The Experts below are selected from a list of 171 Experts worldwide ranked by ideXlab platform
Tomasz A Timek - One of the best experts on this subject based on the ideXlab platform.
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use of an automated suture Fastening Device in minimally invasive aortic valve replacement
The Annals of Thoracic Surgery, 2018Co-Authors: Tyler J Beute, Matthew Oram, Timothy M Schiller, Matthew Goehler, Jessica Parker, Charles L Willekes, Tomasz A TimekAbstract:Background Minimally invasive aortic valve replacement (mAVR) is gaining clinical acceptance; however, it is associated with increased operative times because of the limited surgical field and access. The Cor-Knot (CK; LSI Solutions, Victor, NY) is an automated Fastening Device designed to facilitate suture Fastening, but clinical data in mAVR are lacking. Methods From May 2014 to February 2017, 92 patients underwent mAVR at Spectrum Health in Grand Rapids, Michigan; 39 valves were secured with manually tied sutures, and 53 valves were entirely secured with the CK Device. Preoperative characteristics and 30-day outcomes data were extracted from the local The Society of Thoracic Surgeons database and the patients’ electronic medical records. Survival data were obtained from the Michigan State Social Security Death Index. Results No significant differences in preoperative characteristics were noted between the two groups. Aortic cross-clamp time (72 ± 12 minutes vs 82 ± 15 minutes; p = 0.001) was significantly shorter with CK. There was no difference in the rate of postoperative mortality (0% vs 0%), stroke (0% vs 1.9%), atrial fibrillation (28% vs 33%), renal failure (0% vs 3.8%), or pacemaker implantation (5.1% vs 5.7%) between patients with manually tied sutures and patients with sutures fastened with the CK. Valve function on postoperative echocardiography and 1-year patient survival rates were similar. Conclusions In mAVR, the CK Device was associated with reduced aortic cross-clamp time while providing equivalent clinical outcomes. Larger studies are needed to confirm the efficacy, safety, and cost-effectiveness of the CK Device in minimally invasive aortic valve surgery.
Tyler J Beute - One of the best experts on this subject based on the ideXlab platform.
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use of an automated suture Fastening Device in minimally invasive aortic valve replacement
The Annals of Thoracic Surgery, 2018Co-Authors: Tyler J Beute, Matthew Oram, Timothy M Schiller, Matthew Goehler, Jessica Parker, Charles L Willekes, Tomasz A TimekAbstract:Background Minimally invasive aortic valve replacement (mAVR) is gaining clinical acceptance; however, it is associated with increased operative times because of the limited surgical field and access. The Cor-Knot (CK; LSI Solutions, Victor, NY) is an automated Fastening Device designed to facilitate suture Fastening, but clinical data in mAVR are lacking. Methods From May 2014 to February 2017, 92 patients underwent mAVR at Spectrum Health in Grand Rapids, Michigan; 39 valves were secured with manually tied sutures, and 53 valves were entirely secured with the CK Device. Preoperative characteristics and 30-day outcomes data were extracted from the local The Society of Thoracic Surgeons database and the patients’ electronic medical records. Survival data were obtained from the Michigan State Social Security Death Index. Results No significant differences in preoperative characteristics were noted between the two groups. Aortic cross-clamp time (72 ± 12 minutes vs 82 ± 15 minutes; p = 0.001) was significantly shorter with CK. There was no difference in the rate of postoperative mortality (0% vs 0%), stroke (0% vs 1.9%), atrial fibrillation (28% vs 33%), renal failure (0% vs 3.8%), or pacemaker implantation (5.1% vs 5.7%) between patients with manually tied sutures and patients with sutures fastened with the CK. Valve function on postoperative echocardiography and 1-year patient survival rates were similar. Conclusions In mAVR, the CK Device was associated with reduced aortic cross-clamp time while providing equivalent clinical outcomes. Larger studies are needed to confirm the efficacy, safety, and cost-effectiveness of the CK Device in minimally invasive aortic valve surgery.
S. Chris Malaisrie - One of the best experts on this subject based on the ideXlab platform.
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Alternative Implantation Technique for Rapid Deployment Valve
The Annals of thoracic surgery, 2018Co-Authors: Yuji Kaku, Romualdo J. Segurola, Alfredo Rego, Patrick M. Mccarthy, S. Chris MalaisrieAbstract:We present a simpler and faster way of implanting the Edwards Intuity Elite rapid deployment valve system. Annular sizing and guiding suture placement are performed in the usual manner. After the valve is parachuted down to the annulus, the balloon catheter is detached and a vent catheter is placed through the center hole to maximize exposure of the valve. The guiding sutures are tied down using an automated suture Fastening Device instead of securing snares. Visualization of the tip of the suture fastener on the annulus ensures proper valve seating. The sealing frame is ballooned, and the valve is deployed.
Konstantinos Dean Boudoulas - One of the best experts on this subject based on the ideXlab platform.
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Totally endoscopic aortic valve replacement with stented biological and mechanical aortic prostheses
European Heart Journal, 2020Co-Authors: Antonios A. Pitsis, N Tsotsolis, N Nikoloudakis, Harisios Boudoulas, Konstantinos Dean BoudoulasAbstract:Abstract Background Endoscopic mitral valve surgery has become the gold standard of care in many expert centres around the globe. The aortic valve has not met the same popularity mainly due to the very confined space in the aortic root, and to the close proximity with the sternum which restricts the movement of the endoscopic instruments. When endoscopic aortic valve replacement is practiced in expert centres, is usually performed with the use of sutureless bioprostheses. We hereby present our experience of totally endoscopic aortic valve replacement (TEAVR) with conventional mechanical and biological prostheses. Methods Since January 2019, fifty-two consecutive patients with significant aortic stenosis and/or aortic regurgitation, who were operated with TEAVR with conventional prostheses were studied. 7,69% of the cases were REDOs. The prostheses used were either stented bovine pericardial in 84,6% of the patients and bileaflet mechanical in 15,4%. The operations were performed through a 3 to 4 cm working incision in the 3rd intercostal space (ICS) right parasternally (where an extra small soft tissue protector was deployed), a 10 mm port for the 3D, 30°, endoscope, and a 5 mm port for the left atrial vent. On full cardiopulmonary bypass, the heart was arrested with cardioplegia which was administered either in the aortic root or directly in the coronary ostia. A transverse aortotomy was performed 3 cm above the right coronary ostium. The native valve (tricuspid or bicuspid) was excised, the annulus was sized and the prostheses were inserted using twelve to fifteen annular sutures who were secured using an automated suture-Fastening Device. In order to facilitate exposure in the aortic root, a metal self-expandable net was used. Results The average age of the patients treated was 68,3 years (range 36–81, median 72). The mean EuroSCORE2 was 3,22 (0,9–12,01, SEM:0,71). The mean size of the prostheses inserted was 23,72 mm (21–27, median 23) and the mean postoperative peak gradient was 12,15 (5–19, SEM: 1,00). Mean cross clamp and CPB times were 75,38 min (SEM:5,87) and 116,30 (SEM:8,63). There was no case of paravalvular leak or pacemaker insertion. There was no mortality in this cohort of patients. There was one case of cerebrovascular accident. Conclusions TEAVR can be performed safely with conventional aortic prostheses. There are several advantages of the technique over the other aortic valve replacing approaches. Over the other surgical techniques has the advantage of not fracturing the sternum or spreading or dislodging the ribs and increased patient satisfaction. Over the TAVI has the advantages of fully removing the diseased native valve, securing the prosthesis at the exact annular level without any paravalvular leaks or need for pacemaker insertion and the ability of using mechanical prostheses. The main disadvantages of the technique are the relatively prolonged cross clamp and CPB times and the steep learning curve. TEAVR Funding Acknowledgement Type of funding source: None
Bruno Egnerwalter - One of the best experts on this subject based on the ideXlab platform.
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wiper function unit Fastening Device for e g road vehicle has protective cover that is designed for screwless clamping of wiper function unit and or connection piece where protective cover is pivotably arranged at connection piece
2007Co-Authors: Michael Schaeuble, Bruno EgnerwalterAbstract:The Device has a connection piece (8) comprising a receiving opening (11) for a wiper shaft and fastened to the wiper shaft using a protective cover (18). The connection piece is partially covered by the protective cover (18). The protective cover is designed for a screwless clamping of a wiper function unit and/or the connection piece, where the cover is arranged at the connection piece in a pivotable manner. The protective cover is made from metal or metal alloy.