From MIDCAB to OPCAB: a Race Back to the Future

Abstract:

A trend towards less invasive operations has affected the surgical specialties for the past 10 years. Cardiac surgery had been the slowest subspeciaIty to move in this direction, but in 1995 enthusiasm for "minimally invasive" cardiac operations began to grow. Since the initial report by Acuff published in 1996, minimally invasive coronary bypass surgery has developed and undergone a tremendous evolution resulting in the now mature minimally invasive direct coronary artery bypass (MIDCAB) operation, as well as the still evolving off-pump coronary artery bypass (OPCAB) procedure. The success of MIDCAB has led surgeons to look at past procedures to help develop future multivessel coronary operations.

Authors:

Joseph Elbeery, M.D., F.A.C.S., W. Randolph Chitwood, Jr., F.A.C.S., F.A.C.C.

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Computer-Assisted Endoscopic Coronary Artery Bypass Grafting: The Penn State Experience

Abstract:

The introduction and widespread acceptance of minimally invasive techniques have revolutionized surgical practice in many disciplines over the last two decades. Endoscopic operations have been shown to reduce patient morbidity and provide a more rapid return to work. Until recently, endoscopic approaches have had little impact on the field of cardiac surgery. Endoscopically-sutured coronary anastomoses have not been possible with conventional endoscopic instruments, due in part to their length and imprecision.

Authors:

Christopher T. Ducko, M.D., Edward R. Stephenson Jr., M.D., Ralph J. Damiano, Jr., M.D., F.A.C.S., Sachin Sankholkar, M.S.

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Laparoscopic Aorto-Iliac Surgery: Present Status and Future Perspectives

Abstract:

Over the past few years, the concept of "minimally invasive surgery" has generated a significant interest in the field of cardiovascular surgery. Congenital heart diseases such as patent ductus arteriosus, vascular ring or atrial septal defect have been treated using video-assisted technology. Although patients have undergone mitral valve replacement and repair, the focus of interest in the development of video-assisted cardiac surgery is in the treatment of coronary artery disease.

Authors:

Yves-Marie Dion, M.D., Alain Cardon, M.D., M.Sc., F.A.C.S., Olivier Hartung, M.D., Carlos R. Gracia, M.D., F.A.C.S.

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Superficial Vein Thrombophlebitis as a Marker of Hypercoagulability

Abstract:

Superficial thrombophlebitis (SVT)is a common disorder with potential morbidity from recurrence and pulmonary embolism (PE), but it has received little attention in the literature. The availability of reliable duplex ultrasonography of the deep and superficial venous systems has made routine determination of the location and incidence of deep vein thrombosis (DVT) in association with SVT practical.

Authors:

Anil Hingorani, M.D., Enrico Asher, M.D.

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Thromboembolic Complications of Central Venous Catheterization of the Arm and Neck Veins

Abstract:

For more than 30 years central venous catheterization has provided an important means of long-term vascular access and circulatory monitoring. Thrombosis of central veins is one of the serious complications of this procedure, The reported incidence of thrombosis varies and it is often underestimated clinicaIly due to the pau city of signs and symptoms. Symptomatic subelavian vein thrombosis is estimated to occur in up to 15% of patients with indwelling venous access devices.

Authors:

Yair Galili, M.D., Ariel Halevy, M.D., Arie Bass, M.D., Amir Peer, M.D., David Chayen, M.D., Eran E. Weinmann, M.D., Noa Bendet, M.D.

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