Uniportal versus multiportal video-assisted thoracoscopic surgery for spontaneous pneumothorax.

Background: Multiportal video-assisted thoracic surgery (mVATS) is the standard approach for the surgical treatment of spontaneous pneumothorax. However, uniportal VATS (uVATS) has emerged as an alternative aiming to minimize surgical morbidity. This study aims to strengthen the evidence on the safety and efficiency of uVATS compared to mVATS.

Surgical mediastinal lymph node staging for non-small-cell lung carcinoma.

Background: The current preferred approach for surgical mediastinal staging of non-small-cell lung carcinoma is video-assisted mediastinoscopy. An alternative technique in which lymph nodes are resected instead of biopsied is video-assisted mediastinoscopic lymphadenectomy (VAMLA) that is suggested to be superior in detecting N2 disease. Yet, evidence is conflicting and furthermore limited by sample size.

Bone suture anchor repair and functional outcome of a triceps tendon rupture, a rare clinical entity.

Triceps tendon rupture is rare and easily missed on presentation. A 58-year-old man was seen in our accident and emergency department with an inability to extend his right elbow against gravity after he fell. Ultrasound and MRI confirmed the suspected diagnosis of a traumatic triceps tendon rupture and excluded additional injuries.

Optical imaging versus CT and plain radiography to quantify pectus severity: a systematic review and meta-analysis.

Background: Computed tomography (CT) and two-view chest radiographies are the most commonly used imaging techniques to quantify the severity of pectus excavatum (PE) and pectus carinatum (PC). Both modalities expose patients to ionizing radiation that should ideally be avoided, especially in pediatric patients. In an effort to diminish this exposure, three-dimensional (3D) optical surface imaging has recently been proposed as an alternative method.

Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: a systematic review and meta-analysis.

Primary spontaneous pneumothorax affects up to 28 patients per 100 000 population yearly and is commonly resolved by chest tube drainage. However, drainage is also known to be associated with ipsilateral recurrence rates ranging from 25% to 43%. Preventive video-assisted thoracoscopic surgery (VATS) may be an effective alternative to diminish these recurrence rates and its associated morbidity.

Superior mesenteric and renal flow patterns during intra-aortic counterpulsation.

New Findings: What is the central question of this study? Visceral ischaemia is one of the most feared complications during use of an intra-aortic balloon pump. Using an animal model, we measured the flows at the abdominal level directly and examined flow patterns to enable investigation of flow patterns during the use of the intra-aortic balloon pump. What is the main finding and its importance? We show that there is a significant balloon-related reduction in superior mesenteric flow in both early and mid-diastole.

In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience.

Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center.

Design: A retrospective study of a single-centre PC-ECLS cohort.

Vascular complications following intra-aortic balloon pump implantation: an updated review.

Background: The use of the intra-aortic balloon pump (IABP) as a support device remains controversial due to the fact that a number of studies have shown no benefit in end mortality whilst using this device. One of the reasons for this could be the increase in vascular complications when using the pump. Therefore, the aim of the present review was to assess the current literature available with regards to IABP vascular complications during the clinical situation.

Modalities and Effects of Left Ventricle Unloading on Extracorporeal Life support: a Review of the Current Literature.

Introduction/aim: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support is increasingly used in refractory cardiogenic shock and cardiac arrest, but is characterized by a rise in afterload of the left ventricle (LV) which may ultimately either further impair or delay cardiac contractility improvement. The aim of this study was to provide a comprehensive overview regarding the different LV venting techniques and results currently available in the literature.

Methods: A systematic literature search was performed in the PubMed database: 207 articles published between 1993 and 2016 were included.

The ABLA-BOX: An In Vitro Module of Hybrid Atrial Fibrillation Ablation.

Objective: We present the first testing study on the ABLA-BOX, a new in vitro module of hybrid atrial fibrillation ablation.

Methods: ABLA-BOX consists of two chambers that mimic the epicardial and endocardial sides of the heart. The septum between chambers provides catheter access on both sites of the cardiac tissue.

Does sinus rhythm conversion after cardiac surgery affect postoperative health- related quality of life?

Background: We investigated the impact and the predictive value of sinus rhythm at 12 months (SR12) on subscales of three different HrQoL questionnaires: SF-36., EuroQoL and MFI 20.

Methods: Data of 125 cardiac surgery patients with pre-operative AF from our previous randomized trial were used.

A New 35-mm Short Intra-aortic Balloon Catheter: A Suitable Option Also for Non-Small-Sized Patients?

Objective: Visceral ischemia can be a potentially life-threatening complication of intra-aortic balloon pump (IABP) support. A shorter IABP catheter might lead to a reduction of visceral complications. In this animal study, we evaluate the effects of a 35-mL short catheter in comparison with a 40-mL standard-sized catheter.

Contact forces during hybrid atrial fibrillation ablation: an in vitro evaluation.

Purpose: Data on epicardial contact force efficacy in dual epicardial-endocardial atrial fibrillation ablation procedures are lacking. We present an in vitro study on the importance of epicardial and endocardial contact forces during this procedure.

Methods: The in vitro setup consists of two separate chambers, mimicking the endocardial and epicardial sides of the heart.

Surgical ablation in patients undergoing mitral valve surgery: impact of lesion set and surgical techniques on long-term success.

Aims: To assess the results and impact of lesion set and surgical technique on long-term success of surgical ablation during mitral surgery.

Methods And Results: The patient population consisted of 685 subjects with persistent and long-standing persistent atrial fibrillation (AF) undergoing cardiac surgery for mitral valve disease as the primary indication and concomitant ablation between January 2003 and January 2012 at three institutions. One hundred and sixty-six underwent unipolar (24.

The Optimal Weaning Strategy for Intraaortic Balloon Counterpulsation: Volume-Based Versus Rate-Based Approach in an Animal Model.

Background: Changes in hemodynamics, coronary circulation, visceral flow, and biochemical marker rate reduction or volume deflation for intraaortic balloon pump discontinuation were assessed.

Methods: Twelve healthy pigs were randomly assigned to two groups, the rate-based (RB, n = 6) and volume-based weaning groups (VB, n = 6). Hemodynamics and visceral and coronary flows were measured at baseline after 2 hours of intraaortic balloon pump 1:1, during the first 5 hours of weaning (frequency rate reduced to 1:2 in the RB group and volume decreased by 10%/h in the VB group), after 1 hour of frequency rate 1:3 in the RB group or a volume decrease by 75% in the VB group, 2 hours after withdrawal, and 4 hours after withdrawal.

Comparing short versus standard-length balloon for intra-aortic counterpulsation: results from a porcine model of myocardial ischaemia-reperfusion.

Objectives: We compare a short and a standard-size balloon with same filling volumes to verify the differences in terms of visceral flow, coronary circulation and haemodynamic performance during aortic counterpulsation in an animal model of myocardial ischaemia-reperfusion injury.

Methods: Eighteen healthy pigs underwent 120-min ligation of the left anterior descending coronary artery followed by 6 h of reperfusion, and they were randomly assigned to have intra-aortic balloon counterpulsation (IABP) with a 40-ml short-balloon (n = 6) or a 40-ml standard-length balloon (n = 6), or to undergo no IABP implantation (controls, n = 6). Haemodynamics and visceral and coronary flows were measured at baseline (t0), at 2 h of ischaemia (t1) and every hour thereafter until 6 h of reperfusion (from tR1 to tR6), respectively.

The "Spacemaker", a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study.

Objective: Our aim was to evaluate a new inflatable lung retractor, the "Spacemaker", and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation.

Methods: The device was tested in 12 anesthetized pigs (90-100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space.

Short intra-aortic balloon pump in a swine model of myocardial ischaemia: a proof-of-concept study.

Objectives: This proof-of-concept study examined the haemodynamic performance as well as the coronary and visceral organ perfusion using a new short balloon for intra-aortic counterpulsation (IABP) in a swine model of myocardial ischaemia.

Methods: Eighteen healthy pigs underwent 120-min ligation of the left anterior descending coronary artery followed by 6 h of reperfusion, and they were randomly assigned into 3 groups undergoing IABP implantation with a 35-ml short balloon (n = 6), a 40-ml short balloon (n = 6) or no IABP implantation (controls, n = 6). Haemodynamics, and visceral and coronary flows were measured at baseline (t0), at 2 h of ischaemia (t1) and every hour thereafter until 6 h of reperfusion (from tR1 to tR6), respectively.

Is ganglionated plexi ablation during Maze IV procedure beneficial for postoperative long-term stable sinus rhythm?

Background: We investigated the role of surgical ablation targeting the autonomous nervous system during a Cox-Maze IV procedure in the maintenance of sinus rhythm at long-term follow-up.

Methods: The patient population consisted of 519 subjects with persistent or long-standing persistent atrial fibrillation (AF) undergoing radiofrequency Maze IV during open heart surgery between January 2006 and July 2013 at three institutions without (Group 1) or with (Group 2) ganglionated plexi (GP) ablation. Recurrence of atrial fibrillation off-antiarrhythmic drugs was the primary outcome.

Guideline adherence in antithrombotic treatment after concomitant ablation surgery in atrial fibrillation patients.

Objectives: We investigated real-life oral anticoagulation (OAC) treatment after surgical ablation and examined its adherence to current recommendations. We also explored factors related to OAC use preoperatively and at follow-up.

Methods: One hundred and fifteen patients with atrial fibrillation (AF) were evaluated during 12-month follow-up after surgery.

Poststernotomy mediastinitis and the role of broken steel wires: retrospective study.

Objective: Mediastinitis is a severe complication of cardiac surgery. Sternal instability is concomitantly present in most cases. Broken steel wires may cause sternal instability.