Evolution of Minimally Invasive Coronary Artery Bypass Grafting: Learning Curve.

Objective: Minimally invasive coronary surgery approach for coronary artery bypass grafting is a safe and reproducible procedure for multivessel revascularization. This study reviewed a single surgeon's experience with minimally invasive coronary surgery coronary artery bypass grafting, including operative time, number of bypasses, and conversion to sternotomy.

Methods: A prospective database of consecutive minimally invasive coronary surgery coronary artery bypass grafting procedures from 2005 to 2013 was reviewed.

Minimally Invasive Valve Surgery and Single Vessel Coronary Artery Bypass via Limited Anterior Right Thoracotomy.

Background: Coronary artery bypass grafting with aortic valve replacement (AVR) or mitral valve replacement (MVR) is traditionally performed via sternotomy. Minimally invasive coronary surgery (MICS) and minimally invasive valve surgery have been successfully performed independently. Patients with critical right coronary artery (RCA) stenosis not amenable to percutaneous intervention are candidates for valve replacement and single vessel coronary artery bypass.

Hyperplastic cardiac sarcoma recurrence.

Primary cardiac sarcomas are rare tumors with a median survival of 6-12 months. Data suggest that an aggressive multidisciplinary approach may improve patient outcome. We present the case of a male who underwent resection of cardiac sarcoma three times from the age of 32 to 34.

Results of the Minimally Invasive Coronary Artery Bypass Grafting Angiographic Patency Study.

Objective: Minimally invasive coronary artery bypass grafting is safe and widely applicable, and may be associated with fewer transfusions and infections, and better recovery than standard coronary artery bypass grafting. However, graft patency rates remain unknown. The Minimally Invasive Coronary Artery Bypass Grafting Patency Study prospectively evaluated angiographic graft patency 6 months after minimally invasive coronary artery bypass grafting.

Experience with a minimally invasive approach to combined valve surgery and coronary artery bypass grafting through bilateral thoracotomies.

Background: Minimally invasive coronary artery bypass grafting (MICS-CABG) and minimally invasive valve surgery (MIVS) have been used independently to manage occlusive coronary artery disease and valvular diseases, respectively. We present 12 patients who underwent combined MICS-CABG and MIVS via bilateral mini-thoracotomies.

Methods: We retrospectively reviewed 116 consecutive valve/CABG operations by a single surgeon and compared the outcomes obtained via sternotomy with those obtained via bilateral minithoracotomies.

Resolution of recurrent chest pain with resection of papillary fibroelastoma.

Papillary fibroelastoma (PFE) is a benign primary tumor of the heart usually originating from the heart valves. Nonvalvular fibroelastomas are rare, and reported cases have presented either incidentally or with cerebral embolic phenomena; none have reported recurrent anginal symptoms. We are reporting a case of a 53-year-old female with history of significant radiation exposure to the chest in the past, who presented with recurrent chest pain and was found to have left atrial nonvalvular PFE managed with surgical excision.

A bolus dose of 1.5 mg/kg amrinone effectively improves low cardiac output state following separation from cardiopulmonary bypass in cardiac surgical patients.

Background: The aim of this study was to evaluate the efficacy of 1.5 mg/kg bolus of amrinone on low cardiac output (CO) state following emergence from cardiopulmonary bypass (CPB) in cardiac surgical patients.

Methods: Immediately after emergency from CPB, 14 patients with a cardiac index (CI) less than 2.

The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass.

Although milrinone effectively increases cardiac function, few studies have specifically evaluated its efficacy during cardiac surgery. We investigated the effects of milrinone on hemodynamics and left ventricular function in cardiac surgical patients who were already treated with catecholamines. Thirty-seven patients undergoing cardiac surgery were studied.

The effects of chronic uremia on glucagon binding and action in isolated rat hepatocytes.

Increased liver sensitivity to glucagon has been proposed to play a role in the complex metabolic state of chronic uremia. In order to assess this possibility at the cellular level, we studied basal and glucagon-stimulated alpha-aminoisobutyric acid (AIB) uptake, glucagon binding, and glucagon degradation in isolated hepatocytes from chronic uremic and pair-fed and ad libitum-fed control rats. The uremic rats were euglycemic and hyperglucagonemic when compared with their controls.