Brain and lower body protection during aortic arch surgery.

Background: Deep hypothermic circulatory arrest (DHCA) at ≤20°C for aortic arch surgery has been widely used for decades, with or without cerebral perfusion (CP), antegrade (antegrade cerebral perfusion [ACP]), or retrograde. In recent years nadir temperature progressively increased to 26°C-28°C (moderately hypothermic circulatory arrest [MHCA]), adding ACP. Aim of this multicentric study is to evaluate early results of aortic arch surgery and if DHCA with 10 min of cold reperfusion at the same nadir temperature of the CA before rewarming (delayed rewarming [DR]) can provide a neuroprotection and a lower body protection similar to that provided by MHCA + ACP.

[Echocardiographic assessment of mitral regurgitation in the perspective of valve repair].

Echocardiography is the most used imaging technique for the study of patients with mitral regurgitation because of its wide distribution, non-invasiveness and ability to provide diagnostic, functional, hemodynamic and prognostic evaluations. Also, echocardiography can provide essential information on surgical and percutaneous reparability of the regurgitant valve and can guide the surgical and interventional indications relative to valve repair. However, the echocardiographic study is not always appropriately performed in clinical practice and based on a surgery perspective.

Sternal wrapping: developments and results.

Background: Postoperative sternal wound complications are infrequent events that negatively affect recovery and may have serious consequences. Sternal wrapping, a technique of sternal care, has hemostatic properties without bone wax, and offers mechanical and microbiologic protection.

Methods: From February 1998 to December 2011, 258 patients in 2 Italian institutions underwent various cardiac surgery procedures with sternal wrapping in place, and were followed up for no less then 6 months.

Mini re-sternotomy for aortic valve replacement in patients with patent coronary bypass grafts.

As the population ages, an increasing number of patients with patent coronary grafts will require subsequent aortic valve replacement. Major operative problems include those associated with re-entry and, in particular, damage of the patent grafts. Between January 2007 and October 2008, 10 patients who had previous coronary bypass surgery underwent aortic valve replacement through upper j-shaped mini re-sternotomy.

Anomalous systemic arterial supply to the left lung base without sequestration.

Systemic arterial supply from the descending thoracic aorta to the basal segment of the left lower lobe without a pulmonary arterial supply is a rare congenital anomaly within the spectrum of the sequestration lung disease. We report a case of a young man with anomalous systemic arterial supply to a normal left lower lobe referred to our department because of recurrent haemoptysis who underwent a successful left lower lobectomy.

Acute coronary syndrome in a patient with a single coronary artery arising from the right sinus of Valsalva: a case report.

Coronary anomalies can involve origin or distribution of the artery. Most of these anomalies are not clinically important. A single coronary artery arising from the right coronary sinus of Valsalva is an extremely rare anatomic anomaly.

Video-assisted thoracoscopic clipping of patent ductus arteriosus: close to the gold standard and minimally invasive competitor of percutaneous techniques.

Objective: To review our 12-year experience in video-assisted thoracoscopic surgery (VATS) for patent ductus arteriosus.

Methods: VATS was performed in 743 patients. Three groups were compared: 24 low-birth-weight infants (LBWIs), 676 children between 2.

Ineffectiveness of local wound anesthesia to reduce postoperative pain after median sternotomy.

Postoperative pain control still represents a major challenge in every surgical field. Bupivacaine wound infiltration is frequently used to reduce the pain related to the surgical incision itself. In this randomized study, we investigated the efficacy of bupivacaine local anesthesia after median sternotomy to reduce postoperative pain.

Robotic aortic valve replacement: case report.

We have developed a technique that enables robotic aortic valve replacement with port access via a small right anterior thoracotomy and minimally invasive aortic cross clamping. The procedure is performed under video guidance with all the annular sutures placed with the robot. In the case we report, the patient's postoperative course was extremely simple and pain was minimal.