Longitudinal outcomes following international multicentre experience with robotic aortic valve replacement†.

Objectives: In an effort to maintain the technical aspects of traditional prosthetic surgical aortic valve replacement (AVR) while reducing invasiveness and facilitate options for concomitant operations, transaxillary lateral mini-thoracotomy endoscopic robotic-assisted aortic valve replacement (RAVR) has been introduced. The present data highlight the contemporary international collaborative experience.

Methods: All consecutive patients undergoing standardized RAVR across 10 international sites (1/2020-7/2024) were evaluated using a central database with 1 year follow-up.

Systematic review and meta-analysis of two decades of reported outcomes for robotic coronary artery bypass grafting.

Background: Despite the well-documented safety and feasibility of robotic coronary artery bypass grafting (CABG), widespread adoption of this approach remains limited by its steep learning curve, high procedural costs and paucity of data on longer-term efficacy. This current meta-analysis aims to provide a systematic overview of the outcomes of robot-assisted CABG, with a focus on long term graft patency and freedom from major adverse cardiac and cerebrovascular events (MACCE).

Methods: A systematic literature search of three electronic databases was conducted for studies reporting outcomes of robotic-assisted CABG, and were grouped based on whether patients underwent robot-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB), totally endoscopic coronary artery bypass (TECAB) or were mixed.

del Nido versus blood cardioplegia in adult cardiac surgery: a meta-analysis.

Aims: Initially developed for myocardial protection in immature cardiomyocytes, del Nido cardioplegia has been increasingly used over the past decade in adult patients. Our aim is to analyse the results from randomized controlled trials and observational studies comparing early mortality and postoperative troponin release in patients who underwent cardiac surgery using del Nido solution and blood cardioplegia.

Methods: A literature search was performed through three online databases between January 2010 and August 2022.

The perioperative outcomes of uniportal robotic-assisted thoracic surgeries-a systematic review and meta-analysis of surgical cohort studies and case reports.

Background: Early results have illustrated the multiportal robotic approach to be safe and oncologically efficacious in the treatment of thoracic malignancies. Industry leaders have improved upon the lessons learned during the early multiportal studies and have now come to establish the feasibility of the biportal, and subsequently the uniportal robotic-assisted approach, all in an effort to offer patients equivalent or better outcomes with less surgical trauma. No current, coherent body of evidence currently exists outlining the early-term outcomes of patients undergoing uniportal robotic-assisted thoracic surgery.

The learning curve of the robotic-assisted lobectomy-a systematic review and meta-analysis.

Background: Early studies have illustrated the robotic lobectomy to be safe, oncologically effective, and economically feasible as a therapeutic modality in the treatment of thoracic malignancies. The 'challenging' learning curve seemingly associated with the robotic approach, however, continues to be an often-cited factor to its ongoing uptake, with the overwhelming volume of these surgeries being performed in centers of excellence where extensive experience with minimal access surgery is the norm. An exact quantification of this learning curve challenge, however, has not been made, begging the question of whether this is an outdated assumption, versus fact.

Robotically assisted mitral valve repair-the string, ruler, and bulldog technique.

Robotic mitral valve repair presents its own unique set of challenges. Neochordae implantation is one of the techniques used to achieve adequate repair of the mitral valve. Precise securing of neochordae is vital in achieving a meticulous repair.

Coronary artery bypass surgery for acute coronary syndrome: A network meta-analysis of on-pump cardioplegic arrest, off-pump, and on-pump beating heart strategies.

Background: Coronary artery bypass grafting (CABG) in the setting of an acute coronary syndrome is a high-risk procedure, and the best strategy for myocardial revascularisation remains debated. This study compares the 30-day mortality benefit of on-pump CABG (ONCAB), off-pump CABG (OPCAB), and on-pump beating heart CABG (OnBHCAB) strategies.

Methods: A systematic search of three electronic databases was conducted for studies comparing ONCAB with OPCAB or OnBHCAB in patients with acute coronary syndrome (ACS).

Robotic versus conventional sternotomy mitral valve surgery: a systematic review and meta-analysis.

Background: Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS.

Methods: An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS.

Angiofibromatoid histiosarcoma of the pulmonary artery.

We describe the surgical management of a rare pulmonary angiomatoid fibrous histiosarcoma (AFH). A 62-year-old lady presented with shortness of breath and found to have a large left main pulmonary artery defect that was positron emission tomography-avid. Following discussion in a thoracic multidisciplinary team meeting it was deemed unsafe to biopsy considering its intravascular position.

Minimally-invasive versus transcatheter aortic valve implantation: systematic review with meta-analysis of propensity-matched studies.

Background: Minimally invasive aortic valve replacement (MiAVR) and transcatheter aortic valve implantation (TAVI) provide aortic valve replacement (AVR) by less invasive methods than conventional surgical AVR, by avoiding complete sternotomy. This study directly compares and analyses the available evidence for early outcomes between these two AVR methods.

Methods: Electronic databases were searched from inception until August 2019 for studies comparing MiAVR to TAVI, according to predefined search criteria.

Cytoreductive surgical resection of a rare pulmonary artery intimal sarcoma involving the pulmonary valve and right ventricle: a case report.

Pulmonary artery intimal sarcoma (PAIS) is an extremely rare malignant tumour. It is often misdiagnosed as chronic pulmonary thromboembolism. We describe a complex case in a 70-year-old man with PAIS extending into his right ventricle undergoing salvage cytoreductive surgical resection utilizing bivalirudin for cardiopulmonary bypass anticoagulation due to heparin-induced thrombocytopenia and thrombosis syndrome.

Outcomes of 16,436 patients requiring isolated aortic valve surgery: A statewide cohort study.

Background: Aortic valve surgery (AVS) is the gold standard treatment for symptomatic aortic valve (AV) disease patients. We report the temporal trends in the incidence of patients requiring isolated AVS in an unselected statewide population and their mortality outcomes over 17-years.

Methods: Patients were identified from the New South Wales, Australia, Admitted-Patient-Data-Collection registry between 1-July-2001 and 31-December-2018.

Aortic valve replacement using stented or sutureless/rapid deployment prosthesis via either full-sternotomy or a minimally invasive approach: a network meta-analysis.

Background: New technologies such as sutureless or rapid deployment prosthetic valves and access via minimally invasive incisions offer alternatives to traditional full-sternotomy aortic valve replacement (SAVR). However, a comprehensive comparison of these surgical techniques along with alternative valve prosthesis has not been completed.

Methods: Electronic databases were searched for studies comparing outcomes for SAVR, minimally invasive AVR (MiAVR), sutureless/rapid-deployment AVR (SuAVR) via full-sternotomy, or minimally invasive SuAVR (MiSuAVR) from their inception until September 2018.

Sutureless and rapid deployment implantation in bicuspid aortic valve: results from the sutureless and rapid-deployment aortic valve replacement international registry.

Background: Benefits of sutureless and rapid deployment (SURD) bioprostheses in bicuspid aortic valves (BAV) are controversial. The aim of this study is to report the outcomes of patients undergoing aortic valve replacement (AVR) for BAV from the Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry (SURD-IR).

Methods: Of the 4,636 patients who received primary isolated SURD-AVR between 2007 and 2018, 191 (4.

Mini-access branch-first total arch replacement and frozen elephant trunk procedure.

Minimally-invasive surgery presents its own unique set of challenges, especially when applied to treatment of aortic arch disease. The key components of mini-access aortic arch surgery include safe circulatory control, adequate organ protection, and meticulous surgical technique. This article describes how to perform branch-first total arch replacement with the frozen elephant trunk (FET) procedure for distal arch aneurysms.

Long-term outcomes of the frozen elephant trunk procedure: a systematic review.

Background: The frozen elephant trunk (FET) procedure remains an increasingly popular approach to address complex multi-segmental aortic pathologies, owing to their ability to promote false lumen thrombosis and reduce the need for second-stage operations. While the short-term outcomes of such procedures have been shown to be acceptable, much less is known regarding long-term outcomes. This systematic review evaluates long-term outcomes of the FET procedure.

Single versus double lung transplantation for fibrotic disease-systematic review.

Background: Lung transplantation has long been the accepted therapy for end-stage pulmonary fibrotic disease. Presently, there is an ongoing debate over whether single or bilateral transplantation is the most appropriate treatment for end-stage disease, with a paucity of high-quality evidence comparing the two approaches head-to-head.

Methods: This review was performed in accordance with PRISMA recommendations and guidance.

Ex-vivo lung perfusion versus standard protocol lung transplantation-mid-term survival and meta-analysis.

Background: While extended criteria lung donation has helped expand the lung donor pool, utilization of lungs from donors of at least one other solid organ is still limited to around 15-30%. Ex-vivo lung perfusion (EVLP) offers the ability to expand the number of useable lung grafts through assessment and reconditioning of explanted lungs, particularly those not initially meeting criteria for transplantation. This meta-analysis aimed to examine the mid- to long-term survival and other short-term outcomes of patients transplanted with EVLP-treated lungs versus standard/cold-storage protocol lungs.