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Minimally invasive surgical coronary artery revascularization— how to initiate a safe and sustainable program
The recent reconfirmation of coronary artery bypass grafting (CABG) superiority over current percutaneous coronary interventions (PCIs) in various clinical scenarios resulted in renewed interest in less invasive surgical coronary artery revascularization. The continuous refinement of minimally invasive CABG(MI-CABG) techniques is paralleled by exciting advances in surgical technology that facilitate the safe and efficient harvesting of the internal thoracic artery (ITA) and the construction of multi-vessel coronary artery anastomosis under either direct vision or by using videoscopic or robotic platforms. Read more...
Learning Curve of Cardiac Surgery Residents in Transit-Time Flow Measurement and High-Resolution Epicardial Ultrasonography During Coronary Surgery
Objectives: This study aimed to define the learning curve required for cardiac surgery residents to acquire basic technical and interpretive skills in transit-time flow measurement (TTFM) and high-resolution epicardial ultrasonography (HRUS) during coronary artery bypass grafting (CABG). Read more...
Liver and Systemic Hemodynamics in Children With Cirrhosis: Impact on the Surgical Management in Pediatric Living Donor Liver Transplantation
Cirrhosis in adults is associated with modifications of systemic and liver hemodynamics, whereas little is known about the pediatric population. The aim of this work was to investigate whether alterations of hepatic and systemic hemodynamics were correlated with cirrhosis severity in children. The impact of hemodynamic findings on surgical management in pediatric living donor liver transplantation (LT) was evaluated. Liver and systemic hemodynamics were studied prospectively in 52 children (median age, 1 year; 33 with biliary atresia [BA]). The hemodynamics of native liver were studied preoperatively by Doppler ultrasound and intraoperatively using invasive flowmetry. Portosystemic gradient was invasively measured. Read more...
Lack of a Correlation Between Portal Vein Flow and Pressure: Toward a Shared Interpretation of Hemodynamic Stress Governing Inflow Modulation in Liver Transplantation
The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. Read more...
Is intra-operative blood flow predictive for early failure of radiocephalic arteriovenous fistula?
Background: For over 50 years, radiocephalic wrist arteriovenous fistulae (RCAVF) have been the primary and best vascular access for haemodialysis. Nevertheless, early failure due to thrombosis or non-maturation is a major complication resulting in their abandonment. This prospective study was designed to investigate the predictive value of intra-operative blood flow on early failure of primary RCAVF before the first effective dialysis.
Methods: We enrolled patients undergoing creation of primary RCAVF for haemodialysis based on the preoperative ultrasound vascular mapping discussed in a multi-disciplinary approach.
Intraoperative blood flow measurement was systematically performed once the anastomosis had been completed using a transit-time ultrasonic flowmeter. During the follow-up, blood flow was estimated by colour flow ultrasound at various intervals. Any events related to the RCAVF were recorded.
Results: Read more...
