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Minimally Invasive Cardiac Surgery
Minimally invasive cardiac surgery, encompasses various aspects of cardiac surgical procedures (aortic valve replacement, mitral valve repair, coronary artery bypass surgery, ascending aorta or aortic root surgery) that can be performed with minimally invasive approach either via mini-thoracotomy or mini-sternotomy. MICS CABG (Minimally Invasive Cardiac Surgery/Coronary Artery Bypass Grafting) or the McGinn technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach, and can be performed in patients with multivessel coronary artery disease. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an anterolateral mini-thoracotomy."MICS CABG Technique Overview: Minimally Invasive CABG (MICS CABG) Procedure",, 2010, p. 1 Advantages of minimally invasive heart surgery are less blood loss, reduced post-operative discomfort, faster postoperative recovery an ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Median Sternotomy
Median sternotomy is a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided using a sternal saw. This procedure provides access to the heart and lungs for surgical procedures such as heart transplant, lung transplant, corrective surgery for congenital heart defects, or coronary artery bypass surgery. The median sternotomy was first proposed by Herbert M. N. Milton in 1897. Since the first successful open heart operation in 1953, most cardiac surgeons initially used the bilateral anterior thoracotomy A thoracotomy is a surgical procedure that involves cutting open the chest wall to gain access into the pleural cavity, It is mostly performed by specialist cardiothoracic surgeons, although emergency physicians or paramedics occasionally also ..., which was a very complication-prone and painful approach. In 1957, after the demonstration of the superiority of median sternotomy, it became the standard ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Intercostal Space
The intercostal space (ICS) is the anatomic space between two ribs (Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it. Structures in intercostal space * several kinds of intercostal muscle * intercostal arteries and intercostal veins * intercostal lymph nodes * intercostal nerves Order of components Muscles There are 3 muscular layers in each intercostal space, consisting of the external intercostal muscle, the internal intercostal muscle, and the thinner innermost intercostal muscle. These muscles help to move the ribs during breathing. Neurovascular bundles Neurovascular bundles are located between the internal intercostal muscle and the innermost intercostal muscle. The neurovascular bundle has a strict order of vein-artery-nerve (VAN), from top to bottom. This neurovascular bundle runs high in the intercostal space, and the smaller collateral neurovascular bundle runs just superior ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thoracotomy
A thoracotomy is a surgical procedure that involves cutting open the chest wall to gain access into the pleural cavity, It is mostly performed by specialist cardiothoracic surgeons, although emergency physicians or paramedics occasionally also perform the procedure under life-threatening circumstances. The procedure is performed under general anesthesia with double-lumen intubation, and commonly with epidural analgesia set up pre-sedation for postoperative pain management. The procedure starts with controlled cutting through the skin, intercostal muscles and then parietal pleura, and typically involves transecting at least one rib with a costotome due to the limited range of bucket handle movement each rib has without fracturing. The incised wound is then spread and held apart with a retractor ( rib spreader) to allow passage of surgical instruments and the surgeon's hand. Traditional thoracotomy is thus a highly invasive procedure, with bacterial pneumonia, hemothorax/pl ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Coronary Artery Bypass
Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic (deprived of blood) heart. There are two main approaches. The first uses a cardiopulmonary bypass machine, a machine which takes over the functions of the heart and lungs during surgery by circulating blood and oxygen. With the heart in cardioplegic arrest, harvested arteries and veins are used to connect across problematic regions—a construction known as surgical anastomosis. In the second approach, called the off-pump coronary artery bypass (OPCAB), these anastomoses are construc ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Mitral Valve Repair
Mitral valve repair is a cardiac surgery procedure performed by cardiac surgeons to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the "inflow valve" for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, through the pulmonary veins, to the left atrium of the heart. After the left atrium fills with blood, the mitral valve allows blood to flow from the left atrium into the heart's main pumping chamber called the left ventricle. It then closes to keep blood from leaking back into the left atrium or lungs when the ventricle contracts (squeezes) to push blood out to the body. It has two flaps, or leaflets, known as cusps. The techniques of mitral valve repair include inserting a cloth-covered ring around the valve to bring the leaflets into contact with each other ( annuloplasty), removal of redundant/loose segments of the leaflets (quadrangular resection), and re-suspension of the leaflets with artific ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Mitral Valve Replacement
Mitral valve replacement is a procedure whereby the diseased mitral valve of a patient's heart is replaced by either a mechanical or tissue (bioprosthetic) valve. The mitral valve may need to be replaced because: * The valve is leaky ( mitral valve regurgitation) * The valve is narrowed and doesn't open properly (mitral valve stenosis) Causes of mitral valve disease include infection, calcification and inherited collagen disease. Current mitral valve replacement approaches include open heart surgery and minimally invasive cardiac surgery (MICS). Normal mitral valve anatomy and physiology The mitral valve is a bileaflet valve sited between the left atrium and left ventricle, responsible for preventing blood flowing from the ventricle to the atrium when the heart contracts. It is elliptical, and its area varies from 5.0 to 11.4 cm2. The valve leaflets are separated by two commissures, and each leaflet of the valve (anterior leaflet, the large one, and posterior leafl ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Aortic Valve Replacement
Aortic valve replacement is a cardiac surgery procedure whereby a failing aortic valve is replaced with an artificial heart valve. The aortic valve may need to be replaced because of aortic regurgitation (back flow), or if the valve is narrowed by stenosis. Current methods for aortic valve replacement include open-heart surgery, ''minimally invasive cardiac surgery (MICS)'', ''surgical aortic valve replacement'' (SAVR), percutaneous or transcatheter aortic valve replacement (TAVR; also PAVR, PAVI, TAVI), and robotic aortic valve replacement (RAVR). A cardiologist can evaluate whether a heart valve repair or valve replacement would be of benefit. History During the late 1940s and early 1950s, the first surgical approaches towards treating aortic valve stenosis had limited success. The first attempts were valvotomies, (i.e. cutting the valve while the heart is pumping). A ball valve prosthesis placed on the descending thoracic aorta (heterotopically) was developed by ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Atrial Septal Defect
Atrial septal defect (ASD) is a congenital heart defect in which blood flows between the atrium (heart), atria (upper chambers) of the heart. Some flow is a normal condition both pre-birth and immediately post-birth via the Foramen ovale (heart), foramen ovale; however, when this does not naturally close after birth it is referred to as a patent (open) foramen ovale (PFO). It is common in patients with a congenital interatrial septum, atrial septal aneurysm (ASA). After PFO closure the atria normally are separated by a dividing wall, the interatrial septum. If this septum is defective or absent, then oxygen-rich blood can flow directly from the left side of the heart to mix with the oxygen-poor blood in the right side of the heart; or the opposite, depending on whether the left or right atrium has the higher blood pressure. In the absence of other heart defects, the left atrium has the higher pressure. This can lead to lower-than-normal oxygen levels in the arterial blood that su ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hybrid Coronary Revascularization
Hybrid coronary revascularization (HCR) or hybrid coronary bypass is a relatively new type of heart surgery that provides an alternative to traditional coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI or PTCA) by combining the two into one operation. It is this combining aspect that "hybrid" refers to. HCR is one of several types of hybrid cardiac surgery; it is not to be confused with a MIDCAB (minimally invasive direct coronary artery bypass) procedure, which uses the smaller thoracotomy incision but does not involve coronary stenting. __TOC__ Benefits Hybrid bypass offers all the benefits of a MIDCAB, although there are some disadvantages. # A much smaller incision (made through the rib cage as opposed to cutting the sternum and opening the rib cage) than with traditional bypass surgery. # Less pain for the patient and quicker recovery time. Particularly in high risk patients, morbidity and mortality decreases in comparison to conventional ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Cardioplegia
Cardioplegia is a solution given to the heart during cardiac surgery, to minimize the damage caused by myocardial ischemia while the heart is paused. Overview The word ''cardioplegia'' combines the Greek ''cardio'' meaning the "heart", and ''plegia'' "paralysis". Technically, this means arresting or stopping the heart so that surgical procedures can be done in a still and bloodless field. Most commonly, however, the word ''cardioplegia'' refers to the solution used to bring about asystole of the heart, or heart paralysis. One of the first physicians to use the term cardioplegia was Dr. Lam in 1957. However his work on the myocardial protection was preceded serendipitously by Sydney Ringer in the late 1800s. At that time Ringer and colleagues noticed that tap water had the ability to increase contractility of the heart, likely due to its high calcium content. Sydney Ringer also commented on the importance of potassium ion concentration on depressing intrinsic heart rhythm. Throu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Revascularization
In medical and surgical therapy, revascularization is the restoration of perfusion to a body part or organ that has had ischemia. It is typically accomplished by surgical means. Vascular bypass and angioplasty are the two primary means of revascularization. The term derives from the prefix re-, in this case meaning "restoration" and vasculature, which refers to the circulatory structures of an organ. It is often combined with "urgent" to form urgent vascularization. Revascularization involves a thorough analysis and diagnosis and treatment of the existing diseased vasculature of the affected organ, and can be aided by the use of different imaging modalities such as magnetic resonance imaging, PET scan, CT scan, and X-ray fluoroscopy. Applications For coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), or ischemic heart disease (IHD), is a type of cardiovascular disease, heart disease involving Ischemia, the reduction of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
