Spinal cord monitoring using collateral network near-infrared spectroscopy during extended aortic arch surgery with a frozen elephant trunk.

The true incidence of spinal cord injury associated with modern hybrid extended arch/descending aortic procedures utilizing a frozen elephant trunk (fET) remains unclear, and it is estimated with ~5-8%. Prolonged distal arrest without sufficient hypothermic protection as well as extended coverage of segmental arteries have been suggested to cause this complication, previously uncommon in open arch surgery. Recently, extensive clinical and experimental research led to the implementation of a new method of collateral network near-infrared spectroscopy (cnNIRS) to non-invasively monitor spinal cord oxygenation in the setting of extensive thoracoabdominal aortic repair.

Minimally invasive coronary bypass surgery with bilateral internal thoracic arteries: Early outcomes and angiographic patency.

Objective: Multivessel minimally invasive coronary artery bypass grafting, performed chiefly with left internal thoracic artery and saphenous vein grafts through a left anterolateral thoracotomy, has recently emerged as an alternative to conventional coronary artery bypass grafting. The present study involves our initial experience with respect to early postoperative and angiographic outcomes after total arterial multivessel off-pump minimally invasive coronary artery bypass grafting with bilateral internal thoracic arteries.

Methods: A total of 88 consecutive patients undergoing total arterial off-pump minimally invasive coronary artery bypass grafting with bilateral internal thoracic arteries without ascending aortic manipulation were included in this study.

Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients.

Objectisves: The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients.

Design: A retrospective analysis.

Setting: A university-affiliated heart center.

Value of transesophageal echocardiography (TEE) guidance in minimally invasive mitral valve surgery.

The role of intraoperative transesophageal echocardiography (TEE) has increased tremendously since its first use in 1979. Today intraoperative TEE is a class I indication for surgical mitral valve reconstruction for evaluation of mitral valve pathology, graduation of mitral regurgitation and detection of potential risk factors as well as post-repair assessment. Real-time three-dimensional TEE offers anatomical visualization of the mitral valve apparatus, fundamental for virtual surgical planning of proper annuloplasty ring size.