RIGHT ANTEROLATERAL THORACOTOMY - GENTLE ACCESS TO THE HEART: JUDGMENT BASED ON HALF A CENTURY OF EXPERIENCE

2021 ◽  
Vol 16 (4) ◽  
pp. 21-29
Author(s):  
Yu.L. Shevchenko ◽  
S.A. Matveev ◽  
V.G. Gudymovich ◽  
V.I. Vasilashko
Keyword(s):  
Anterolateral Thoracotomy

Closed Mitral Valvotomy for Mitral Stenosis in Mirror Image Dextrocardia

1995 ◽  
Vol 3 (2) ◽  
pp. 75-77 ◽  
Author(s):  
Gutti Ramasubrahmanyam ◽  
Dronamraju Dilip ◽  
Pirovam Venkat Ramnarayan ◽  
Raju Subramaniam Iyer ◽  
Kothapalle Venugopal Naidu
Keyword(s):  
Mitral Valve ◽  
Surgical Approach ◽  
Mitral Stenosis ◽  
Mirror Image ◽  
Abnormal Position ◽  
Mitral Valve Area ◽  
Anterolateral Thoracotomy ◽  
Mitral Valvotomy ◽  
Valve Area

A 22-year-old female with mirror image dextrocardia and rheumatic valvular mitral stenosis underwent closed mitral valvotomy using a Tubb's dilator with good results. Despite abnormal position of situs, the surgical approach was simple through right anterolateral thoracotomy, and the operator's hands were mirror image to that of levocardia valvotomy in certain steps. Preoperative mitral valve area was 0.8 cm2, and peak and mean diastolic gradients were 21 and 15 mmHg respectively. Postoperatively, valve area improved to 2.16 cm2, and peak and mean diastolic gradients were 8 and 3.1 mmHg, respectively.

scholarly journals Cosmetic approach of atrial septal defect repair through right anterolateral thoracotomy

2009 ◽  
Vol 35 (2) ◽  
pp. 75-76 ◽  
Author(s):  
Asit Baran Adhikary ◽  
Sarwar Kamal ◽  
Sanjoy Kumar Saha ◽  
Aslam Hossain ◽  
Sayed Abdul Quader ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Anterolateral Thoracotomy ◽  
Defect Repair

Keywords: Atrial septal defect; Cosmetic approach; ThoracotomyOnline: 27 August 2009DOI: 10.3329/bmrcb.v35i2.2766Bangladesh Med Res Counc Bull 2009; 35: 75-76

Abstract 12091: Novel ECMO Cannulation Strategy Expedites Conversion to LVAD

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Lisa S Foley ◽  
T. B Reece ◽  
Andreas Brieke ◽  
Amrut Ambardekar ◽  
Joseph C Cleveland ◽  
...  
Keyword(s):  
Survival Rate ◽  
Cardiogenic Shock ◽  
Recovery Time ◽  
Multiple Organ ◽  
High Survival ◽  
High Survival Rate ◽  
Anterolateral Thoracotomy ◽  
Device Implantation ◽  
Organ Recovery ◽  
Va Ecmo

Objectives: Venoarterial (VA) ECMO has emerged as a successful modality for bridging patients with critical cardiogenic shock to durable support. However, LV distention on ECMO impairs RV and lung recovery and can result in the need for a temporary RVAD. Additionally, patients on VA ECMO with organ dysfunction may require ongoing LV assistance for recovery prior to durable LVAD conversion. Placement of a large apical LV vent allows bedside conversion to LVAD and provides time for organ recovery prior to elective durable device implantation. Hypothesis: We hypothesized that LV venting on ECMO accelerates RV recovery, hastening conversion to LVAD. Methods: ECMO cases from January 2012 to April 2014 were reviewed following IRB approval. Sixteen patients met INTERMACS Category 1 criteria who were placed on VA ECMO for cardiogenic or post-cardiotomy shock. Eight patients had LV venting and eight had standard peripheral cannulation. Refractory pulmonary edema, CPR during cannulation, and severe LV distention were indications for LV venting. A 32 French malleable cannula was placed by limited anterolateral thoracotomy into the LV apex. Bedside LVAD conversion was performed by percutaneous decannulation of the venous line and removal of oxygenator from circuit. Results: Conversion to temporary LVAD was successful in all LV vent cases at a mean timepoint of 5.9 (±1.3) days after LV venting compared with 13.5 (±4.9) days in non-vented patients (p = 0.07). RVAD requirement was 25% in non-vented patients and 0% in vented patients. 30-day mortality was 25% for both groups. Conclusions: LV venting as an adjunct to VA ECMO facilitates RV recovery to enable early LVAD conversion at the bedside. It also provides organ recovery time and obviates the need for a temporary RVAD at the time of durable LVAD implantation. In conclusion, the LV apical venting technique allows staged recovery of critically ill patients in biventricular and multiple organ failure with a high survival rate.

Thoracic surgery

2011 ◽  
Author(s):  
G. N. Morritt ◽  
A. N. Morritt
Keyword(s):  
Median Sternotomy ◽  
Rigid Bronchoscopy ◽  
Tube Thoracostomy ◽  
Chest Drain ◽  
Posterolateral Thoracotomy ◽  
Anterolateral Thoracotomy ◽  
Lower Lobectomy ◽  
Left Upper Lobectomy ◽  
Right Lower Lobectomy ◽  
Insertion Tube

Bronchoscopy 692Rigid bronchoscopy 694Flexible bronchoscopy 696Cervical mediastinoscopy 698Anterior mediastinotomy 700Chest drain insertion: tube thoracostomy 702Posterolateral thoracotomy 706Anterolateral thoracotomy 708Median sternotomy 710Lobectomy 712Right upper lobectomy 714Right middle lobectomy 716Right lower lobectomy 718Left upper lobectomy ...

Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Through Limited Left Anterolateral Thoracotomy: An Alternative to Repeat Sternotomy

2020 ◽  
Vol 11 (3) ◽  
pp. 346-349
Author(s):  
Tarun Raina Ramman ◽  
Kuntal Roy Chowdhuri ◽  
Nayem Raja ◽  
Sumir Girotra ◽  
Sushil Azad ◽  
...  
Keyword(s):  
At Risk ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Cardiac Injury ◽  
Pulmonary Valve Replacement ◽  
Anterolateral Thoracotomy ◽  
Repaired Tetralogy Of Fallot

We report two patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement through a limited left anterolateral thoracotomy. We describe the technique in detail. Both patients were at risk of cardiac injury during repeat sternotomy. This approach reliably avoids the risk of cardiac injury during repeat sternotomy and appears to be safe, simple, and reproducible.

scholarly journals Thoracotomy versus transhiatal esophageal dissection: which is the best surgical approach to short esophagus?

2011 ◽  
Vol 26 (3) ◽  
pp. 214-219 ◽  
Author(s):  
Thiago Beduschi ◽  
André Vicente Bigolin ◽  
Leandro Totti Cavazzola
Keyword(s):  
Short Esophagus ◽  
Anterolateral Thoracotomy ◽  
Mediastinal Dissection ◽  
Transhiatal Approach ◽  
Esophageal Dissection ◽  
Group A ◽  
Final Length ◽  
Group B ◽  
Approach Group ◽  
Length Gain

PURPOSE: To evaluate different approaches performed to obtain a more significant esophageal length. METHODS: An experimental model using 28 cadavers was conceived. Randomized groups: Group A (n=10) underwent laparotomic transhiatal approach; Group B (n=9) which differed from the first in the conduction of a wide phrenotomy and Group C (n=9) esophageal dissection was performed through a left anterolateral thoracotomy. RESULTS: Final length variations for Group A were 2.12cm and 3.29cm and for Group B 3.24 cm and 3.66cm, without and with esophageal traction, respectively. In Group C length gain observed was 3.81 cm. The mediastinal dissections conducted through the hiatus was considered the procedure that produced the better esophageal mobilization, and the association of wide phrenotomy significantly improved the results. CONCLUSION: The mediastinal dissection was the most effective to improving gain in abdominal esophagus. When toracotomy and laparotomy were compared, no significant differences were observed in the outcome.

Sign in / Sign up

Export Citation Format

Share Document