1,720,982 research outputs found
How to implant the Jarvik 2000 post-auricular driveline: evolution to a novel technique
Full text linkThe post-auricular (PA) driveline positioning for percutaneous power delivery is a specific feature of the Jarvik 2000 FlowMaker LVAD. We applied several technical refinements to optimise the PA implant. Here, we present and discuss these modifications. We retrospectively reviewed all patients implanted with Jarvik 2000 at our Institution. Different PA implant techniques were described. A machine learning analysis was performed to evaluate the determinants of driveline infection. From December 2008 to December 2017, 62 patients were implanted with Jarvik 2000, at our Institution. The PA connection was managed through the "question mark-shaped" incision in 24 patients (39%) and with the "C-shaped" in 18 (29%), whereas 10 (16%) cases received the "vertical incision" and 10 (16%) the "orthogonal incision". The implant technique resulted highly predictive of driveline infection. The rate of driveline infections was numerically lower among cases managed with the last two techniques. After evolving through different implant techniques, we propose and suggest the "orthogonal incision" to maximise the advantages of the Jarvik 2000 post-auricular driveline
Bilateral mini-thoracotomy approach for minimally invasive implantation of HeartMate 3
Full text linkIrreversible cardiac failure with intraventricular thrombosis: A novel technique of paracorporeal biventricular assist device implantation with ventricles excision
Full text linkAnalysis of early and long-term outcomes of acute type A aortic dissection according to the new international aortic arch surgery study group recommendations
Full text linkSurgical Treatment of Congenital Mitral Valve Dysplasia
No full textBackground and Aim of the StudyCongenital mitral valve (MV) dysplasia is a relatively rare and highly complex cardiac disease. We present our results and illustrate the techniques used to repair these valves.
MethodsBetween 1972 and 2014, 100 consecutive patients underwent surgical repair of congenital MV dysplasia at our institution. Predominant MV regurgitation was present in 53 patients (53%) whereas mitral stenosis was prevalent in 47 (47%).
ResultsThere were five early (5%) and eight late deaths (9%). Actuarial survival was 95%, 94%, and 93% at 5, 10, and 20 years, respectively. Sixteen patients (18%) required reintervention due to subsequent MV dysfunction. Actuarial freedom from reintervention for MV dysfunction was 95%, 92%, and 89% at 5, 10, and 20 years, respectively.
ConclusionsThe mechanism underlying the valve dysfunction in congenital mitral valve dysplasia is multifactorial and requires the application of a variety of surgical techniques for repai
Vacuum-Assisted Closure Therapy for the Treatment of Poststernotomy Wound Dehiscence in Neonates and Infants
No full textAbstractWe sought to analyze effectiveness and results of a vacuum-assisted closure system for the treatment of sternal wound dehiscence in newborns and children after cardiac surgery in our institution. Six patients with poststernotomy wound problems (large defects of epithelialization or mediastinitis) were treated with a vacuum-assisted closure (VAC) therapy. Median age was 5 months (range: 1–144); VAC therapy was started with negative pressure −75 mm Hg, continuously. All children achieved healing of the sternal wound and a subsequent closure after a median length of treatment of 8.3 days (range: 4–14). In conclusion, VAC therapy with high negative pressure is safe, effective, and is a well-tolerated therapy in pediatric patients with either early- or late poststernotomy wound dehiscence.</jats:p
Aortic dissection during heart transplant: when a nightmare comes true
No full text: Although heart transplant is a simple surgical procedure, it is actually considered challenging to perform this procedure in patients with a long-term left ventricular assist device assistance. We present the case of a patient who was bridged to the transplant by using a Jarvik 2000 left ventricular assist device. During the debridement, an acute type A aortic dissection occurred and the surgical strategy was suddenly replanned. The acute aortic dissection is one of the most feared complications, but it could be well managed, thanks to a rapid replanning of the surgical strategy
Repair Techniques for Mitral Valve Insufficiency in Children
No full textCongenital mitral valve (MV) dysplasia is a relatively rare and highly complex cardiac disease. We sought to provide a comprehensive analysis of the current surgical techniques for treating mitral valve insufficiency and the results of mitral valve repair at our institution. Between 1972 and 2017, 104 consecutive patients underwent surgical repair of congenital MV dysplasia-insufficiency at our institution. Among these, 59 patients presented with MV insufficiency (or prevalent MV insufficiency) and were part of the study. There was 1 early (1.7%) and 1 late death (1.7%). Survival at 5, 10 and 20 years was 98%, 98% and 94%, respectively. Eight patients (14%) required MV replacement for residual significant MV insufficiency. Freedom from re-intervention for MV dysfunction at 5, 10 and 20 years were 89%, 84% and 79%, respectively. Surgical techniques for treating mitral valve insufficiency must be tailored for each patient with the main goal of achieving a proper valve function, rather than a "normal" anatomy. The mechanism underlying valve dysfunction in congenital mitral valve insufficiency is multifactorial and requires the application of a variety of surgical techniques in each case
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