Oleksandr Babliak - Academia.edu (original) (raw)
Papers by Oleksandr Babliak
Interdisciplinary CardioVascular and Thoracic Surgery, Jan 3, 2024
JTCVS Techniques, Nov 30, 2023
PubMed, Apr 25, 2015
The basic principles of diagnosis and management of pulmonary atresia with ventricular septal def... more The basic principles of diagnosis and management of pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries are systematizes in this paper. The personal experience of surgical treatment of consecutive 66 patients with this disease is analyzed, including one-stage and multistage approaches.
Špitalʹna hìrurgìâ, Nov 13, 2015
У роботі описано та проаналізовано методи рентгенангіохірургічних процедур та операцій, які прово... more У роботі описано та проаналізовано методи рентгенангіохірургічних процедур та операцій, які проводили 83 оперованим пацієнтам з конотрункальними вадами серця та великих аорто-легеневих колатеральних артерій (ВАЛКА) з 2007 до 2014 р. Всього було проведено 284 ангіопроцедури та 65 ангіооперацій. Катетеризація серця з рентгенангіографією залишається обов'язковим методом у діагностиці та плануванні лікування пацієнтів із конотрункальними уродженими вадами серця з ВАЛКА. Широкий спектр рентгенохірургічних операцій дозволяє оптимізувати гемодинаміку вади на різних етапах хірургічного лікування. The X-ray surgical methods, which were used for diagnosis and treatment of the 83 patients with conotruncul heart defects and major aortopulmonary collateral arteries (MAPCA) from 2007 to 2014 are analyzed in the article. A total number of procedures was 284 angioprocedures and 65 angiooperations. The heart catheterization with angiography remains the obligatory method in the management of patients with conotruncal heart defects and MAPCA. A wide range of X-ray surgical procedures helps to optimize the hemodynamic parameters before and after anatomic correction.
The American Journal of Cardiology, 1983
European Journal of Cardio-Thoracic Surgery
Objective To describe the technique and evaluate the results of the isolated coronary artery bypa... more Objective To describe the technique and evaluate the results of the isolated coronary artery bypass grafting or combined grafting procedures with mitral valve repair/replacement and/or left ventricle aneurysm repair performed through the single left anterior minithoracotomy. Methods Perioperative data of all patients, who required isolated or combined coronary grafting from July 2017 to December 2021 were observed. The focus was on 560 patients, who underwent isolated or combined multivessel coronary bypass using “Total Coronary Revascularization via left Anterior Thoracotomy” technique. Main perioperative outcomes were analysed. Results Left anterior minithoracotomy was used in 521 (97.7%) out of 533 patients, who required isolated multivessel surgical coronary revascularization, and in 39 (32.5%) out of 120 patients, who required combined procedures. In 39 patients multivessel grafting was combined with 25 mitral valve and 22 left ventricular procedures. Mitral valve repair was pe...
Transplantation and artificial organs, 2021
Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using... more Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using the technique of total coronary revascularization via left anterior thoracotomy (TCRAT) is routinely performed in our institution since July 2017. This technique is used in all patients regardless of the number of anastomoses, quality and location of coronary targets, body mass index, age, comorbidities and predicted postoperative risk. The aim. To present the results of 349 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive CABG. To compare perioperative outcomes of minimally invasive CABG in patients with existent risk factors for CABG and to identify possible contraindications to the use of this CABG technique. Materials and methods. From July 2017 to January 2020, 357 consecutive patients were underwent multivessel CABG at our institution. Eight (2.3%) patients in whom CABG was performed through the median sternotomy were excluded...
Klinichna khirurhiia, 1997
Surgical treatment was conducted in 113 patients with the mitral valve failure, complicated by si... more Surgical treatment was conducted in 113 patients with the mitral valve failure, complicated by significant enlargement of the left auricle (LA). The simultant operation had included the mitral valve prosthesis and the LA reducing plasty according to the original method. The additional surgical correction of other valves affection was conducted in 44 patients. The hospital lethality have constituted 6.2%.
Ukrainian journal of cardiovascular surgery, 2020
Background. Minimally invasive mitral valve surgery provides many advantages for patients. The ... more Background. Minimally invasive mitral valve surgery provides many advantages for patients. The aim. To investigate and represent our own experience in minimally invasive mitral valve surgery, and to describe the operative technique. Materials and methods. The study was included 100 consecutive patients who underwent a minimally invasive mitral valve repair or replacement through the right lateral minithoracotomy from June 2017 to December 2019. Results. Mitral valve repair was performed in 87 patients (87%), and 13 patients (13%) were required mitral valve replacement. In 24 patients (24%), concomitant procedures were performed: tricuspid valve repair, atrial septal defect repair and left atrial myxomectomy. Ring anuloplasty was performed in all patients who underwent mitral valve repair. Additional methods of correction were used in accordance to the lesion anatomy: neochords implantation, cleft and leaflet perforation closure, leaflet resection, Alfieri (edge-to-edge) stitch, po...
Multimedia Manual of Cardiothoracic Surgery, Nov 23, 2022
Journal of Visualized Surgery
Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coron... more Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coronary revascularization through the left anterior thoracotomy, evaluate the intraoperative and early postoperative results. Methods: In this single-center retrospective cohort study we investigated the outcomes of 521 consecutive patients with isolated multivessel coronary artery disease (CAD) who were operated from July 2017 to December 2021. All operations performed via the left anterior minithoracotomy through the fourth intercostal space. Transthoracic clamp and blood cardioplegia were used for heart arrest and special maneuvers for coronary exposition. This technique was named total coronary revascularization via left anterior thoracotomy (TCRAT). Results: The mean number of grafts was 2.97±0.7 [range, 2-5]. Left internal mammary artery (LIMA) was used in 494 (94.8%) patients, the right internal mammary artery (RIMA) in 10 (1.9%) patients, radial artery in 153 (29.4%) patients, and veins in 429 (82.3%) patients. In our series the mortality rate was 0.57% (3 cases), 2 (0.38%) conversions to sternotomy due to acute aortic dissection and no postoperative myocardial infarctions were observed. There were 2 (0.38%) postoperative strokes and 6 (1.15%) revisions for postoperative bleeding without conversion to sternotomy. The total operation time was 269±51.8 minutes, cardiopulmonary bypass time 145.7±33.5 minutes, and aortic cross-clamp time 71.9±19.9 minutes. The mean intensive care stay was 2.1±1.2 days and mean total hospital stay 5.9±2.2 days Conclusions: The TCRAT technique could be used as a routine method of coronary artery bypass grafting (CABG) and provide the possibility to fully eliminate sternotomy for almost all patients (except porcelain aorta) with isolated multivessel CAD. Special surgical maneuvers for coronary targets exposure have made TCRAT more universal in practice than other minimally invasive CABG techniques. This technique preserves principles of complete coronary revascularisation and is applicable for multivessel CABG with use of standard coronary instruments and anastomotic techniques.
Journal of Visualized Surgery
Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coron... more Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coronary revascularization through the left anterior thoracotomy, evaluate the intraoperative and early postoperative results. Methods: In this single-center retrospective cohort study we investigated the outcomes of 521 consecutive patients with isolated multivessel coronary artery disease (CAD) who were operated from July 2017 to December 2021. All operations performed via the left anterior minithoracotomy through the fourth intercostal space. Transthoracic clamp and blood cardioplegia were used for heart arrest and special maneuvers for coronary exposition. This technique was named total coronary revascularization via left anterior thoracotomy (TCRAT). Results: The mean number of grafts was 2.97±0.7 [range, 2-5]. Left internal mammary artery (LIMA) was used in 494 (94.8%) patients, the right internal mammary artery (RIMA) in 10 (1.9%) patients, radial artery in 153 (29.4%) patients, and veins in 429 (82.3%) patients. In our series the mortality rate was 0.57% (3 cases), 2 (0.38%) conversions to sternotomy due to acute aortic dissection and no postoperative myocardial infarctions were observed. There were 2 (0.38%) postoperative strokes and 6 (1.15%) revisions for postoperative bleeding without conversion to sternotomy. The total operation time was 269±51.8 minutes, cardiopulmonary bypass time 145.7±33.5 minutes, and aortic cross-clamp time 71.9±19.9 minutes. The mean intensive care stay was 2.1±1.2 days and mean total hospital stay 5.9±2.2 days Conclusions: The TCRAT technique could be used as a routine method of coronary artery bypass grafting (CABG) and provide the possibility to fully eliminate sternotomy for almost all patients (except porcelain aorta) with isolated multivessel CAD. Special surgical maneuvers for coronary targets exposure have made TCRAT more universal in practice than other minimally invasive CABG techniques. This technique preserves principles of complete coronary revascularisation and is applicable for multivessel CABG with use of standard coronary instruments and anastomotic techniques.
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Right axillary transverse minithoracotomy is not conventionally used for ventricular septal defec... more Right axillary transverse minithoracotomy is not conventionally used for ventricular septal defect (VSD) repair because of complicated VSD exposure and the need for a temporary tricuspid valve leaflet detachment to facilitate VSD exposure. Recently, our team developed a new, not previously described surgical maneuver that markedly facilitates perimembranous VSD exposure without any need for tricuspid valve leaflet detachment. The above-mentioned VSD exposure maneuver was used in 21 patients with a median age of 5 months (range, 1.5 to 132 months) and a median body weight of 7 kg (range, 4 to 47 kg). The length of the incision varied from 3 to 4.5 cm over the fourth intercostal space within the anterior and posterior axillary lines. Central cardiopulmonary bypass cannulation and antegrade blood cardioplegia were performed in all patients. Bent/angled instruments were used throughout the procedure to facilitate the surgeon’s view. Pericardial sutures and suspension of tricuspid valve ...
Ukrainian journal of cardiovascular surgery, 2020
Background. Minimally invasive cardiac surgery is becoming more widespread. The aim of the stud... more Background. Minimally invasive cardiac surgery is becoming more widespread. The aim of the study was to evaluate the outcomes in 343 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive coronary revascularization. Materials and methods. From July 2017 to December 2019 we performed total coronary revascularization via left anterior minithoracotomy (TCRAT) in 343 consecutive patients with isolated multivessel coronary artery disease. In 83 (24.2%) of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). Cardiopulmonary bypass (CPB), aortic cross-clamping and blood cardioplegia were used in all patients. The patients were divided into two groups, uniarterial and multiarterial, to compare and analyze perioperative parameters. Results. No cases of postoperative myocardial infarction, surgically induced infection, or conver...
We are presenting the case of the minimally invasive total repair of Tetralogy of Fallot in a 2 m... more We are presenting the case of the minimally invasive total repair of Tetralogy of Fallot in a 2 months old male patient.<br> Echocardiography showed good LV contractility, open permanent ductus arteriosus (PDA), open permanent foramen ovale (PFO), large ventricular septal defect (VSD), severe infundibular stenosis and hypoplastic main pulmonary artery (PA) and PA branches<br> Our operation plan was: Right axillary minithoracotomy in 4th intercostal space; Thymectomy; Central cardiopulmonary bypass (CPB) cannulation; PDA closure; Aortic cross-clamp and cardioplegia administration; Trans-atrial VSD closure with glutaraldehyde treated auto-pericardial patch; PFO closure; Trans-annular right ventricular outflow tract (RVOT) and PA repair with auto-pericardial patch closure.<br> For the right axillary access patient had been rotated on the left lateral decubitus position. Horizontal skin incision was made over the 4th intercostal space between anterior and posterior axi...
Seminars in Thoracic and Cardiovascular Surgery, 2020
To present the technique and to evaluate the outcomes of the multivessel minimally invasive coron... more To present the technique and to evaluate the outcomes of the multivessel minimally invasive coronary revascularization through the left anterior thoracotomy. From July 2017 to March 2019 in 229 consecutive patients with isolated multivessel coronary artery disease we performed complete coronary revascularization through the left anterior minithoracotomy (6-8 cm skin incision). In 47 of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). Cardiopulmonary bypass (CPB), Chitwood clamp and blood cardioplegia were used in all patients. Heart strings, encircling tapes and Chitwood clamp were used to reduce the distance from skin to coronary targets. Usual coronary instruments were used. The perioperative outcomes of multiarterial graft strategy group were compared with uniarterial graft strategy group. There were no mortality, no perioperative myocardial infarcts, and no conversion to sternotomy with either graft strategy groups. The mean number of distal anastomoses, CPB time, and total hospital stay were not different between the groups. Aortic cross-clamp time ((83.8±17.4 (45;121) vs. 67.8±17.4 (35;146), p< 0.0001) and total operation time (283.5±45 (205;495) vs. 254.3±48.6 (175;590), p=0.0003) were longer in patients with multiarterial revascularization compared to uniarterial revascularization using LIMA and veins. Multivessel coronary bypass grafting using CPB and cardioplegia can be routinely performed minimally invasively through the left anterior thoracotomy. In selected patients multiarterial revascularization could be done with excellent procedural outcomes.
Proceedings of the Shevchenko Scientific Society. Medical Sciences, 2019
Вступ. Представлено досвід мініінвазивного багатосудинного коронарного шунтування в умовах передн... more Вступ. Представлено досвід мініінвазивного багатосудинного коронарного шунтування в умовах передньої торакотомії в хірургії ішемічної хвороби серця. Ми рутинно використовуємо розроблену нами методику незалежно від кількості шунтів, якості та локації коронарних артерій, скоротливої здатності лівого шлуночка, віку, ваги та статі пацієнта. Мета роботи. Описано розроблену нами методику мініінвазивного багатосудинного коронарного шунтування в умовах передньо мініторакотомії з використанням штучного кровообігу та кров'яної кардіоплегії. Матеріали і методи. Метод використано в 220 пацієнтів. Всім пацієнтам виконали повну реваскуляризацію міокарда. Кількість шунтів-від 2 до 5, в середньому-3,37± 0,68 на пацієнта. Ліва внутрішня мамарна артерія була використана у 206 пацієнтів, права внутрішня мамарна артерія-у 4 пацієнтів, променева артерія-у 37 пацієнтів, венозні кондуїти використовували-у 193 пацієнтів, повна артеріальна реваскуляризація виконана 29 пацієнтам.
We are presenting the case of minimally invasive repair of large left ventricle inferior pseudoan... more We are presenting the case of minimally invasive repair of large left ventricle inferior pseudoaneurysm and concomitant CABG procedure. The patient was a 63 years old man who was presented with shortness of breath and severe angina pectoris.<br> Operation plan consisted of: left anterior minithoracotomy in 4th intercostal space, left internal mammary artery harvesting, peripheral cannulation for cardiopulmonary bypass, aortic cross-clamp and cardioplegia administration, pseudoaneurysm repair and LIMA to LAD anastomosis. <br> Postop ECHO showed better EF and reduction of MV insufficiency from moderate to minimal. <br> The patient spent 2 days in ICU and discharged home on the 6th postoperative day.
Interdisciplinary CardioVascular and Thoracic Surgery, Jan 3, 2024
JTCVS Techniques, Nov 30, 2023
PubMed, Apr 25, 2015
The basic principles of diagnosis and management of pulmonary atresia with ventricular septal def... more The basic principles of diagnosis and management of pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries are systematizes in this paper. The personal experience of surgical treatment of consecutive 66 patients with this disease is analyzed, including one-stage and multistage approaches.
Špitalʹna hìrurgìâ, Nov 13, 2015
У роботі описано та проаналізовано методи рентгенангіохірургічних процедур та операцій, які прово... more У роботі описано та проаналізовано методи рентгенангіохірургічних процедур та операцій, які проводили 83 оперованим пацієнтам з конотрункальними вадами серця та великих аорто-легеневих колатеральних артерій (ВАЛКА) з 2007 до 2014 р. Всього було проведено 284 ангіопроцедури та 65 ангіооперацій. Катетеризація серця з рентгенангіографією залишається обов'язковим методом у діагностиці та плануванні лікування пацієнтів із конотрункальними уродженими вадами серця з ВАЛКА. Широкий спектр рентгенохірургічних операцій дозволяє оптимізувати гемодинаміку вади на різних етапах хірургічного лікування. The X-ray surgical methods, which were used for diagnosis and treatment of the 83 patients with conotruncul heart defects and major aortopulmonary collateral arteries (MAPCA) from 2007 to 2014 are analyzed in the article. A total number of procedures was 284 angioprocedures and 65 angiooperations. The heart catheterization with angiography remains the obligatory method in the management of patients with conotruncal heart defects and MAPCA. A wide range of X-ray surgical procedures helps to optimize the hemodynamic parameters before and after anatomic correction.
The American Journal of Cardiology, 1983
European Journal of Cardio-Thoracic Surgery
Objective To describe the technique and evaluate the results of the isolated coronary artery bypa... more Objective To describe the technique and evaluate the results of the isolated coronary artery bypass grafting or combined grafting procedures with mitral valve repair/replacement and/or left ventricle aneurysm repair performed through the single left anterior minithoracotomy. Methods Perioperative data of all patients, who required isolated or combined coronary grafting from July 2017 to December 2021 were observed. The focus was on 560 patients, who underwent isolated or combined multivessel coronary bypass using “Total Coronary Revascularization via left Anterior Thoracotomy” technique. Main perioperative outcomes were analysed. Results Left anterior minithoracotomy was used in 521 (97.7%) out of 533 patients, who required isolated multivessel surgical coronary revascularization, and in 39 (32.5%) out of 120 patients, who required combined procedures. In 39 patients multivessel grafting was combined with 25 mitral valve and 22 left ventricular procedures. Mitral valve repair was pe...
Transplantation and artificial organs, 2021
Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using... more Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using the technique of total coronary revascularization via left anterior thoracotomy (TCRAT) is routinely performed in our institution since July 2017. This technique is used in all patients regardless of the number of anastomoses, quality and location of coronary targets, body mass index, age, comorbidities and predicted postoperative risk. The aim. To present the results of 349 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive CABG. To compare perioperative outcomes of minimally invasive CABG in patients with existent risk factors for CABG and to identify possible contraindications to the use of this CABG technique. Materials and methods. From July 2017 to January 2020, 357 consecutive patients were underwent multivessel CABG at our institution. Eight (2.3%) patients in whom CABG was performed through the median sternotomy were excluded...
Klinichna khirurhiia, 1997
Surgical treatment was conducted in 113 patients with the mitral valve failure, complicated by si... more Surgical treatment was conducted in 113 patients with the mitral valve failure, complicated by significant enlargement of the left auricle (LA). The simultant operation had included the mitral valve prosthesis and the LA reducing plasty according to the original method. The additional surgical correction of other valves affection was conducted in 44 patients. The hospital lethality have constituted 6.2%.
Ukrainian journal of cardiovascular surgery, 2020
Background. Minimally invasive mitral valve surgery provides many advantages for patients. The ... more Background. Minimally invasive mitral valve surgery provides many advantages for patients. The aim. To investigate and represent our own experience in minimally invasive mitral valve surgery, and to describe the operative technique. Materials and methods. The study was included 100 consecutive patients who underwent a minimally invasive mitral valve repair or replacement through the right lateral minithoracotomy from June 2017 to December 2019. Results. Mitral valve repair was performed in 87 patients (87%), and 13 patients (13%) were required mitral valve replacement. In 24 patients (24%), concomitant procedures were performed: tricuspid valve repair, atrial septal defect repair and left atrial myxomectomy. Ring anuloplasty was performed in all patients who underwent mitral valve repair. Additional methods of correction were used in accordance to the lesion anatomy: neochords implantation, cleft and leaflet perforation closure, leaflet resection, Alfieri (edge-to-edge) stitch, po...
Multimedia Manual of Cardiothoracic Surgery, Nov 23, 2022
Journal of Visualized Surgery
Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coron... more Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coronary revascularization through the left anterior thoracotomy, evaluate the intraoperative and early postoperative results. Methods: In this single-center retrospective cohort study we investigated the outcomes of 521 consecutive patients with isolated multivessel coronary artery disease (CAD) who were operated from July 2017 to December 2021. All operations performed via the left anterior minithoracotomy through the fourth intercostal space. Transthoracic clamp and blood cardioplegia were used for heart arrest and special maneuvers for coronary exposition. This technique was named total coronary revascularization via left anterior thoracotomy (TCRAT). Results: The mean number of grafts was 2.97±0.7 [range, 2-5]. Left internal mammary artery (LIMA) was used in 494 (94.8%) patients, the right internal mammary artery (RIMA) in 10 (1.9%) patients, radial artery in 153 (29.4%) patients, and veins in 429 (82.3%) patients. In our series the mortality rate was 0.57% (3 cases), 2 (0.38%) conversions to sternotomy due to acute aortic dissection and no postoperative myocardial infarctions were observed. There were 2 (0.38%) postoperative strokes and 6 (1.15%) revisions for postoperative bleeding without conversion to sternotomy. The total operation time was 269±51.8 minutes, cardiopulmonary bypass time 145.7±33.5 minutes, and aortic cross-clamp time 71.9±19.9 minutes. The mean intensive care stay was 2.1±1.2 days and mean total hospital stay 5.9±2.2 days Conclusions: The TCRAT technique could be used as a routine method of coronary artery bypass grafting (CABG) and provide the possibility to fully eliminate sternotomy for almost all patients (except porcelain aorta) with isolated multivessel CAD. Special surgical maneuvers for coronary targets exposure have made TCRAT more universal in practice than other minimally invasive CABG techniques. This technique preserves principles of complete coronary revascularisation and is applicable for multivessel CABG with use of standard coronary instruments and anastomotic techniques.
Journal of Visualized Surgery
Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coron... more Background: Our aim was to describe the technique of minimally invasive on-pump multivessel coronary revascularization through the left anterior thoracotomy, evaluate the intraoperative and early postoperative results. Methods: In this single-center retrospective cohort study we investigated the outcomes of 521 consecutive patients with isolated multivessel coronary artery disease (CAD) who were operated from July 2017 to December 2021. All operations performed via the left anterior minithoracotomy through the fourth intercostal space. Transthoracic clamp and blood cardioplegia were used for heart arrest and special maneuvers for coronary exposition. This technique was named total coronary revascularization via left anterior thoracotomy (TCRAT). Results: The mean number of grafts was 2.97±0.7 [range, 2-5]. Left internal mammary artery (LIMA) was used in 494 (94.8%) patients, the right internal mammary artery (RIMA) in 10 (1.9%) patients, radial artery in 153 (29.4%) patients, and veins in 429 (82.3%) patients. In our series the mortality rate was 0.57% (3 cases), 2 (0.38%) conversions to sternotomy due to acute aortic dissection and no postoperative myocardial infarctions were observed. There were 2 (0.38%) postoperative strokes and 6 (1.15%) revisions for postoperative bleeding without conversion to sternotomy. The total operation time was 269±51.8 minutes, cardiopulmonary bypass time 145.7±33.5 minutes, and aortic cross-clamp time 71.9±19.9 minutes. The mean intensive care stay was 2.1±1.2 days and mean total hospital stay 5.9±2.2 days Conclusions: The TCRAT technique could be used as a routine method of coronary artery bypass grafting (CABG) and provide the possibility to fully eliminate sternotomy for almost all patients (except porcelain aorta) with isolated multivessel CAD. Special surgical maneuvers for coronary targets exposure have made TCRAT more universal in practice than other minimally invasive CABG techniques. This technique preserves principles of complete coronary revascularisation and is applicable for multivessel CABG with use of standard coronary instruments and anastomotic techniques.
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Right axillary transverse minithoracotomy is not conventionally used for ventricular septal defec... more Right axillary transverse minithoracotomy is not conventionally used for ventricular septal defect (VSD) repair because of complicated VSD exposure and the need for a temporary tricuspid valve leaflet detachment to facilitate VSD exposure. Recently, our team developed a new, not previously described surgical maneuver that markedly facilitates perimembranous VSD exposure without any need for tricuspid valve leaflet detachment. The above-mentioned VSD exposure maneuver was used in 21 patients with a median age of 5 months (range, 1.5 to 132 months) and a median body weight of 7 kg (range, 4 to 47 kg). The length of the incision varied from 3 to 4.5 cm over the fourth intercostal space within the anterior and posterior axillary lines. Central cardiopulmonary bypass cannulation and antegrade blood cardioplegia were performed in all patients. Bent/angled instruments were used throughout the procedure to facilitate the surgeon’s view. Pericardial sutures and suspension of tricuspid valve ...
Ukrainian journal of cardiovascular surgery, 2020
Background. Minimally invasive cardiac surgery is becoming more widespread. The aim of the stud... more Background. Minimally invasive cardiac surgery is becoming more widespread. The aim of the study was to evaluate the outcomes in 343 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive coronary revascularization. Materials and methods. From July 2017 to December 2019 we performed total coronary revascularization via left anterior minithoracotomy (TCRAT) in 343 consecutive patients with isolated multivessel coronary artery disease. In 83 (24.2%) of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). Cardiopulmonary bypass (CPB), aortic cross-clamping and blood cardioplegia were used in all patients. The patients were divided into two groups, uniarterial and multiarterial, to compare and analyze perioperative parameters. Results. No cases of postoperative myocardial infarction, surgically induced infection, or conver...
We are presenting the case of the minimally invasive total repair of Tetralogy of Fallot in a 2 m... more We are presenting the case of the minimally invasive total repair of Tetralogy of Fallot in a 2 months old male patient.<br> Echocardiography showed good LV contractility, open permanent ductus arteriosus (PDA), open permanent foramen ovale (PFO), large ventricular septal defect (VSD), severe infundibular stenosis and hypoplastic main pulmonary artery (PA) and PA branches<br> Our operation plan was: Right axillary minithoracotomy in 4th intercostal space; Thymectomy; Central cardiopulmonary bypass (CPB) cannulation; PDA closure; Aortic cross-clamp and cardioplegia administration; Trans-atrial VSD closure with glutaraldehyde treated auto-pericardial patch; PFO closure; Trans-annular right ventricular outflow tract (RVOT) and PA repair with auto-pericardial patch closure.<br> For the right axillary access patient had been rotated on the left lateral decubitus position. Horizontal skin incision was made over the 4th intercostal space between anterior and posterior axi...
Seminars in Thoracic and Cardiovascular Surgery, 2020
To present the technique and to evaluate the outcomes of the multivessel minimally invasive coron... more To present the technique and to evaluate the outcomes of the multivessel minimally invasive coronary revascularization through the left anterior thoracotomy. From July 2017 to March 2019 in 229 consecutive patients with isolated multivessel coronary artery disease we performed complete coronary revascularization through the left anterior minithoracotomy (6-8 cm skin incision). In 47 of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). Cardiopulmonary bypass (CPB), Chitwood clamp and blood cardioplegia were used in all patients. Heart strings, encircling tapes and Chitwood clamp were used to reduce the distance from skin to coronary targets. Usual coronary instruments were used. The perioperative outcomes of multiarterial graft strategy group were compared with uniarterial graft strategy group. There were no mortality, no perioperative myocardial infarcts, and no conversion to sternotomy with either graft strategy groups. The mean number of distal anastomoses, CPB time, and total hospital stay were not different between the groups. Aortic cross-clamp time ((83.8±17.4 (45;121) vs. 67.8±17.4 (35;146), p< 0.0001) and total operation time (283.5±45 (205;495) vs. 254.3±48.6 (175;590), p=0.0003) were longer in patients with multiarterial revascularization compared to uniarterial revascularization using LIMA and veins. Multivessel coronary bypass grafting using CPB and cardioplegia can be routinely performed minimally invasively through the left anterior thoracotomy. In selected patients multiarterial revascularization could be done with excellent procedural outcomes.
Proceedings of the Shevchenko Scientific Society. Medical Sciences, 2019
Вступ. Представлено досвід мініінвазивного багатосудинного коронарного шунтування в умовах передн... more Вступ. Представлено досвід мініінвазивного багатосудинного коронарного шунтування в умовах передньої торакотомії в хірургії ішемічної хвороби серця. Ми рутинно використовуємо розроблену нами методику незалежно від кількості шунтів, якості та локації коронарних артерій, скоротливої здатності лівого шлуночка, віку, ваги та статі пацієнта. Мета роботи. Описано розроблену нами методику мініінвазивного багатосудинного коронарного шунтування в умовах передньо мініторакотомії з використанням штучного кровообігу та кров'яної кардіоплегії. Матеріали і методи. Метод використано в 220 пацієнтів. Всім пацієнтам виконали повну реваскуляризацію міокарда. Кількість шунтів-від 2 до 5, в середньому-3,37± 0,68 на пацієнта. Ліва внутрішня мамарна артерія була використана у 206 пацієнтів, права внутрішня мамарна артерія-у 4 пацієнтів, променева артерія-у 37 пацієнтів, венозні кондуїти використовували-у 193 пацієнтів, повна артеріальна реваскуляризація виконана 29 пацієнтам.
We are presenting the case of minimally invasive repair of large left ventricle inferior pseudoan... more We are presenting the case of minimally invasive repair of large left ventricle inferior pseudoaneurysm and concomitant CABG procedure. The patient was a 63 years old man who was presented with shortness of breath and severe angina pectoris.<br> Operation plan consisted of: left anterior minithoracotomy in 4th intercostal space, left internal mammary artery harvesting, peripheral cannulation for cardiopulmonary bypass, aortic cross-clamp and cardioplegia administration, pseudoaneurysm repair and LIMA to LAD anastomosis. <br> Postop ECHO showed better EF and reduction of MV insufficiency from moderate to minimal. <br> The patient spent 2 days in ICU and discharged home on the 6th postoperative day.