Optimising vein graft outcomes

Optimising vein graft outcomes
John Pepper
http://www.ctsnet.org/article/optimizing-vein-graft-outcomes?utm_source=iContact&utm_medium=email&utm_campaign=CTSNet&utm_content=Pulse+11%2F29%2F16

Minimal information on type of anastomosis versus SVG failure
Endoscopic harvest  not good
Buffered solution good

Hybrid Repairs of Arch Aneurysms

Hybrid Repairs of Arch Aneurysms
http://www.ctsnet.org/article/hybrid-repairs-arch-aneurysms

Hybrid Repairs does not replace open repairs.
Why
for morbidity
hybrid results is not so good
the Critical complication : new type A dissection
Zero: WD Kent JTCVS 2014
Open mortality 14%!!

Proper selection of patients

Valve Sparing Aortic Root Replacement

Valve Sparing Aortic Root Replacement

By Gabriel Loor

https://www.vumedi.com/video/valve-sparing-aortic-root-replacement/

Indication: above 50mm

1st row 6 mattress sutures 2-0 pledget

Minimally Invasive Mitral Valve Repair of Bi-leaflet Prolapse

Minimally Invasive Mitral Valve Repair of Bi-leaflet Prolapse

By Hugo Vanermen

https://www.vumedi.com/video/minimally-invasive-mitral-valve-repair-of-bi-leaflet-prolapse/

MICS

1st: valve annular sutures (start from 10 o'clock)

2nd: assessment

He uesd pledgets and artificial chordae on anterior mitral valve to prevent malformation of leaflet.

Effect of aortic pericardial valve choice on outcomes and left ventricular mass regression in patients with left ventricular hypertrophy

Effect of aortic pericardial valve choice on outcomes and left ventricular mass regression in patients with left ventricular hypertrophy
J Thorac Cardiovasc Surg 2016;152:1291-8


I was surprised of the bigger difference than I expected.

Trifecta use was associated with significantly increased left ventricular mass regression and improved intermediate-term clinical outcome in patients with left ventricular hypertrophy undergoing AVR for AS, compared with use of the Perimount Magna Ease.

Because
The orifice area of Trifecta is bigger than that of Perimount Magna Ease. 

I should check our data.

Clinical Significance of Spontaneous Echo Contrast on Extracorporeal Membrane Oxygenation

http://www.annalsthoracicsurgery.org/article/S0003-4975(16)30914-6/fulltext


Spontaneous echo contrast (SEC)　= moyamoya echo

SEC on VA-ECMO resulted in an increased risk of intracardiac thrombus and stroke. Maintaining pulsatility while the patient is on ECMO may result in a decreased chance of developing SEC and stroke.


My Question
Maintaining pulsatility might lead to improve LV function and survival?

Distasl Bypassのこだわりの手術手技

第3回　関西血管外科倶楽部
Distasl Bypassのこだわりの手術手技

１
下腿切断後の義肢装具の固定位置を考慮しSVGを通す経路を考えたほうが良い。可能なら解剖学的経路。
下腿切断時（前）にBKバイパスは必要なのか。大腿動脈内膜摘除で十分ではないか。

2
Dual Bypass (Y-shape composite)
日本でしかされていない。本当にいいのかわからない。
遠隔期に片方が閉塞すると言われている。
CABGでは通常の手技。3本の冠動脈それぞれが独立しコネクションが少ないため。
Distasl Bypassではコネクション多いため意義が少ない。一方でAngiosomeという冠動脈に近い考え方もあるが、最近はやや言われなくなってきている。
SVGを採取した創は、閉じずに人工真皮で対応する。