Best Practices of Aortic Valve Replacement With the Edwards Intuity Elite Valve.

Purpose: The Edwards Intuity Elite (EIE; Edwards Lifesciences, Irvine, CA) valve system is a recent surgical aortic valve designed to expedite implantation, facilitate minimally invasive approaches, and provide low gradients, particularly in smaller valve sizes. The report reviews various best practices learned through experience with the EIE valve system.

Description: With its sealing frame designed to anchor and seal the valve after resection of the diseased native aortic valve, EIE use differs from that of conventional sutured valves.

Limited access left thoracotomy for reoperative coronary artery disease: on or off pump.

Between 1971 and 1988 left thoracotomy was performed on pump for selected reoperations. Since 1993, 92 patients were operated on with a limited approach and an increased number of cases were done off pump (70 patients). The purpose of this paper is to describe the transition of our operative techniques from on pump to off pump for reoperative coronary patients.

Minimally invasive coronary artery bypass grafting using the right gastroepiploic artery without pump.

Objective: To explore the feasibility to operate on the right coronary artery and its branches utilizing the right gastroepiploic artery (RGEA) without cardiopulmonary bypass (CPB). All cases were performed since May 1996.

Methods: A small mid-line incision including splitting of the lower sternum gave excellent exposure.

Reoperations with the right gastroepiploic artery without cardiopulmonary bypass.

The right gastroepiploic artery (RGEA) has been utilized as the bypass conduit on the inferior surface of the heart with a minimally invasive approach. Fourteen patients had reoperative coronary bypass surgery for severely symptomatic single-vessel disease of the right coronary artery. All surgeries were performed since May 1996.

Left thoracotomy reoperation for coronary artery disease.

Twenty patients underwent reoperative coronary artery bypass grafting (CABG) through a left thoracotomy since 1971. This was their second CABG in 16 patients, third in three patients and fourth in one patient. Surgery was performed from 1 to 16 years following the initial procedure.