Training Cardiac Surgeons: Safety and Requirements.

To analyze whether cardiac surgical residents can perform their first surgeries without compromising patients' safety or outcomes, by comparing their performance and results to those of senior surgeons. All documented CABGs conducted between 2002 and 2020 were included. Surgeries were divided according to the experience level of the main surgeon (defined by the number of CABG conducted by him/her) using the following thresholds: 1000; 150; 80 and 35. This resulted in 5 groups: senior surgeons (the reference group); attending surgeons; fellow surgeons; advanced residents and new residents. Primary endpoint was 30 day mortality. Secondary endpoints included a list of intra and post-operative …

We are Still Learning from Death: After CPR, Balloon Expanding Valve (Intuity Aortic Valve) Revealed to be in Position

Patients with high predicated risk undergo TAVI as an alternative treatment to surgical valve replacement...

In vitro effect of leptin on human cardiac contractility

AbstractLeptin, a hormone produced by adipose tissue, has been linked to many regulatory pathways. Its role in the complex relationship between obesity and CVD is not yet clear. The aim of the present study was to evaluate whether leptin interferes directly with cardiac function regulation, altering its contractile force character, and hence contributing to different pathological processes. Muscle samples were obtained from human atrial myocardium. Each trial included two samples from the same patient. They were simultaneously electrically stimulated under sustained perfusion to perform isometric contractions. One sample was treated with a high concentration of human recombinant leptin (1 µ…

Preoperative Planning for Guidewires Employing Shape-Regularized Segmentation and Optimized Trajectories

Upcoming robotic interventions for endovascular procedures can significantly reduce the high radiation exposure currently endured by surgeons. Robotically driven guidewires replace manual insertion and leave the surgeon the task of planning optimal trajectories based on segmentation of associated risk structures. However, such a pipeline brings new challenges. While Deep learning based segmentation such as U-Net can achieve outstanding Dice scores, it fails to provide suitable results for trajectory planning in annotation scarce environments. We propose a preoperative pipeline featuring a shape regularized U-Net that extracts coherent anatomies from pixelwise predictions. It uses Rapidly-ex…

"3D Printed Complexed Arota as A Preoperative Guidance and Postoperative Results’ Evaluation"

We describe a case of 55 years old female who underwent an aortic valve replacement using a mechanical valve...

Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original …

Minimally invasive coronary artery bypass grafting via a lower ministernotomy for left anterior descending artery myocardial bridging: mid-term results

Abstract OBJECTIVES Coronary artery bypass grafting or supra-arterial myotomy is now suggested as a better therapeutic option in myocardial bridging (MB) when medical treatment fails to control symptoms. For left anterior descending (LAD) MB, minimally invasive coronary artery bypass via a lower ministernotomy can be offered. METHODS Forty-four consecutive patients who underwent elective minimally invasive coronary artery bypass surgery from 2005 to 2014 via an inferior sternotomy using the left internal mammary artery as a bypass graft for LAD MB were evaluated retrospectively. RESULTS The mean age was 59.1 ± 13.1 years with 26 (59%) men and 18 (41%) women. The mean body mass index was 27.…

Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) via Inferior Sternotomy: A “Gold Standard” Therapy for Single LAD Muscle Bridging?

Development and evaluation of 3-dimensional printed models of the human tracheobronchial system for training in flexible bronchoscopy.

OBJECTIVES Training and assessment of proper skills in flexible bronchoscopy are major educational goals for cardiothoracic residents. Therefore, we developed 3-dimensional (3D) printed models of the human tracheobronchial system for training and assessment of cardiothoracic residents in flexible bronchoscopy. METHODS Three models of normal (size/shape) human tracheobronchial anatomy were generated using a commercially available 3D printer. Ten residents (inexperienced: Group 1; experienced: Group 2) participated in this study with an experimental setting of initial assessment (Model 1), training (15 min, Model 2) and post-training assessment (Model 3). The time needed for flexible bronchos…