Prospective evaluation of biodegradable polymeric sealant for intraoperative air leaks.

Background: A biodegradable polymeric sealant has been previously shown to reduce postoperative air leaks after open pulmonary resection. The aim of this study was to evaluate safety and efficacy during minimally invasive pulmonary resection.

Methods: In a multicenter prospective single-arm trial, 112 patients with a median age of 69 years (range 34-87 years) were treated with sealant for at least one intraoperative air leak after standard methods of repair (sutures, staples or cautery) following minimally invasive pulmonary resection (Video-Assisted Thoracic Surgery (VATS) or Robotic-Assisted).

Thoracic robotics at the Heart Hospital Baylor Plano: the first 20 cases.

A da Vinci Robotic Surgical System was purchased for The Heart Hospital Baylor Plano in fall 2011 and a program for robotic-assisted thoracic surgery commenced at the facility. Successive thoracic patients were offered and accepted a robotic-assisted operation. No patient was excluded because of age, height, weight, or comorbidities.

Biphasic shocks compared with monophasic damped sine wave shocks for direct ventricular defibrillation during open heart surgery.

Background: Biphasic waveform shocks are more effective than monophasic shocks for transchest ventricular defibrillation, atrial cardioversion, and defibrillation with implantable defibrillators but have not been studied for open chest, intraoperative defibrillation. This prospective, blinded, randomized clinical study compares biphasic and monophasic shock effectiveness and establishes intraoperative energy dose-response curves.

Methods: Patients undergoing cardiothoracic surgery with bypass cardioplegia were randomly assigned to the monophasic or biphasic shock group.

Physiology of nonpulsatile circulation: acute versus chronic support.

Mammals seem to be able to adapt to nonpulsatile circulation. For chronic support, pressure and flow, not the presence of a pulse, are the major requirements to sustain normal organ function. Pulsatile flow, however, seems to offer advantages over nonpulsatile flow for acute support in maintaining lymphatic flow, decreasing systemic vascular resistance, improving peripheral and pulmonary capillary perfusion, and reversing shock.