Background: The purpose of this study was to explore the application of lower sternal incision with on-pump, beating heart intracardiac procedures for the treatment of congenital heart disease.
Methods: A total of 106 cases with congenital heart disease were performed with lower sternal incision under the beating heart condition. The sternum was sawed open to the third sternocostal joint through a small incision in the lower sternum. Cardiopulmonary bypass was developed without aortic cross-clamping. The simultaneous left atrium and ventricle suction and integrating sequential deairing procedure was established to improve the exposure of the surgical field and intraoperative de-airing. We also randomly selected 100 patients with similar disease and age as controls. These control patients underwent middle sternal incision surgery with arresting heart.
Results: The results showed that all the patients were successfully completed with the surgery without death and serious complications, eg, air embolism, residual shunt, and complete atrioventricular block. The operative and cardiopulmonary bypass time in the experimental group was not significantly different from that in the control group. The length of the skin incision in the experimental group was shortened by 4.8 cm compared to that in the control group. The incidence of sternal deformity in patients under 3 years old in the experimental group was significantly lower than that in the control group.
Conclusions: Lower sternal incision with beating heart can reduce the surgical injury, simplify the operation procedure, and improve the therapeutic efficacy. It is a safe and effective approach for the treatment of congenital heart disease.
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http://dx.doi.org/10.1532/HSF98.20111189 | DOI Listing |
Pediatric patients undergoing cardiothoracic surgery are at increased risk for health care-associated infections, especially surgical site infections (SSIs). Delayed sternal closures are associated with prolonged lengths of stay and contribute to infection risks and morbidities. At a single-site academic pediatric center, we created an SSI-prevention bundle targeting the preoperative, intraoperative, and postoperative care periods.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
January 2025
Department of Cardiothoracic Surgery, Heart-Thorax Center, Klinikum Fulda, University Medicine Marburg, Campus Fulda, 36043 Fulda, Germany.
Objective: Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB.
Methods: From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine.
Ann Plast Surg
February 2025
From the Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN.
Background: While there is mounting evidence that closed suction drains are not necessary, there is a paucity of literature to demonstrate that drains are harmful after breast reduction. The purpose of this study was to investigate the effect of drains on postoperative seroma, hematoma, and infection, as well as elucidate any risk factors that may be implicated in the development of these complications.
Methods: A retrospective cohort study was conducted of all reduction mammaplasty procedures at our university medical center between 2010-2020.
Front Cardiovasc Med
January 2025
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, United States.
, a genus of soil and vegetation-based fungi, is a rare cause of infections in immunocompromised individuals, including transplant recipients. In this case, we describe successful treatment of mediastinitis in the recipient of an orthotopic heart transplant. Treatment included multiple courses of combination antibiotic and antifungal therapy several surgical debridements, continuous mediastinal irrigation with antifungal agents, and staged closure with an omental flap.
View Article and Find Full Text PDFHeart Lung Circ
January 2025
Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Vic, Australia.
Background & Aim: Sternotomy remains a commonly used technique to access the heart for cardiac surgery worldwide. To date, there is no clear consensus on the single superior sternal closure technique. Patient-specific factors such as osteoporosis, diabetes, old age, body habitus influence a surgeon's choice in this matter as do techniques commonly used during the training period and used in the current workplace.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!