradation of lung function after ECC. Additionally, activated leukocytes and oxygen free radicals have been implicated in the pathogenesis of lung injury associated with cardiopulmonary bypass [9]. The comparison of multivessel () and single-vessel () coronary diseases resulted in significantly different operation times and slightly different anesthetic management, factors potentially influencing postoperative pulmonary function that could not be controlled for in this study. Our results indicate that after surgery the irritation of the intercostal nerves during the first 3 days postoperatively proved to cause pain of higher intensity than the sternotomy after procedure despite systematic analgetic therapy. Similar results were described by other authors [19]. Consequently, the influence of pain leads to inadequate and shallow breathing [4]. This explains why VC and FEV 1 in the group on the first postoperative day were not significantly different compared to the procedure. Following reduction of the wound pain better recovery of lung function was observed among the patients on OD 3. During the rest of the study period significantly higher lung function values were documented in these patients compared to patients. One can conclude that with improved pain therapy (e.g. intercostal nerve block) the lung function can be further improved significantly during the postoperative period for patients. However, the oxygen concentration in the blood showed no differences in both groups. In our study, we could demonstrate that the anterolateral approach for procedures, causes significantly more pain in the early postoperative period with standard analgetic treatment. Nevertheless, pulmonary function measurements show a clearly faster normalization rate in patients, even though temporary single lung ventilation was instituted. This might reflect a longer operation time as well as more-aggravated damage of the lungs from CB. atients with significantly impaired pulmonary function, therefore, should preferably undergo a procedure if their coronary status allows for it. We recommend a more sophisticated analgesic treatment, such as intercostal nerve block, to further accelerate the postoperative recovery of patients. References 1. Berrizbeitia LD, Tessler S, Jacobowitz IJ, et al. Effect of sternotomy and coronary bypass surgery on postoperative pulmonary mechanics. Chest 1989;96: Cartwright RS, Lim TK, Luft UC, alich WE. athophysiological changes in the lungs during extracorporeal circulation. Circ Res 1962;10: Gale GD, Teasdale SJ, Sanders DE, et al. ulmonary atelectasis and other respiratory complications after cardiopulmonary bypass and investigation of etiological factors. Can Anaesth Soc J 1979;26: Cohen AJ, Moore, Jones C, et al. Effect of internal mammary harvest on postoperative pain and pulmonary function. Ann Thorac Surg 1993;56: Rolla G, Fogliati, Bucca C, et al. Effect of pleurotomy on pulmonary function after coronary artery bypass grafting with internal mammary artery. Respir Med 1994;88: Vargas FS, Terra-Filho M, Hueb W, et al. ulmonary function after coronary artery bypass surgery. Respir Med 1997; 91: Baer DM, Osborn JJ. The post-perfusion pulmonary congestion syndrome. Am J Clin athol 1960;34: Ghia J, Anderson NB. ulmonary function and cardiopulmonary bypass. JAMA 1970;212: Gu YJ, de Vries AJ, Boonstra W, van Overen W. Leukocyte depletion results in improved lung function and reduced inflammatory response after cardiac surgery. J Thorac Cardiovasc Surg 1996;112: Ratliff NB, Young WG, Hackel DB, et al. ulmonary injury secondary to extracorporeal circulation. J Thorac Cardiovasc Surg 1973;65: Hagl C, Harringer W, Gohrbandt B, Haverich A. Site of pleural drain and early postoperative pulmonary function following coronary artery bypass grafting with internal mammary artery. Chest 1999;115:
5 Ann Thorac Surg LICHTENBERG ET AL 2000;70:461 5 ULMONARY FUNCTION AND AIN AFTER Jamison RN, Brown GK. Validation of hourly pain intensity profiles with chronic pain patients. ain 1991;45: Murphy DF, McDonald A, ower C, et al. Measurement of pain: a comparison of the visual analogue with a nonvisual analogue scale. Clin J ain 1988;3: Cremer J, Struber M, Wittwer T, et al. Off-bypass coronary bypass grafting via minithoracotomy using mechanical epicardial stabilization. Ann Thorac Surg 1997;63:S Acuff TE, Landreneau RJ, Griffith B, Mack MJ. Minimally invasive coronary artery bypass grafting. Ann Thorac Surg 1996;61: Calafiore AM, Di Giammarco G, Teodori G, et al. Left anterior descending coronary artery grafting via left anterior small thoracotomy without cardiopulmonary bypass. Ann Thorac Surg 1996;61: Vargas FS, Cukier A, Terra-Filho M, et al. Influence of atelectasis on pulmonary function after coronary artery bypass grafting. Chest 1993;104: Kouchoukos NT, Karp RB. Functional disturbances following extracorporeal circulatory support in cardiac surgery. In: Ionescu MJ, Wooler GH, eds. Current techniques in ECC. London: Butterworth; 1976: Walther T, Falk V, Metz S, et al. ain and quality of life after minimally invasive versus conventional cardiac surgery. Ann Thorac Surg 1999;67: New Requirements for Recertification in the Year 2001 Diplomates of the American Board of Thoracic Surgery who plan to participate in the recertification process within the next few years should pay particular attention to this notice, because the requirements will change effective in the year In addition to an active medical license and institutional clinical privileges in thoracic surgery, beginning in 2001, a valid certificate will be an absolute requirement for entrance into the recertification process. If your certificate has expired, the only pathway for renewal of a certificate will be to take and pass the art I (written) and the art II (oral) certifying examinations. In 2001, the American Board of Thoracic Surgery will no longer publish the names of individuals who have not recertified. In the past, a designation of NR (not recertified) was used in the American Board of Medical Specialities directories if a Diplomate had not recertified. The Diplomate s name will be published upon successful completion of the recertification process. The CME requirements will also change in The new CME requirements will be 70 Category I credits in either cardiothoracic surgery or general surgery earned during the 2 years prior to applying for recertification. SESATS and SESAS will be the only self-instructional material allowed for credit. No Category II credits will be allowed. The hysicians Recognition Award for recertifying in general surgery will not be accepted in fulfillment of the CME requirement for recertification. The preceding information only partially outlines the CME requirements. Interested individuals should refer to the 2000 Booklet of Information for a complete description of acceptable CME credits. Diplomates should maintain a documented list of their major cases performed during the year prior to application for recertification. This practice review should consist of 1 year s consecutive major operative experiences. If more than 100 cases occur in 1 year, only 100 should be listed. Candidates for recertification will be required to complete both the general thoracic and the cardiac portions of the SESATS self-assessment examination. It is not necessary for candidates to purchase SESATS prior to applying for recertification because SESATS will be sent to candidates after their application has been approved. Diplomates may recertify up to 3 years before the expiration of their certificate. Their new certificate will be dated 10 years from the time of expiration of their original certificate or most recent recertification certificate. In other words, recertifying early does not alter the 10-year validation. Recertification is also open to Diplomates with an unlimited certificate and will in no way affect the validity of their original certificate. The deadline for submission of applications for the recertification process is May 1 of each year. A recertification brochure outlining the rules and requirements for recertification in thoracic surgery is available upon request from the American Board of Thoracic Surgery, One Rotary Center, Suite 803, Evanston, IL 60201; telephone number: (847) ; fax: (847) ; abts_evanston@msn.com by The Society of Thoracic Surgeons Ann Thorac Surg 2000;70: /00/$20.00 ublished by Elsevier Science Inc
Minimally invasive surgical techniques have been successfully
Development of Robotic Enhanced Endoscopic Surgery for the Treatment of Coronary Artery Disease Utz Kappert, MD; Jens Schneider, MD; Romuald Cichon, MD; Vassilios Gulielmos, MD; Sems-Malte Tugtekin, MD;
More informationMinimally invasive direct coronary artery bypass for left anterior descending artery revascularization analysis of 300 cases
Original paper Videosurgery Minimally invasive direct coronary artery bypass for left anterior descending artery revascularization analysis of 300 cases Lufeng Zhang, Zhongqi Cui, Zhiming Song, Hang Yang,
More informationPort-Access Coronary Artery Bypass Grafting With the Use of Cardiopulmonary Bypass and Cardioplegic Arrest
Port-Access Coronary Artery Bypass Grafting With the Use of Cardiopulmonary Bypass and Cardioplegic Arrest Hermann Reichenspurner, MD, PhD, Vassilios Gulielmos, MD, Jaqueline Wunderlich, MD, Markus Dangel,
More informationAmong the potential advantages of minimally invasive
Endoscopic Internal Thoracic Artery Dissection Leads to Significant Reduction of Pain After Minimally Invasive Direct Coronary Artery Bypass Graft Surgery Jan Bucerius, MD, Sebastian Metz, MD, Thomas Walther,
More informationCORONARY ARTERY BYPASS GRAFTING (CABG) (Part 1) Mark Shikhman, MD, Ph.D., CSA Andrea Scott, CST
CORONARY ARTERY BYPASS GRAFTING (CABG) (Part 1) Mark Shikhman, MD, Ph.D., CSA Andrea Scott, CST I have constructed this lecture based on publications by leading cardiothoracic American surgeons: Timothy
More informationTSDA ACGME Milestones
TSDA ACGME Milestones Short MW and Edwards JA. Assessing resident milestones using a CASPE March 2012 Short MW and Edwards JA. Assessing resident milestones using a CASPE March 2012 Short
More informationThe long-term benefits of coronary artery bypass grafting
Robotic Coronary Artery Bypass Grafting Kenneth K. Liao, MD, PhD The long-term benefits of coronary artery bypass grafting (CABG) in treating coronary artery disease are attributed mainly to the use of
More informationTechnique of closed chest coronary artery surgery on the beating heart q
European Journal of Cardio-thoracic Surgery 20 (2001) 765 769 www.elsevier.com/locate/ejcts Technique of closed chest coronary artery surgery on the beating heart q Utz Kappert a, *, Romuald Cichon a,
More informationImmediate pulmonary dysfunction in ischemic heart disease patients undergoing off-pump versus on-pump CABG
Available online at www.sciencedirect.com ScienceDirect Journal of the Egyptian Society of Cardio-Thoracic Surgery 24 (2016) 15e20 http://www.journals.elsevier.com/journal-of-the-egyptian-society-of-cardio-thoracic-surgery/
More informationDemonstration of Uneven. the infusion on myocardial temperature was insufficient
Demonstration of Uneven in Patients with Coronary Lesions Rolf Ekroth, M.D., HAkan erggren, M.D., Goran Sudow, M.D., Josef Wojciechowski, M.D., o F. Zackrisson, M.D., and Goran William-Olsson, M.D. ASTRACT
More informationRobotic Hybrid Coronary Revascularization
Robotic Hybrid Coronary Revascularization Important benefits before, during, and after surgery If you have coronary artery disease (CAD), your doctor may discuss several treatment options with you. These
More informationCEU Final Exam for Code It! Sixth Edition
CEU Final Exam for 3-2-1 Code It! Sixth Edition Note to CEU applicant In order to receive CEU credit for taking this exam, the following criteria must be met: You must be certified by AAPC prior to purchasing
More informationSurgical pitfalls of minimally invasive direct coronary artery bypass procedure from the viewpoint of a surgeon in the learning curve
Original paper Videosurgery Surgical pitfalls of minimally invasive direct coronary artery bypass procedure from the viewpoint of a surgeon in the learning curve Bilgin Emrecan 1, Ahmet Coșkun Özdemir
More informationMIDCAB Approach for Single Vessel Coronary Artery Bypass Graft
MIDCAB Approach for Single Vessel Coronary Artery Bypass Graft V.A. Subramanian Interest in minimally invasive direct coronary artery bypass (MIDCAB) grafting on the beating heart is growing. The premise
More informationOPCABG for Full Myocardial Revascularisation How we do it
OPCABG for Full Myocardial Revascularisation How we do it 28 th SHA Conferance Dr.Farouk Oueida Head of Cardiac Surgery Dept. SBCC-Dammam KSA The Less Invasive CABG Full Revascularisation Full Sternotomy
More informationThe pericardial sac is composed of the outer fibrous pericardium
Pericardiectomy for Constrictive or Recurrent Inflammatory Pericarditis Mauricio A. Villavicencio, MD, Joseph A. Dearani, MD, and Thoralf M. Sundt, III, MD Anatomy and Preoperative Considerations The pericardial
More informationminimally invasive techniques
minimally invasive techniques Evaluation of Different Minimally Invasive Techniques in Pediatric Cardiac Surgery* Is a Full Sternotomy Always a Necessity? Christian Hagl, MD; Ulrich Stock, MD; Axel Haverich,
More informationThe most important advantage of CABG over PTCA is its
Coronary Artery Bypass With Only In Situ Bilateral Internal Thoracic Arteries and Right Gastroepiploic Artery Hiroshi Nishida, MD; Yasuko Tomizawa, MD; Masahiro Endo, MD; Hitoshi Koyanagi, MD; Hiroshi
More informationIntraoperative application of Cytosorb in cardiac surgery
Intraoperative application of Cytosorb in cardiac surgery Dr. Carolyn Weber Heart Center of the University of Cologne Dept. of Cardiothoracic Surgery Cologne, Germany SIRS & Cardiopulmonary Bypass (CPB)
More informationPort-Access Multivessel Coronary Artery Bypass Grafting
Port-Access Multivessel Coronary Artery Bypass Grafting James I. Fann, Mark A. Groh, Mario F. Pompili, Thomas A. Burdon, and Bruce A. Reitz In the 1950s and 1960s, Drs Dernikhov, Kolesov, and others successfully
More informationInfluence of Pleurotomy on Pulmonary Function After Off-Pump Coronary Artery Bypass Grafting
Influence of Pleurotomy on Pulmonary Function After Off-Pump Coronary Artery Bypass Grafting CARDIOVASCULAR Solange Guizilini, PhD, Walter J. Gomes, MD, PhD, Sonia M. Faresin, MD, PhD, Douglas W. Bolzan,
More informationCardiothoracic Fellow Expectations Division of Cardiac Anesthesia, Beth Israel Deaconess Medical Center
The fellowship in Cardiothoracic Anesthesia at the Beth Israel Deaconess Medical Center is intended to provide the foundation for a career as either an academic cardiothoracic anesthesiologist or clinical
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE
202 NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedures overview of totally endoscopic robotically assisted coronary artery bypass surgery Introduction
More informationCORONARY ARTERY BYPASS GRAFT (CABG) MEASURES GROUP OVERVIEW
CONARY ARTERY BYPASS GRAFT (CABG) MEASURES GROUP OVERVIEW 2015 PQRS OPTIONS F MEASURES GROUPS: 2015 PQRS MEASURES IN CONARY ARTERY BYPASS GRAFT (CABG) MEASURES GROUP: #43 Coronary Artery Bypass Graft (CABG):
More informationEvaluation of routine postoperative chest X-rays in the management of the cardiac surgical patient 1
European Journal of Cardio-thoracic Surgery 12 (1997) 72 729 Evaluation of routine postoperative chest X-rays in the management of the cardiac surgical patient 1 Podila Sita Rama Rao *, Qamar Abid, Khalid
More informationMinimal access aortic valve surgery has become one of
Minimal Access Aortic Valve Surgery Through an Upper Hemisternotomy Approach Prem S. Shekar, MD Minimal access aortic valve surgery has become one of the accepted forms of surgical therapy for patients
More informationRecent technologic advances have brought completely. Robotic Endoscopic Left Internal Mammary Artery Harvesting: What Have We Learned After 100 Cases?
Robotic Endoscopic Left Internal Mammary Artery Harvesting: What Have We Learned After 100 Cases? Armin Oehlinger, MD, Nikolaos Bonaros, MD, Thomas Schachner, MD, Elisabeth Ruetzler, MD, Guy Friedrich,
More informationReduction of the Inflammatory Response in Patients Undergoing Minimally Invasive Coronary Artery Bypass Grafting. Patients and Methods Patients
Reduction of the Inflammatory Response in Patients Undergoing Minimally Invasive Coronary Artery Bypass Grafting Y. John Gu, MD, PhD, Massimo A. Mariani, MD, PhD, Willem van Oeveren, PhD, Jan G. Grandjean,
More informationParenchyma-sparing lung resections are a potential therapeutic
Lung Segmentectomy for Patients with Peripheral T1 Lesions Bryan A. Whitson, MD, Rafael S. Andrade, MD, and Michael A. Maddaus, MD Parenchyma-sparing lung resections are a potential therapeutic option
More informationDr Nikolaos Baikoussis
Dr Nikolaos Baikoussis Cardiac Surgeon Evangelismos General Hospital of Athens, Greece STS database: any procedure not performed with a full sternotomy (FS) and cardiopulmonary bypass (CPB)..(TAVI) Schmitto
More informationIndex. Note: Page numbers of article titles are in boldface type
Index Note: Page numbers of article titles are in boldface type A Acute coronary syndrome, perioperative oxygen in, 599 600 Acute lung injury (ALI). See Lung injury and Acute respiratory distress syndrome.
More informationImages have been removed from the PowerPoint slides in this handout due to copyright restrictions.
Percutaneous Coronary Intervention https://www.youtube.com/watch?v=bssqnhylvma Types of PCI Procedures Balloon Angioplasty Rotational Atherectomy Coronary Stent Balloon Inflation Rotational Atherectomy
More informationUniversity of Florida Department of Surgery. CardioThoracic Surgery VA Learning Objectives
University of Florida Department of Surgery CardioThoracic Surgery VA Learning Objectives This service performs coronary revascularization, valve replacement and lung cancer resections. There are 2 faculty
More informationDaryoush Samim, Enrico Ferrari, MD, FETCS, PD&MER
On- pump versus off- pump coronary artery bypass grafting with left internal mammary artery for left anterior descending artery stenosis: a retrospective study over 15 years Daryoush Samim, Enrico Ferrari,
More informationA Prospective Randomized Study of Sternal Closure: Comparison of Mersilene Tape versus Standard Wire Closure
Original Article A Prospective Randomized Study of Sternal Closure: Comparison of Mersilene Tape versus Standard Wire Closure Hiroshi Imagawa, MD, 1 Susumu Nakano, MD, 2 Kanji Kawachi, MD, 1 Shinji Takano,
More informationICU Management of Minimally Invasive Cardiac Surgery
ICU Management of Minimally Invasive Cardiac Surgery Benjamin A. Kohl, MD, FCCM Chief of Critical Care, Aria-Jefferson Health Professor of Anesthesiology Thomas Jefferson University Sidney Kimmel Medical
More informationParenchymal air leak is a frequent complication after. Pleural Tent After Upper Lobectomy: A Randomized Study of Efficacy and Duration of Effect
Pleural After Upper Lobectomy: A Randomized Study of Efficacy and Duration of Effect Alessandro Brunelli, MD, Majed Al Refai, MD, Marco Monteverde, MD, Alessandro Borri, MD, Michele Salati, MD, Armando
More informationMyocardial revascularization without cardiopulmonary
Multiple Arterial Conduits Without Cardiopulmonary Bypass: Early Angiographic Results Antonio M. Calafiore, MD, Giovanni Teodori, MD, Gabriele Di Giammarco, MD, Giuseppe Vitolla, MD, Nicola Maddestra,
More informationOriginal article. INTRODUCTION MATERIAL AND METHODS. artery disease, reduces PO 2
Original article Effect of different dosages of nitroglycerin infusion on arterial blood gas tensions in patients undergoing on- pump coronary artery bypass graft surgery Gholamreza Masoumi 1, Evaz Hidar
More informationRetrospective Study Of Redo Cardiac Surgery In A Single Centre. R Karthekeyan, K Selvaraju, L Ramanathan, M Rakesh, S Rao, M Vakamudi, K Balakrishnan
ISPUB.COM The Internet Journal of Anesthesiology Volume 12 Number 2 Retrospective Study Of Redo Cardiac Surgery In A Single Centre R Karthekeyan, K Selvaraju, L Ramanathan, M Rakesh, S Rao, M Vakamudi,
More informationCoronary artery bypass grafting (CABG) without an
Coronary Artery Bypass Grafting on the Beating Heart Evaluated With Integrated Backscatter Kenichi Imasaka, MD, Shigeki Morita, MD, Ichiro Nagano, MD, Munetaka Masuda, MD, Ryuji Tominaga, MD, and Hisataka
More informationRCH Trauma Guideline. Management of Traumatic Pneumothorax & Haemothorax. Trauma Service, Division of Surgery
RCH Trauma Guideline Management of Traumatic Pneumothorax & Haemothorax Trauma Service, Division of Surgery Aim To describe safe and competent management of traumatic pneumothorax and haemothorax at RCH.
More informationDeclaration of conflict of interest NONE
Declaration of conflict of interest NONE Claudio Muneretto MD, PhD Director of Division of Cardiac Surgery University of Brescia Medical School Italy Hybrid Chymera Different features and potential advantages
More informationMyocardial enzyme release after standard coronary artery bypass grafting
Cardiopulmonary Support and Physiology Schachner et al Myocardial enzyme release in totally endoscopic coronary artery bypass grafting on the arrested heart Thomas Schachner, MD, a Nikolaos Bonaros, MD,
More informationPhrenic Nerve Injury Associated With High Free Right Internal Mammary Artery Harvesting
Phrenic Nerve Injury Associated With High Free Right Internal Mammary Artery Harvesting Yongzhi Deng, MD, Karen Byth, PhD, and Hugh S. Paterson, FRACS Department of Cardiothoracic Surgery, Westmead Hospital,
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Ablation, radiofrequency, anesthetic considerations for, 479 489 Acute aortic syndrome, thoracic endovascular repair of, 457 462 aortic
More informationCHEST INJURIES. Jacek Piątkowski M.D., Ph. D.
CHEST INJURIES Jacek Piątkowski M.D., Ph. D. CHEST INJURIES 3-4% of all injuries 8% of patients hospitalized due to injuries 65% of patients who died at the accident place CLASSIFICATION OF THE CHEST INJURIES
More informationAngiographic 5-Year Follow-up Study of Right Gastroepiploic Artery Grafts
Angiographic 5-Year Follow-up Study of Right Gastroepiploic Artery Grafts Sari Voutilainen, MD, Kalervo Verkkala, MD, PhD, Antero J~irvinen, MD, PhD, and Pekka Keto, MD, PhD Departments of Thoracic and
More informationAfter unsuccessful attempts to perform totally endoscopic coronary
Robotic totally endoscopic coronary artery bypass: Program development and learning curve issues J. Bonatti T. Schachner O. Bernecker O. Chevtchik N. Bonaros H. Ott G. Friedrich F. Weidinger G. Laufer
More informationAnatomical studies concerning technical feasibility of minimally invasive axillocoronary bypass grafting 1
European Journal of Cardio-thoracic Surgery 14 (Suppl. 1) (1998) S71 S75 Anatomical studies concerning technical feasibility of minimally invasive axillocoronary bypass grafting 1 Johannes Bonatti a, *,
More informationLess Invasive, Continuous Hemodynamic Monitoring During Minimally Invasive Coronary Surgery
Less Invasive, Continuous Hemodynamic Monitoring During Minimally Invasive Coronary Surgery Oliver Gödje, MD, Christian Thiel, MS, Peter Lamm, MD, Hermann Reichenspurner, MD, PhD, Christof Schmitz, MD,
More informationOptions for my no option Patients Treating Heart Conditions Via a Tiny Catheter
Options for my no option Patients Treating Heart Conditions Via a Tiny Catheter Nirat Beohar, MD Associate Professor of Medicine Director Cardiac Catheterization Laboratory, Medical Director Structural
More informationSURGICAL MYOCARDIAL REVASCULARIZATION: ARTERIAL VS VENOUS GRAFTS, SINGLE VS MULTIPLE GRAFTS?
SURGICAL MYOCARDIAL REVASCULARIZATION: ARTERIAL VS VENOUS GRAFTS, SINGLE VS MULTIPLE GRAFTS? Luigi Martinelli Chief, Dept. of Surgery Istituto Clinico Ligure di Alta Specialità RAPALLO During 1987 2006,
More information2016 Physician Quality Reporting System Data Collection Form: Coronary Artery Bypass Graft (CABG) (for patients aged 18 years and older)
2016 Physician Quality Reporting System Data Collection Form: Coronary Artery Bypass Graft (CABG) (for patients aged 18 years and older) IMPORTANT: Any measure with a 0% performance rate (100% for inverse
More informationEmergency surgery in acute coronary syndrome
Emergency surgery in acute coronary syndrome Teerawoot Jantarawan Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
More informationRobotic-assisted right upper lobectomy
Robotic Thoracic Surgery Column Robotic-assisted right upper lobectomy Shiguang Xu, Tong Wang, Wei Xu, Xingchi Liu, Bo Li, Shumin Wang Department of Thoracic Surgery, Northern Hospital, Shenyang 110015,
More informationLeft Anterior Descending Coronary Artery Grafting via Left Anterior Small Thoracotomy Without Cardiopulmonary Bypass
Left Anterior Descending Coronary Artery Grafting via Left Anterior Small Thoracotomy Without Cardiopulmonary Bypass Antonio M. Calafiore, MD, Gabriele Di Giammarco, MD, Giovanni Teodori, MD, Giovanni
More informationMinimally invasive left ventricular assist device placement
Original Article on Cardiac Surgery Minimally invasive left ventricular assist device placement Allen Cheng Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, USA
More informationLung cancer or primary malignant tumors of the mediastinum
Technique of Superior Vena Cava Resection for Lung Carcinomas David R. Jones, MD Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville,
More informationMICS CABG. Putting the future of MICS in your hands today
MICS CABG Putting the future of MICS in your hands today This presentation is based on a compilation of the surgical techniques and protocols of: Dr. Joseph McGinn - Staten Island, New York Dr. Marc Ruel
More informationOff-pump bypass grafting of the anterior descending
Thoracoscopic Harvest of the Internal Thoracic Artery: A Multicenter Experience in 218 Cases Francis G. Duhaylongsod, MD, William R. Mayfield, MD, and Randall K. Wolf, MD Division of Cardiothoracic Surgery,
More informationAlper Toker, MD. VATS decortication. Istanbul University, Istanbul Medical School Department of Thoracic Surgery
VATS decortication Alper Toker, MD Istanbul University, Istanbul Medical School Department of Thoracic Surgery Pleural space infection is a common pathology causing morbidity and mortality. It is a collection
More informationThe arterial switch operation has been the accepted procedure
The Arterial Switch Procedure: Closed Coronary Artery Transfer Edward L. Bove, MD The arterial switch operation has been the accepted procedure for the repair of transposition of the great arteries (TGA)
More informationSurgery has been proven to be beneficial for selected patients
Thoracoscopic Lung Volume Reduction Surgery Robert J. McKenna, Jr, MD Surgery has been proven to be beneficial for selected patients with severe emphysema. Compared with medical management, lung volume
More informationMinimally Invasive Mitral Valve Repair: Indications and Approach
Minimally Invasive Mitral Valve Repair: Indications and Approach Juan P. Umaña, M.D. Chief Medical Officer Director, Cardiovascular Medicine FCI - Institute of Cardiology Bogota Colombia 1 Mitral Valve
More informationDESCRIPTION: Percentage of patients aged 18 years and older undergoing isolated CABG surgery who received an IMA graft
Measure #43 (NQF 0134): Coronary Artery Bypass Graft (CABG): Use of Internal Mammary Artery (IMA) in Patients with Isolated CABG Surgery National Quality Strategy Domain: Effective Clinical Care 2017 OPTIONS
More informationBilateral Simultaneous Pleurodesis by Median Sternotomy for Spontaneous Pneumo thorax
Bilateral Simultaneous Pleurodesis by Median Sternotomy for Spontaneous Pneumo thorax I. Kalnins, M.B., T. A. Torda, F.F.A.R.C.S,, and J. S. Wright, F.R.A.C.S. ABSTRACT Bilateral pleurodesis by median
More informationHeart may be rotated but not compressed
Tips And Techniques For Multivessel OPCAB John D. Puskas, MD, Emory University, Atlanta AATS Adult Cardiac Skills April 28, 2012 San Francisco, CA Beating Heart Surgery vs Beat The Heart Surgery OPCAB
More informationInteresting Cases - A Case Report: Renal Cell Carcinoma With Tumor Mass In IVC And Heart. O Wenker, L Chaloupka, R Joswiak, D Thakar, C Wood, G Walsh
ISPUB.COM The Internet Journal of Thoracic and Cardiovascular Surgery Volume 3 Number 2 Interesting Cases - A Case Report: Renal Cell Carcinoma With Tumor Mass In IVC And Heart O Wenker, L Chaloupka, R
More informationAirway Management in a Patient with Klippel-Feil Syndrome Using Extracorporeal Membrane Oxygenator
Airway Management in a Patient with Klippel-Feil Syndrome Using Extracorporeal Membrane Oxygenator Beckerman Z*, Cohen O, Adler Z, Segal D, Mishali D and Bolotin G Department of Cardiac Surgery, Rambam
More informationMarc Albert, Adrian Ursulescu, Ulrich FW Franke Department of Cardiovascular Surgery Robert-Bosch-Hospital, Stuttgart, Germany
The total arterial myocardial revascularization using bilateral IMA and the role of post-operative sternal stabilization to reduce wound infections in a large cohort study. Marc Albert, Adrian Ursulescu,
More informationFariba Rezaeetalab Associate Professor,Pulmonologist
Fariba Rezaeetalab Associate Professor,Pulmonologist rezaitalabf@mums.ac.ir Patient related risk factors Procedure related risk factors Preoperative risk assessment Risk reduction strategies Age Obesity
More informationAnalysis of Mortality Within the First Six Months After Coronary Reoperation
Analysis of Mortality Within the First Six Months After Coronary Reoperation Frans M. van Eck, MD, Luc Noyez, MD, PhD, Freek W. A. Verheugt, MD, PhD, and Rene M. H. J. Brouwer, MD, PhD Departments of Thoracic
More informationOver the past 2 years, there has been rapid adoption
A Survey on Minimally Invasive Coronary Artery Bypass Grafting Hani Shennib, MD, Michael J. Mack, MD, and Allan G. L. Lee, MSc Divisions of Cardiothoracic Surgery, The Montreal General Hospital, McGill
More informationDistal Coronary Artery Dissection Following Percutaneous Transluminal Coronary Angioplasty
Distal Coronary rtery Dissection Following Percutaneous Transluminal Coronary ngioplasty Douglas. Murphy, M.D., Joseph M. Craver, M.D., and Spencer. King 111, M.D. STRCT The most common cause of acute
More informationThe recent interest in minimal access surgery throughout
Partial Versus Full Sternotomy for Aortic Valve Replacement Michael F. Szwerc, MD, Daniel H. Benckart, MD, Robert J. Wiechmann, MD, Edward B. Savage, MD, Gary W. Szydlowski, MD, George J. Magovern, Jr,
More informationSaphenous Vein Autograft Replacement
Saphenous Vein Autograft Replacement of Severe Segmental Coronary Artery Occlusion Operative Technique Rene G. Favaloro, M.D. D irect operation on the coronary artery has been performed in 180 patients
More informationSELECTIVE ANTEGRADE TECHNIQUE OF CHOICE
SELECTIVE ANTEGRADE CEREBRAL PERFUSION IS THE TECHNIQUE OF CHOICE MARKO TURINA University of Zurich Zurich, Switzerland What is so special about the operation on the aortic arch? Disease process is usually
More informationEmergency Approach to the Subclavian and Innominate Vessels
Emergency Approach to the Subclavian and Innominate Vessels Joseph J. Amato, M.D., Robert M. Vanecko, M.D., See Tao Yao, M.D., and Milton Weinberg, Jr., M.D. T he operative approach to an acutely injured
More informationExtra Corporeal Life Support for Acute Heart failure
Extra Corporeal Life Support for Acute Heart failure Benjamin Medalion, MD Director Heart and Lung Transplantation Department of Cardiothoracic Surgery Rabin Medical Center, Beilinson Campus, Israel Mechanical
More informationThe evolution of the Fontan procedure for single ventricle
Hemi-Fontan Procedure Thomas L. Spray, MD The evolution of the Fontan procedure for single ventricle cardiac malformations has included the development of several surgical modifications that appear to
More informationF mary artery (IMA) graft carries a greater long-term
Internal Mammary Artery Grafts: The Shortest Route to the Coronarv Arteries J Thomas J. Vander Salm, MD, Sultan Chowdhary, MD,. N. Okike, MD, A. Thomas ezzella, MD, and Michael K. asque, MD University
More informationThe technique of unilateral double lobar lung transplantation in a canine model
The technique of unilateral double lobar lung transplantation in a canine model Daisuke Okutani, MD Hiroshi Date, MD Makio Hayama, MD Hidetoshi Inokawa, MD Mikio Okazaki, MD Itaru Nagahiro, MD Yoshifumi
More informationI thoracic artery (LITA) anastomosed to the anterior
Similar Hospital Morbidity With the Use of One or Two Internal Thoracic Arteries Eric Berreklouw, MD, Jacques P. A. M. Schonberger, MD, PhD, Johannus H. Bavinck, MD, Victor J. Verwaal, MD, Evert L. Koldewijn,
More informationAbout OMICS International Conferences
About OMICS Group OMICS Group is an amalgamation of Open Access publications and worldwide international science conferences and events. Established in the year 2007 with the sole aim of making the information
More informationCARDIOCHIRURGIA MINI-INVASIVA: INVASIVA: efficacia per il paziente efficienza per la sanita. Dott. Davide Ricci
CARDIOCHIRURGIA MINI-INVASIVA: INVASIVA: efficacia per il paziente efficienza per la sanita Dott. Davide Ricci SC Cardiochirurgia U Universita degli Studi di Torino Minimally Invasive Surgical approaches
More informationREVASCULARIZATION. A solution for minimally invasive beating heart coronary artery bypass grafting
REVASCULARIZATION A solution for minimally invasive beating heart coronary artery bypass grafting The da Vinci Surgical System High-definition 3D vision EndoWrist instrumentation EndoWrist Instrumentation
More informationR complication of cardiopulmonary bypass (CPB) since. Respiratory Dysfunction After Uncomplicated Cardiomlmonarv Bvpass
Respiratory Dysfunction After Uncomplicated Cardiomlmonarv Bvpass I J J I David P. Taggart, MD(Hons), Mohammed El-Fiky, MB, Rodger Carter, MSc, Adrian Bowman, PhD, and David J. Wheatley, FRCS Departments
More informationOPCAB IS NOT BETTER THAN CONVENTIONAL CABG
OPCAB IS NOT BETTER THAN CONVENTIONAL CABG Harold L. Lazar, M.D. Harold L. Lazar, M.D. Professor of Cardiothoracic Surgery Boston Medical Center and the Boston University School of Medicine Boston, MA
More informationFemoral Versus Aortic Cannulation for Surgery of Chronic Ascending Aortic Aneurysm
Femoral Versus Aortic Cannulation for Surgery of Chronic Ascending Aortic Aneurysm Fitsum Lakew, MD, Piotr Pasek, MD, Michael Zacher, MD, Anno Diegeler, MD, and Paul P. Urbanski, MD Department of Cardiovascular
More informationLung dysfunction after cardiac surgery still remains an
Effect of Cardiopulmonary Bypass on Pulmonary Gas Exchange: A Prospective Randomized Study Craig M. Cox, FRCA, Raimondo Ascione, MD, Alan M. Cohen, FRCA, Ian M. Davies, FRCA, Ian G. Ryder, FRCA, and Gianni
More informationThoracoscopic left upper lobectomy with systematic lymph nodes dissection under left pulmonary artery clamping
GCTAB Column Thoracoscopic left upper lobectomy with systematic lymph nodes dissection under left pulmonary artery clamping Yi-Nan Dong, Nan Sun, Yi Ren, Liang Zhang, Ji-Jia Li, Yong-Yu Liu Department
More informationFacing Coronary Artery Bypass Surgery? Learn about minimally invasive da Vinci Surgery
Facing Coronary Artery Bypass Surgery? Learn about minimally invasive da Vinci Surgery The Condition: Coronary Artery Disease Coronary artery disease is a form of heart disease that affects your arteries.
More informationHybrid Coronary Revascularization by Endoscopic Robotic Coronary Artery Bypass Grafting on Beating Heart and Stent Placement
Hybrid Coronary Revascularization by Endoscopic Robotic Coronary Artery Bypass Grafting on Beating Heart and Stent Placement Changqing Gao, MD, Ming Yang, MD, Yang Wu, MD, Gang Wang, MD, Cangsong Xiao,
More informationEndoscopic harvesting of the left internal mammary artery
Masters of Cardiothoracic Surgery Endoscopic harvesting of the left internal mammary artery Tomasz Hrapkowicz 1, Gianluigi Bisleri 2 1 Division of Cardiac Surgery and Transplantology, Silesian Center for
More informationIn 1980, Bex and associates 1 first introduced the initial
Technique of Aortic Translocation for the Management of Transposition of the Great Arteries with a Ventricular Septal Defect and Pulmonary Stenosis Victor O. Morell, MD, and Peter D. Wearden, MD, PhD In
More information14) A MODIFIED ANAESTHESIA PROTOCOL FOR PATIENTS UNDERGOING MINIMAL INVASIVE CARDIAC SURGERY BY RIGHT THORACOTOMY- A SINGLE CENTER EXPERIENCE.
14) A MODIFIED ANAESTHESIA PROTOCOL FOR PATIENTS UNDERGOING MINIMAL INVASIVE CARDIAC SURGERY BY RIGHT THORACOTOMY- A SINGLE CENTER EXPERIENCE. Thosani R.M. 1, Shah B.K. 2, Gandhi H.G. 3, Sharath Kumar
More informationA Measure to Avoid Pleura Injuries in XLIF at Upper Lumbar Levels
A Measure to Avoid Pleura Injuries in XLIF at Upper Lumbar Levels Takao Nakajima 1, Yong Kim 2, Masabumi Miyamoto 3 Dept. of Orthop. Surg., Nippon Medical School, Chiba Hokusoh Hospital 1 Dept. of Orthop.
More informationOff-Pump Cardiac Surgery is not Dead
Off-Pump Cardiac Surgery is not Dead Gonzalo J. Carrizo, M.D. Fellow Cardiothoracic Surgery Division Cardiothoracic Surgery Department of Surgery University of Colorado Hopeman Lectureship September 10,2007
More information