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Endovascular Treatment of Acute Descending Thoracic Aortic DissectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this report, a case of acute type B aortic dissection complicated by limb malperfusion is used to illustrate a variety of approaches used to treat this condition. (Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Nimesh D. Desai, Joseph E. Bavaria Tags: Cardiac Surgery - R. Morton Bolman, III, Associate Editor Source Type: journals

Operative Repair of Type B Aortic DissectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although endovascular repair of acute type B aortic dissections offers many advantages, no long-term data are available to analyze late outcomes, and endovascular capabilities are a relatively recent development and may not be universally available. Accordingly, conventional open repair remains a viable and valuable option. The operative repair of type B aortic dissections can be considered in the 3 following circumstances: (Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: R. Scott Mitchell Tags: Cardiac Surgery - R. Morton Bolman, III, Associate Editor Source Type: journals

Acute Type A Aortic DissectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Acute type A aortic dissection (Type I, proximal, ascending) is a true surgical emergency. It is estimated that patients suffering this calamity experience approximately a 1% per hour mortality in the first 48 hours and 90% of these patients will be dead by the end of 3 months without surgery. The majority of type A dissections propagate through the aortic arch and the descending and thoracoabdominal aorta. The dissection flap can be associated with malperfusion of virtually any major artery emanating from the aorta by virtue of either static or dynamic obstructive physiology. That said, however, the most common modes of d...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: R. Morton Bolman Tags: Cardiac Surgery - R. Morton Bolman, III, Associate Editor Source Type: journals

Surgical Mediastinal Lymph Node Sampling for Staging of Non-Small Cell Lung CarcinomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Mediastinal lymph node sampling has been used to diagnose lymphoma and sarcoidosis and to diagnose and stage non-small-cell lung cancer (NSCLC). The optimal treatment of patients with NSCLC is determined by mediastinal lymph node involvement. Surgical staging is the gold standard for NSCLC patient management. (Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Jeffrey J. Siracuse, Malcolm M. DeCamp Tags: General Thoracic Surgery - David R. Jones, Associate Editor Source Type: journals

Endobronchial UltrasoundEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The gold standard for mediastinal lymph node staging is mediastinoscopy. Standard mediastinoscopy or video mediastinoscopy provides access to levels 2R, 2L, 7, 4R, 4L, and 10 lymph nodes. Standard mediastinoscopy helps confirm the presence of malignant disease in clinically suspicious lymph nodes and is reliable for diagnosing occult microscopic disease for the adequate staging of lung cancer. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has provided an alternative to mediastinoscopy for the biopsy of mediastinal lymph nodes in select clinical situations as well as provided access to more pe...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Traves D. Crabtree Tags: General Thoracic Surgery - David R. Jones, Associate Editor Source Type: journals

Hybrid Procedure for Hypoplastic Left Heart Syndrome: The Nemours ApproachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The management of hypoplastic left heart syndrome (HLHS) has evolved primarily into a sequence of staged surgical interventions originally described by Norwood and colleagues. A significant improvement in early survival following Stage I Norwood in recent years has led to the recognition of conditions associated with “high risk” for poor outcome, including low birth weight, prematurity, noncardiac conditions, and genetic or chromosomal abnormalities. The decreased survival in high-risk patients along with the suboptimal neurocognitive function reported among survivors of staged reconstruction have provided the stimulus...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Christian Pizarro, Christopher D. Derby, Wolfgang A. Radtke Tags: Congenital Surgery - Scott M. Bradley, Associate Editor Source Type: journals

The Hybrid Approach to Hypoplastic Left Heart SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The goal of the hybrid approach for hypoplastic left heart syndrome (HLHS) is to lessen the cumulative impact of staged interventions, thereby improving the quantity and quality of life for our patients. This novel strategy of care occurs through a collaborative effort between congenital heart surgeons and interventional cardiologists. In this same spirit, the conduct of each component of the staged hybrid procedures is aimed at minimizing injury. Lessons learned during the development of this technique, in over 100 children, have led to the technique highlighted below. (Source: Operative Techniques in Thoracic and Cardiov...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Mark Galantowicz Tags: Congenital Surgery - Scott M. Bradley, Associate Editor Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The hybrid approach to hypoplastic left heart syndrome provides one of the most innovative additions to our field over the last decade. It offers the potential advantages of avoiding an operation with cardiopulmonary bypass in the neonatal period. The hybrid approach requires close collaboration between surgeon and interventional cardiologist. It also requires planned coordination between the first and second stage procedures. Mark Galantowicz from Nationwide Children's Hospital and Christian Pizarro from the Nemours Cardiac Center present their respective approaches. Each article provides the reader with a detailed descri...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Fred A. Crawford Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Source Type: journals

2009 TopicsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Source Type: journals

Association OfficersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - September 29, 2009 Category: Cardiovascular & Thoracic Surgery Source Type: journals

Technique for Managing Tracheo-Innominate Artery FistulaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Tracheo-innominate artery fistula (TIF) is an uncommon complication (0.1-1%) following both open and percutaneous tracheostomy. TIF is caused by pressure from the tracheostomy tube, cuff, or balloon, causing erosion of the trachea and innominate artery (). Current tracheostomy tube designs employing a gentle curve (compared with rigid tubes with 90° bend) and compliant, low-pressure endotracheal cuffs (compared with high-pressure cuffs) have decreased the incidence of TIF. Other factors that have been implicated include a low tracheostomy tube placement, malpositioned cannula tip, excessive neck movement, prior radiation,...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Gorav Ailawadi Tags: General Thoracic Surgery - David R. Jones, Associate Editor Source Type: journals

Technique of Mediastinal Germ Cell Tumor ResectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The anterior mediastinum represents the second most common site of germ cell tumor origin. Nonseminomatous germ cell cancers not only comprise the main category of the malignant germ cell tumors arising in the mediastinum (PMNSGCT) but also the most challenging from both oncologic and surgical standpoints. Although histologically similar to their more commonly occurring testicular counterparts, PMNSGCT have an overall worse prognosis and therefore have been categorized as “poor risk” along with other subsets of testicular nonseminomatous germ cell tumors. (Source: Operative Techniques in Thoracic and Cardiovascular Sur...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Kenneth A. Kesler Tags: General Thoracic Surgery - David R. Jones, Associate Editor Source Type: journals

En-bloc Rotation of the Truncus Arteriosus—A Technique for Complete Anatomic Repair of Transposition of the Great Arteries/Ventricular Septal Defect/Left Ventricular Outflow Tract Obstruction or Double Outlet Right Ventricle/Left Ventricular Outflow Tract ObstructionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Rastelli procedure has been traditionally used for repair of transposition of the great arteries (TGA) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO), or double outlet right ventricle with subpulmonary VSD and LVOTO. The Rastelli procedure in its original version involves an intracardiac baffle, which forms the left ventricular outflow tract from the VSD to the aortic valve. This results in a long intracardiac tunnel and has an inherent tendency to obstruction. A homograft or xenograft is also needed for reconstruction of the right ventricular outflow tract. Resection of the...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Rudolf Mair Tags: Congenital Surgery - Scott M. Bradley, Associate Editor Source Type: journals

The Double-Root Translocation TechniqueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Surgical management of patients with ventriculoarterial discordance, ventricular septal defect (VSD), and pulmonary outflow tract obstruction (PS) remains challenging. The Rastelli procedure has been the surgical approach to such patients. However, given its poor long-term results, an alternative surgical technique is required. With the aims of preserving the competence and growth potential of both the native aortic and the pulmonary valves, as well as of achieving better long-term results, we proposed the “double-root translocation” technique for biventricular outflow tract reconstruction. Since March 2004, we have us...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Sheng-Shou Hu, Shou-Jun Li, Zhi-Gang Liu, Yan Li, Liqing Wang Tags: Congenital Surgery - Scott M. Bradley, Associate Editor Source Type: journals

Pulmonary Root TranslocationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pulmonary root translocation is a technique that we have used since April 1994 as an alternative treatment for transposition of the great arteries with ventricular septal defect (VSD) and pulmonary stenosis and for selected cases of double-outlet right ventricle with a subpulmonary VSD. More recently, we have extended its use as part of the double-switch procedure in patients with congenitally corrected transposition, pulmonary stenosis, and large VSD. (Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: José Pedro da Silva, Luciana da Fonseca Tags: Congenital Surgery - Scott M. Bradley, Associate Editor Source Type: journals

Aortic Fenestration for DissectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Aortic fenestration has been used at our institution since 1973. The indications for this procedure and the technique have evolved, now being exclusively performed for patients with acute limb and/or organ ischemia secondary to descending aortic dissection. Paramount to the success of this procedure is early recognition and quick intervention to avoid irreversible end-organ damage and fixed thrombosis in the false lumen. Physical examination and diagnostic computed tomography can aid in obtaining a quick diagnosis. Contraindications to aortic fenestration include delayed diagnosis (after 48 hours the success of re-establis...
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: John A. Elefteriades, Juan C. Escalon Tags: Cardiac Surgery - R. Morton Bolman, III, Associate Editor Source Type: journals

Endovascular Therapy for Malperfusion in Acute Type B Aortic DissectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Presentation with acute type B aortic dissection (B-AD) in the setting of malperfusion is associated with a high risk for major morbidity due to end-organ ischemia. This presentation has traditionally been considered an indication for operation where the entry tear is resected, and branch vessel perfusion is subsequently restored either as a result of the aortic repair or by direct revascularization of the peripheral arterial bed. (Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Himanshu J. Patel, David M. Williams Tags: Cardiac Surgery - R. Morton Bolman, III, Associate Editor Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes endovascular stent graft application to the area of the primary tear. Also described are methods of percutaneous fenestration, accompanied, if necessary, by stenting of the true lumen for distal malperfusion. These methods are nicely illustrated and described in this excellent article. (Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Fred A. Crawford Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Source Type: journals

2009 TopicsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Source Type: journals

Association OfficersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas)
Source: Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas - June 25, 2009 Category: Cardiovascular & Thoracic Surgery Source Type: journals