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The Coronaries
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
Claudio Muneretto, Chang Guohao, Theo Kofidis
According to the definition from the American Heart Association and the European Society for Cardiology, HCR for multi-vessel disease is defined as a planned, intentional combination of the LIMA to LAD grafting and a catheter-based intervention to one or more non-LAD coronary arteries during the same hospital stay. This can be performed concurrently in a hybrid operating room in a single operative setting (same-stop hybrid revascularization) or can be performed in two different stages, separated by a period of hours to a few weeks, often during the same hospital stay [2] (Figure 12.4.4). This hybrid approach is especially useful in patients with multi-vessel coronary artery disease.
Endovascular repair of descending thoracic aortic aneurysms
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
Farah Mohammad, Rob Harriz, Loay S. Kabbani
A hybrid operating room is the safest set-up in which surgery can be performed. Surgery can be executed under local, regional, or general anesthesia. The authors prefer general anesthesia, to prevent patient movement during critical parts of the procedure, and to hold respirations when needed.
Setting up a catheterization laboratory: Organizational, architectural, and equipment considerations
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
Since the procedure room is the core of the facility, its design should not be compromised by competing architec- tural considerations. The first consideration is to provide adequate floor space. Many state department health codes specify minimum floor areas. In addition, X-ray equipment manufacturers specify minimum room sizes and minimum clearances between equipment and adjacent walls. However, irrespective of whatever code requirements exist, procedure rooms should be a minimum of 500 square feet; however, 600 square feet is ideal. Biplane X-ray systems require additional space. If a laboratory is to function as a hybrid operating room, 800 square feet is required to contain all the necessary equipment and provide sufficient space for circulation.
Application of the Hybrid Operating Room in Surgery: A Systematic Review
Published in Journal of Investigative Surgery, 2022
With the increase of complexity of interventional and surgical procedures, conventional radiology departments and operating suites could no longer meet the requirement of interventional radiologists and surgeons, and the idea of combining interventional radiology departments and operating suites was proposed. At the same time, the need of minimally invasive surgical procedures, and the preoperative, intraoperative and postoperative imaging examinations were also considered in the proposal. Along with these ideas, techniques including endoscopy, laparoscope, and catheterization all experienced technical improvements. The hybrid operating room (OR) was eventually developed to combine interventional radiology departments, mini-invasive surgery, simultaneous usage of endoscopic and laparoscopic techniques, and the application of various intraoperative imaging systems, the demand of surgery, anesthesia, intervention, and radiology could be met at the same time. In this way, the time from diagnosis to curative treatment could be significantly reduced in the hybrid OR, resulting in increased survival and facilitating difficult intraoperative detection and resection of deep lesions.
Safe implementation of enhanced recovery after surgery protocol in transfemoral transcatheter aortic valve replacement
Published in Baylor University Medical Center Proceedings, 2021
Molly Szerlip, Deborah Tabachnick, Mohanad Hamandi, LuAnn Caras, Allison T. Lanfear, John J. Squiers, Katherine Harrington, Srinivasa P. Potluri, J. Michael DiMaio, Jordan Wooley, Benjamin Pollock, Justin M. Schaffer, William T. Brinkman, David L. Brown, Michael J. Mack
Institutional review board approval was obtained to conduct this retrospective review. All patients undergoing TAVR at our institution are evaluated by a heart team approach to determine suitability for this procedure. This assessment includes standard tests such as transthoracic echocardiography, computed tomography with reconstructions, pulmonary function testing, frailty assessments, basic laboratory testing, electrocardiogram, and clinical evaluation by at least one cardiologist and two cardiac surgeons. All procedures were performed by an interventional cardiologist and cardiac surgeon in the hybrid operating room or catheterization laboratory with full operating room capability, including a primed cardiopulmonary bypass pump and a perfusionist in attendance. All patients received anesthesia care by a cardiac anesthesiologist regardless of the anesthetic approach taken. A dedicated sonographer was present for all cases. Before implementation of ERAS, the standard of care was leaving patients intubated postoperatively, admission to the intensive care unit, and subsequent delayed extubation.
Managing large lead vegetations in transvenous lead extractions using a percutaneous aspiration technique
Published in Expert Review of Medical Devices, 2018
Christoph T. Starck, Jürgen Eulert-Grehn, Marian Kukucka, Dirk Eggert-Doktor, Thomas Dreizler, Benjamin Haupt, Volkmar Falk
Percutaneous aspiration of large lead vegetations prior and during transvenous lead extraction procedures is safe and effective.The reported aspiration procedure is minimal-invasive. It facilitates safe transvenous lead extraction in patients with large lead vegetations and avoids the need for open surgical extraction.Septic embolization of lead vegetations to the pulmonary circulation is eliminated or minimized.Since the aspiration procedure is based on an extracorporeal circuit the involvement of a cardiac surgeon and a perfusionist is mandatory, if the transvenous lead extraction procedure is performed by a cardiologist. The ideal operative environment is a hybrid operating room.The results of this initial experience and the effect on long-term outcomes need to be investigated in further larger and prospective studies.