Novel Brain Protection Method for Zone 0 Endovascular Aortic Repair with Selective Cerebral Perfusion.

Zone 0 thoracic endovascular aortic repair (TEVAR) is associated with a high incidence of cerebral infarction mostly due to the embolic shower of a plaque from the aortic arch when the stent graft brushes against the aortic wall. Thus, it is important to develop a method for protecting the brain from such embolism. We report the outcomes of Zone 0 TEVAR with a novel brain protection method using selective cerebral perfusion under extracorporeal membrane oxygenation (ECMO).

Safety of perioperative period in robot-assisted atrial septal defect repair under hyperkalemic arrest.

Background: Various attempts have been made to meet patient desires, especially among younger and otherwise healthy individuals, for cosmetically satisfying incision with atrial septal defect (ASD) repair. One of procedures was a robotic-assisted totally endoscopic ASD repair via only two ports under hyperkalemic arrest without aortic cross-clamping. This study investigated perioperative management and safety for robotic-assisted total endoscopic ASD repair surgery under hyperkalemic arrest.

Combined robot-assisted mitral valve plasty and Nuss procedure via small ports.

Pectus excavatum (PE) can be associated with cardiac disorders that also require surgical repair. Totally endoscopic robot-assisted mitral valve plasty for mitral valve regurgitation was performed while elevating the sternum with the aid of our original electrical sternum lifting system. Then, the Nuss procedure was performed successfully via small incision.

[Minimally Invasive Cardiac Surgery for a Heart Tumor after Breast Cancer Therapy and Partial Lung Resection for Lung Cancer;Report of a Case].

Papillary fibroelastoma is a benign tumor of the heart, constituting less than 10% of heart tumors. When papillary fibroelastoma is diagnosed, surgical treatment must be considered because it may cause embolization such as myocardial infarction and strokes. We experienced a patient with papillary fibroelastoma of the tricuspid valve after total resection of the right breast for breast cancer and partial lung resection for lung cancer.

First Major Clinical Outcomes of Totally Endoscopic Robotic Mitral Valve Repair in Japan - A Single-Center Experience.

Background: In 2018, Japan became the first country to have robotic cardiac surgery covered under the national health insurance. The number of patients undergoing robotic mitral valve (MV) repair has been estimated to increase remarkably, but no reports in Japan have yet described the outcomes of robotic MV repair. This study aimed to analyze the early clinical outcomes of patients undergoing totally endoscopic robotic MV repair (TERMVR) as a landmark national study for this procedure.

A Novel Shape-Memory Monofilament Suture for Minimally Invasive Thoracoscopic Cardiac Surgery.

Objectives: Endoscopic knot tying can complicate or prolong minimally invasive surgical procedures. A novel shape-memory monofilament suture with a spiral tail has been developed to speed up suture fixation during minimally invasive cardiac surgery. The purpose of this study was to evaluate its usefulness and safety in minimally invasive cardiac surgery.

Nonresectional Simplified Folding Technique in Robotic Mitral Valve Plasty: Comparison with Leaflet Resection Technique.

Objective: The mitral valve plasty (MVP) technique for degenerative disease is typically leaflet resection and suturing. However, this technique is time consuming and unreproducible. To overcome this disadvantage, we developed a nonresectional folding technique, which is fast and reproducible.

Risk factors to predict leg ischemia in patients undergoing single femoral artery cannulation in minimally invasive cardiac surgery.

Background: In peripheral cannulation for cardiopulmonary bypass, there is always a risk of ischemia in the extremities, caused by femoral artery cannulation. This report aimed to evaluate the outcome and the risk factors in patients undergoing minimally invasive cardiac surgery in mitral valve surgery.

Methods: We retrospectively reviewed all minimally invasive mitral valve surgery at our institute from May 2014 to December 2016.

No-touch aorta robot-assisted atrial septal defect repair via two ports.

Objectives: Atrial septal defect (ASD) repairs have been successfully performed on arrested hearts with robotic assistance. The present study assessed the feasibility, safety, and efficacy of totally endoscopic cardiac surgery using a no-touch aorta technique for ASD via only 2 ports, and we named this procedure two-port robotic cardiac surgery (TROCS).

Methods: Between May 2014 and June 2016, 8 consecutive patients underwent TROCS for ASD using the da Vinci surgical system (Intuitive Surgical Inc.

Hybrid treatment combining robotic coronary artery bypass grafting and percutaneous catheter radiofrequency ablation.

Isolated coronary artery bypass grafting associated with atrial fibrillation is routinely performed through a sternotomy, and cardiac arrest. Advancements in this surgical approach have led to better cosmesis, a quick postoperative recovery, with the same postoperative results. We report a case of a novel, less invasive hybrid treatment combining robot-assisted coronary artery bypass grafting and percutaneous radiofrequency catheter ablation.

Surgical Repair for the Treatment of Pulmonary Vein Stenosis After Radiofrequency Ablation.

Radiofrequency ablation procedures for atrial fibrillation are occasionally associated with pulmonary vein stenosis (PVS). A common treatment for PVS is catheter intervention; however, because of the high restenosis rate, it is not suitable for young patients. The case presented herein is of a young male patient with severe bilateral PVS who underwent successful surgical pulmonary vein repair by sutureless technique.

Robotic mitral valve plasty for mitral regurgitation after blunt chest trauma in Barlow's disease.

We successfully treated a case of mitral regurgitation due to chest trauma in Barlow's disease. A 71-year-old man was admitted with severe mitral regurgitation after blunt compression of the chest by a heavy object 5 months earlier. Preoperative examination revealed wide chordae tendineae rupture and myxomatous changes to the bileaflets.

Hyperkalemic arrest and the aortic no-touch technique in minimally invasive atrial septal defect closure in adults.

To avoid aortic cross-clamping and cardioplegic ischaemia, we propose the induction of hyperkalemic arrest and using aortic no-touch technique in minimally invasive atrial septal defect (ASD) closure. Twenty-eight patients were included in this study. After establishment of cardiopulmonary bypass, potassium was administered to induce hyperkalemic arrest.

A Novel Robotic Bilateral Internal Mammary Artery Harvest Using Double Docking Technique for Coronary Artery Bypass Grafting.

da Vinci Surgical System (da Vinci) enabled port access for internal mammary arteries (IMA) harvesting. However, bilateral IMA (BIMA) harvesting is difficult when performed on single side. We developed a novel technique of double docking the da Vinci by transpositioning from the left side to the right and examined the feasibility.

Totally endoscopic robotic resection of left atrial myxoma with persistent left superior vena cava.

A 68-year old man with a cardiac tumour was admitted for robotic tumour resection using the da Vinci S Surgical System. While undergoing preoperative examination, he was found to have a persistent left superior vena cava. After general anaesthesia and single-lung ventilation, cardiopulmonary bypass was established, with venous drainage through bilateral internal jugular and right femoral veins and arterial return through the right femoral artery.

Two-Port Robotic Cardiac Surgery (TROCS) for Atrial Septal Defect (ASD) Using Cross-Arm Technique--TROCS ASD Repair.

Background: We successfully performed totally endoscopic atrial septal defect (ASD) repair via 2 ports, and we named this procedure two-port robotic cardiac surgery (TROCS).Methods and Results:A 51-year-old woman with secundum ASD underwent robot-assisted ASD repair under ventricle fibrillation without aortic cross-clamping. Two ports were placed in the right side of the chest, and 1 port was for the robotic endoscope.

A novel one-shot circular stapler closure for atrial septal defect in a beating-heart porcine model.

Purpose: In surgical atrial septal defect (ASD) closure, there are no techniques or devices that can close the ASD accurately in a short time under a beating heart. We have developed a simple and automatic ASD closure technique using a circular stapler. This study assessed the feasibility and efficacy of a new circular stapler closure for ASD.

Co-occurrence of papillary thyroid cancer and MALT lymphoma of the thyroid with severe airway obstruction: A case report and review of the literature.

Introduction: Co-occurrence of papillary thyroid carcinoma (PTC) and mucosa-associated lymphoid tissue (MALT) lymphoma resulting in severe airway obstruction is very rare.

Presentation Of Case: A 58-year-old woman visited our department because of enlargement of a neck mass. Computed tomography (CT) and ultrasonography showed 2 discrete hypoechoic nodules.

Repair of right ventricle rupture caused by left coronary artery occlusion.

A 67-year-old man was admitted with right ventricular free wall rupture secondary to occlusion of the left anterior descending artery. Emergency coronary angiography showed total occlusion of the proximal left anterior descending artery and severe stenosis of the proximal right coronary artery. Echocardiography revealed acute cardiac tamponade, and free wall rupture of the heart was suspected.

[Aortic valve replacement and ventricular septal defect closure after previous bilateral internal thoracic artery bypass grafting; report of a case].

The patient was a 74-year-old man with a history of ventricular-septal defect (VSD). He underwent coronary artery bypass grafting (CABG), which was performed using the bilateral internal thoracic artery (ITA) 9 years ago. Since 2009, he experienced heart failure, and in 2011, he started administration of tolvaptan, vasopressin V2 receptor antagonist.

[Infected implantable cardioverter-defibrillator lead extraction under deep hypothermic circulatory arrest; report of a case].

We performed infected implantable cardioverter-defibrillator lead extraction under deep hypothermic circulatory arrest in a 58-year-old man. Venogram during the implantation of the lead had revealed complete obstruction of the innominate vein. Preoperative trans-esophageal ecocardiogram revealed intracardiac vegetation with a diameter of 20×13 mm.