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Augmented and Virtual Visualization for Image-Guided Cardiac Therapeutics
Published in Terry M. Peters, Cristian A. Linte, Ziv Yaniv, Jacqueline Williams, Mixed and Augmented Reality in Medicine, 2018
Cristian A. Linte, Terry M. Peters, Michael S. Sacks
The adoption of less invasive techniques posed some problems in terms of their workflow integration and yield of clinically acceptable outcomes. However, the morbidity associated with the surgery, together with the success of less invasive approaches in other surgical specialties, have fueled their emergence into cardiac therapy (Linte et al., 2010b). Multiple access routes, including partial sternotomies, limited access thoracotomies, or catheter-based techniques have all been used as an alternative to the traditional full median sternotomy. Initial attempts were aimed at performing coronary artery bypass graft (CABG) surgery via minimally invasive access to the arrested heart without cardiopulmonary bypass. A number of centers reported their experience with robot-assisted atrial septal defect repair, mitral valve (MV) repair and replacement, transluminal or transapical aortic valve implantation or percutaneous pulmonary vein isolation for the treatment of atrial fibrillation. The increasing use of endovascular techniques is one of the most rapid advances in cardiac interventions, rendering vascular-guided interventions as the ultimate, least invasive cardiac therapy approach (Joels et al., 2009).
Suture Techniques and Selection
Published in Chih-Chang Chu, J. Anthony von Fraunhofer, Howard P. Greisler, Wound Closure Biomaterials and Devices, 2018
S.S. Kang, W. Irvin, J.R. Perez-Sanz, H. P. Greisler
Major wound complications after median sternotomy are infrequent, occurring in less than 2% of patients,51 and the most common complication is sternal dehiscence.52 Closure of a median sternotomy is commonly accomplished using monofilament stainless steel wire, either placed through the sternum away from the divided edge or passed completely around the sternum.
Mitral valve surgery: current status and future prospects of the minimally invasive approach
Published in Expert Review of Medical Devices, 2021
Karel M. Van Praet, Jörg Kempfert, Stephan Jacobs, Christof Stamm, Serdar Akansel, Markus Kofler, Simon H. Sündermann, Timo Z. Nazari Shafti, Katharina Jakobs, Stefan Holzendorf, Axel Unbehaun, Volkmar Falk
Full median sternotomy has been the standard access for most cardiac surgical procedures for over 50 years, providing good surgical exposure and allowing central cannulation for cardiopulmonary bypass (CPB) [18]. Minimally invasive surgical (MIS) techniques also termed ‘sternal sparing’ strategies, introduced in the mid-1990s, have led to a decrease in surgical trauma and postoperative recovery, resulting in increased acceptance of these approaches [2,4,12,19]. There are many advantages of a MIS approach to the MV via a right lateral mini-thoracotomy, namely: fewer blood transfusions, less pain, shorter ventilation time, shorter length of stay in the intensive care unit and the hospital, earlier return to normal activities, lower risk of wound infections and cosmetic improvements [4].