Harmonic scalpel versus electrocautery for harvest of radial artery conduits: Reduced risk of spasm and intimal injury on optical coherence tomography

Slides:

Advertisements

Similar presentations

The “occasional open heart surgeon” revisited

Advertisements

Total arterial revascularization of triple vessel coronary disease based on combined internal thoracic and radial artery grafts Robert H. Habib, PhD,

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Lost in translation The Journal of Thoracic and Cardiovascular Surgery

Manuel J. Antunes, MD, PhD, DSc

Chetan Pasrija, MD, Michael A. Mazzeffi, MD, MPH, Zachary N. Kon, MD

Lars G. Svensson, MD, PhD, Eugene H. Blackstone, MD

Mitral stenosis with pulmonary hypertension: We should operate early

Catheter-based infrared light scanner as a tool to assess conduit quality in coronary artery bypass surgery Nicholas Burris, BS, Kimberly Schwartz, RNFA,

Emile N. Brown, BS, Zachary N. Kon, BA, Richard Tran, BS, Nicholas S

Optical Coherence Tomography Imaging as a Quality Assurance Tool for Evaluating Endoscopic Harvest of the Radial Artery Nicholas S. Burris, BS, Emile.

Alan P. Kypson, MD, David W. Frazier, MD, Jon F. Moran, MD

Interventional radiology suite or hybrid operating room: Which is the best for lung nodule localization? Robert B. Cameron, MD The Journal of Thoracic.

Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off-pump coronary artery bypass

Pseudoaneurysm complicating right ventricle–to–pulmonary artery conduit surgery: Why single-center observational studies still matter Petros V. Anagnostopoulos,

Right internal thoracic artery or saphenous vein grafting

Personalized cardiac surgery: Can noninvasive flow imaging lead to individualized resection strategies for bicuspid aortopathy? Nicholas D. Andersen,

Allograft carotid artery as a systemic-to-pulmonary conduit

Centers for Disease Control “increased-risk” organ donor: Not so risky? Francis D. Pagani, MD, PhD The Journal of Thoracic and Cardiovascular Surgery

Victor van Berkel, MD, PhD

William M. DeCampli, MD, PhD

Silvana Molossi, MD, PhD, Carlos M. Mery, MD, MPH

A new approach: Ischemic mitral regurgitation guidelines by and for surgeons Patrick M. McCarthy, MD The Journal of Thoracic and Cardiovascular Surgery

Multilevel data analysis: What? Why? How?

The appendage strikes back: The last surgeon

Harold L. Lazar, MD The Journal of Thoracic and Cardiovascular Surgery

The lord of the rings Antonio Miceli, MD, PhD

High-resolution computed tomography with three-dimensional reconstruction for assessment of chronic pulmonary thromboembolic disease Thoralf M. Sundt,

Gastric conduit revision after esophagectomy: The raising of Lazarus

Surgical economics: MACRA, MIPS, and bundles—Lessons learned in the first 3 years of a coronary artery bypass grafting alternative payment model Daniel.

Leora B. Balsam, MD The Journal of Thoracic and Cardiovascular Surgery

The assessment of cost effectiveness and the effectiveness of cost assessment in cardiothoracic surgery Vinay Badhwar, MD The Journal of Thoracic and.

It's not “just a shunt” but sometimes it should be…

Military surgeons just want to have fun

A first start for lung transplantation?

Confusion still exists regarding postoperative delirium and its etiology after esophagectomy Robert B. Cameron, MD The Journal of Thoracic and Cardiovascular.

Joseph A. Dearani, MD, Michael J. Ackerman, MD, PhD

A case of chest wall angiosarcoma associated with breast implants

Fueling the heart: Shifting the myocardial metabolome by targeting endothelial autophagy Nicholas D. Andersen, MD The Journal of Thoracic and Cardiovascular.

A fate worse than death Jennifer S. Lawton, MD

Cardiac surgery in patients with a porcelain aorta

Impact of the Learning Curve for Endoscopic Vein Harvest on Conduit Quality and Early Graft Patency Pranjal Desai, MD, Soroosh Kiani, BS, Nannan Thiruvanthan,

Conservative management of an intrapericardial contained rupture of the right pulmonary artery in blunt trauma: A good idea? Pierre Demondion, MD, Patrick.

Commentary: Do the right thing! Ethical versus legal

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

The thoracoabdominal saga and heroes

Patrick T. Roughneen, MD, Grant T. Fankhauser, MD, Abe DeAnda, MD

Shunt right or left? Decision 2016

Ralph S. Mosca, MD The Journal of Thoracic and Cardiovascular Surgery

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The future of cardiac surgery training: A survival guide

The continuing challenge of congenital heart disease in China

Between a rock and a hard place

Should it stay or should it go?

“The more things change…”: The challenges ahead

Commentary: Judgment day: Should you add atrial fibrillation ablation?

Toward a more rational approach in treating type B aortic dissection

Managing conflicts of interest

First in line for robotic surgery: Would you want to know?

Ryan R. Davies, MD The Journal of Thoracic and Cardiovascular Surgery

Apples remain apples NO matter what

Respect the aorta The Journal of Thoracic and Cardiovascular Surgery

Preoperative PFTs: The answer is blowing in the wind

Endoscopy after esophagectomy: Doctors' dilemma

Sunjay Kaushal, MD, PhD, Brody Wehman, MD

Thirty-two years after total right heart bypass

Did you like Terminator 3 better than Terminator 2

Journal changes and initiatives

Deciding how much to pay for effective care

Presentation transcript:

Harmonic scalpel versus electrocautery for harvest of radial artery conduits: Reduced risk of spasm and intimal injury on optical coherence tomography Philip S. Brazio, BS, BA, Patrick C. Laird, BA, Chenyang Xu, PhD, Junyan Gu, MD, PhD, Nicholas S. Burris, BS, Emile N. Brown, BS, Zachary N. Kon, BA, Robert S. Poston, MD The Journal of Thoracic and Cardiovascular Surgery Volume 136, Issue 5, Pages 1302-1308 (November 2008) DOI: 10.1016/j.jtcvs.2008.05.060 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Localization of the optical coherence tomographic imaging probe within the radial artery. The infrared light emitted from the tip of the optical coherence tomographic probe (A) can easily be visualized through the luminal wall of the radial artery (arrow, B) during image acquisition. This enables external marking of abnormal areas of the artery, thereby providing a roadmap for selecting the optimal portion of the conduit for bypass. Imaging-guided biopsy specimens also can be obtained for histologic confirmation of optical coherence tomographic findings. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1302-1308DOI: (10.1016/j.jtcvs.2008.05.060) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Endothelial integrity of harvested radial artery portions according to histologic findings (CD31 staining, A and D; elastin staining, B and E) and optical coherence tomographic analysis (C and F). A, B, and C, Normal artery portions; D, E, and F, artery portions with dissection. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1302-1308DOI: (10.1016/j.jtcvs.2008.05.060) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Optical coherence tomographic frames at 3 points of the radial artery before (A and C) and after (B and D) harvest. The mean luminal area (LA) of the artery harvested with the harmonic scalpel (A and B) increased by 6.5%, whereas the LA of the artery harvested by means of electrocautery decreased by 66.9% (C and D). After harvesting, panel B shows small areas of mild focal spasm, whereas panel D displays severe diffuse spasm (string sign). The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1302-1308DOI: (10.1016/j.jtcvs.2008.05.060) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions