Physiological optimization of robotic endoscopic epicardial CRT-D implantation using multielectrode electroanatomic mapping.

Multielectrode epicardial mapping during robotic implantation of cardiac resynchronization-defibrillator system. Robotically assisted endoscopic implantation of cardiac implantable devices is well documented to be both feasible and safe, and this technique provides particular benefit in patients with limited vascular access. In a patient meeting Class I indication for cardiac resynchronization therapy with defibrillator and inaccessible vascular access, we describe in this case an optimization strategy for intraoperative left ventricular lead placement utilizing robotic epicardial electroanatomic mapping as well as the feasibility of implanting a totally epicardial biventricular cardioverter-defibrillator system.

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics.

The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy and referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted because recent literature has supported the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision.