All posts by totem

Apple watch saves student’s life

Mr Love had a dangerous abnormality- a hole in his heart that he’d had since birth.

His upper lung was also pumping into the wrong atrium of his heart – the right side instead of the left.

“So the blood needlessly circulates around the lung and doesn’t get out into the rest of his body,” his cardiothoracic surgeon Professor Michael Wilson explained. View story here.

Article by Sophie Walsh, Reporter Channel Nine News

‘The best surgeon will eventually be a robot.’

The revolution in robotics and artificial intelligence has made its way into surgery. Patients needing coronary artery bypasses would normally require open heart surgery but now, thanks to robots, they are facing far less traumatic surgery and a much faster recovery.

Australian Broadcasting Corporation
Broadcast: 03/07/2017
Reporter: Matt Peacock

View the full news article.

78% Stroke Reduction with Newer No-Touch Beating Heart Bypass Surgery, According to Landmark Study

Lower stroke, mortality, renal failure, bleeding, atrial fibrillation, and length of intensive care unit stay with newer no-touch technique.

Feb 27, 2017, 07:00 ET

View the full news article.

Four surgical methods of coronary artery bypass grafting with increasing degrees of aortic manipulation. Percentages pictured represent the relative decrease in risk of perioperative stroke using anOPCABG compared to the other techniques. CABG = coronary artery bypass grafting with cardiopulmonary bypass; anOPCABG = anaortic off-pump coronary artery bypass grafting; LIMA = left internal mammary artery; OPCABG-HS = off-pump coronary artery bypass grafting with the Heartstring system; OPCABG-PC = off-pump coronary artery bypass grafting with partial clamp; RIMA = right internal mammary artery.

A better bypass

Coronary artery bypass grafting (CABG) might be the standard treatment for coronary disease, but it comes with an increased risk of post-operative stroke compared to other techniques.

But new research suggests that a few tweaks to the technique might decrease this risk, especially for patients whose risk of stroke is higher to start with.

Moreover, it might improve a number of common post-operative complications as well.

Download the radio interview

https://www.youtube.com/watch?v=ymM1Z3KVkZs

This interview originally aired on the ABC website

Bilateral internal mammary arteries: evidence and technical considerations

Vallely MP, Edelman JJ, Wilson MK

Ann Cardiothorac Surg 2013 Jul;2(4):570-7

PMID: 23977638

Abstract

Bilateral internal mammary artery (BIMA) grafts are used for coronary revascularisation by only a minority of surgeons, despite a growing body of evidence suggesting improved survival when compared to use of only one internal mammary artery with additional saphenous vein grafts. Herein we review the evidence supporting revascularisation with BIMA and suggest reasons why the majority of surgeons use only one internal mammary artery. We discuss technical considerations, various graft combinations and the use of BIMA to facilitate anaortic off-pump coronary artery bypass (OPCAB).

Anaortic off-pump coronary artery bypass grafting in the elderly and very elderly

Cooper EA, Edelman JJ, Black D, Brereton RJ, Ross DE, Bannon PG, Wilson MK, Vallely MP

Heart Lung Circ 2013 Dec;22(12):989-95

PMID: 23827207

View article on PubMed

Abstract

BACKGROUND: Elderly patients undergoing surgical revascularisation may disproportionately benefit from avoiding manipulation of the ascending aorta and cardiopulmonary bypass. In this multi-centre observational study, we sought to determine the 30-day outcomes of anaortic off-pump coronary artery bypass (OPCAB) in an elderly and very-elderly population.

METHODS: Data were prospectively collected for all patients aged >70 years old (y) undergoing anaortic OPCAB at three hospitals between January 2002 and October 2011. Analysis was carried out on two age sub-groups (70-79 y vs. ≥80 y). Multiple logistic regression was used to identify predictors of post-operative 30-day mortality.

RESULTS: In total, 1135 patients >70 years underwent anaortic OPCAB – 817 (72%) patients were aged 70-79 y while 318 (28%) were aged ≥80 y. The rate of mortality and morbidity for both groups was low: 30-day mortality (70-79 y: 1.8%; ≥80 y: 2.8%) or permanent stroke (70-79 y: 0.2%; ≥80 y: 0.9%). Chronic lung disease, a history of previous myocardial infarction and left main disease were independent predictors of 30-day mortality.

CONCLUSIONS: OPCAB is associated with low rates of 30-day mortality and peri-operative stroke in this elderly and very elderly patient cohort. Anaortic OPCAB can provide excellent short-term post-operative outcomes and may give the elderly and very elderly population the opportunity to benefit from surgical coronary revascularisation.