Resection of a cardiac tumour with reconstruction of the atria and the superior vena cava.

Cardiac tumours are very rare and their complete resection, when feasible, remains the only curative treatment. We present the case of a patient who had aortic stenosis. The routine preoperative workup also identified stenosis in the left anterior descending and right coronary arteries, and most importantly, an invasive tumour at the confluence of the superior vena cava-right atrium-left atrium.

Reconstruction of a large pulmonary artery aneurysm using a vascular prosthesis.

A pulmonary artery aneurysm is a rare, heterogeneous disease for which there are currently no surgical guidelines. We present the case of a symptomatic patient presenting with a large aneurysm of the distal pulmonary trunk and left pulmonary artery. The aneurysm was resected through a full median sternotomy under cardiopulmonary bypass and aortic cross-clamping.

Passive leg raising-induced changes in pulse pressure variation to assess fluid responsiveness in mechanically ventilated patients: a multicentre prospective observational study.

Background: Passive leg raising-induced changes in cardiac index can be used to predict fluid responsiveness. We investigated whether passive leg raising-induced changes in pulse pressure variation (ΔPPV) can also predict fluid responsiveness in mechanically ventilated patients.

Methods: In this multicentre prospective observational study, we included 270 critically ill patients on mechanical ventilation in whom volume expansion was indicated because of acute circulatory failure.

Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant.

Objectives: Our goal was to compare pacemaker rate usage following two different operating techniques for implanting the Perceval aortic valve replacement.

Methods: In this retrospective, single-centre study, we studied patients with isolated or concomitant Perceval aortic valve replacement operated on first between April 2013 and January 2016, following traditional operating techniques, with patients operated on between January 2016 and December 2020, after the adoption of a modified protocol based on different annulus sizing, higher positioning of the valve and no ballooning after valve deployment was adopted. The operations were performed by 2 surgeons, and patients were followed-up for a period of 30 days.

Right anterior minithoracotomy with total central cannulation.

A right anterior minithoracotomy is gaining wider acceptance among the members of the surgical community for the treatment of isolated aortic valve replacement. Usually, the cardiopulmonary bypass circuit is implanted either totally peripherally or with 1 cannula in a central position and the other in a peripheral one. This procedure has its drawbacks because it adds potential peripheral morbidity during or after the operation.

Reversed C-shaped Scanner-guided Ministernotomy for Isolated Aortic Valve Replacement.

Here we present our technique of aortic valve replacement through a reversed C-shaped ministernotomy in 36 patients operated between 2017 and 2019. All patients had a preoperative computed tomography that guided the surgical approach. The sternum was incised at the level of the first and third or the second and fourth intercostal spaces.

The Ross procedure in adults patients with reconstruction of the RVOT with a bioprosthetic valve.

The Ross procedure is now a well established treatment for aortic valve pathology in young adult patients. However, there are several technical aspects of this operation that are still under debate. One of them is the necessity for reconstruction of the right ventricular outflow tract.

Standardized loop technique for mitral valve repair offers good midterm results.

Background: We reviewed the midterm results of our approach for mitral valve repair with the use of standardized loops.

Methods: In a retrospective single-center study, mitral repairs performed between November 2015 and December 2019 with the standardized loop technique were included. Predefined loops of 15 and 25 mm (Gore-Tex) were implanted for posterior or anterior mitral prolapses, respectively.

Axillary TAVR under locoregional anesthesia in a patient with peripheral artery disease.

Transcatheter aortic valve replacement (TAVR) is now a relatively commonly performed procedure and the number of eligible patients is growing exponentially.  In candidates with peripheral arterial disease, the axillary artery approach is an option worth considering. Usually TAVR performed using this approach is done under general anesthesia with tracheal intubation.

Severe Acute Proximal Pulmonary Embolism and COVID-19: A Word of Caution.

Acute pulmonary embolism is an uncharacteristic presentation in patients with coronavirus 2019 (COVID-19). Here we describe the case of a young woman presenting with severe pulmonary embolism, without any associated symptoms of infections. A clot in a patent foramen ovale was noted.

Assessment of macro- and micro-oxygenation parameters during fractional fluid infusion: A pilot study.

Purpose: The main goal of this study was to assess whether maximal fluid infusion improves both oxygen delivery (DO) and micro-circulatory parameters during hemodilution. The secondary objective was to assess the ability of baseline micro-circulatory parameters to predict oxygen consumption (VO) response following fluid infusion.

Materials And Methods: In a postoperative cardiac ICU, patients received repeated fluid infusion until stroke volume (SV) was maximized.

A Standardized Loop Technique for Mitral Valve Repair.

The loop technique is widely used for mitral valve repair. However, estimation of the correct loops' length remains challenging. We describe a standardized technique with implantation of standardized 15- and 25-mm loops for posterior and anterior mitral prolapses.

Preload dependency determines the effects of phenylephrine on cardiac output in anaesthetised patients: A prospective observational study.

Background: Although phenylephrine is widely used in the operating room to control arterial pressure, its haemodynamic effects remain controversial.

Objective: We hypothesised that the effect of phenylephrine on cardiac output is affected by preload dependency.

Design: A prospective observational study.

Assessment of changes in cardiac index with calibrated pulse contour analysis in cardiac surgery: A prospective observational study.

Objectives: To assess the trending ability of calibrated pulse contour cardiac index (CIPC) monitoring during haemodynamic changes (passive leg raising [PLR] and fluid loading) compared with transpulmonary thermodilution CI (CITD).

Method: Seventy-eight mechanically-ventilated patients admitted to intensive care with calibrated pulse contour following cardiac surgery were prospectively included and investigated during PLR, and after fluid loading. Fluid responsiveness was defined as a≥15% CITD increase after a 500ml bolus.

Near-Infrared Spectroscopy Hemoglobin Index Measurement During Fluid Challenge: A Prospective Study in Cardiac Surgery Patients.

Objective: Little is known about changes in near-infrared spectroscopy-derived tissue hemoglobin index (HbI). The authors tested the hypothesis that absolute values and changes in brain hemoglobin index (HbIb) and skeletal muscle hemoglobin index (HbIm) could differ from the reference arterial hemoglobin (Hb) during fluid challenge.

Design: A prospective, monocenter observational study.

Cerebral and somatic near-infrared spectroscopy measurements during fluid challenge in cardiac surgery patients: a descriptive pilot study.

Objective: Little is known about changes in near-infrared spectroscopy (NIRS)-derived cerebral (rSO(2)b) and somatic (rSO(2)s) oxygen saturation during a fluid challenge. The authors tested the hypothesis that they could differ from central venous oxygen saturation (ScvO(2)) and from one site to another.

Design: A prospective observational study.

A comparison of endotracheal bioimpedance cardiography and transpulmonary thermodilution in cardiac surgery patients.

Objectives: The authors hypothesized that bioimpedance cardiography measured by the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient and reliable method for both cardiac index (CI) assessment and prediction in fluid responsiveness.

Design: A prospective observational study.

Setting: A teaching university hospital.