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Article ; Online: David V procedure and hemiarch replacement in a patient with Loeys-Dietz-Syndrome and beta thalassemia minor: a case report.

Kainz, Frieda-Maria / Freystaetter, Kathrin / Podesser, Bruno K / Holzinger, Christoph

2023 Volume 18, Issue 1, Page(s) 253

Abstract: We report the case of a 36-year-old European female patient presenting with a sinus valsalva aneurysm of 47 mm with moderate aortic regurgitation. Additionally, an aneurysm of the brachiocephalic trunk and multiple aneurysms of the right internal mammary ...

Abstract	We report the case of a 36-year-old European female patient presenting with a sinus valsalva aneurysm of 47 mm with moderate aortic regurgitation. Additionally, an aneurysm of the brachiocephalic trunk and multiple aneurysms of the right internal mammary artery were identified. Previous medical history included Loeys-Dietz syndrome (LDS) Type RII due to a TGF-beta receptor mutation, and beta thalassemia minor with a baseline hemoglobin of 9,3 g/dL on admission.Reconstruction of the aortic root and hemiarch replacement was performed in circulatory arrest under moderate hypothermia. During surgery, hypothermia was required as part of the cerebral protection strategy. We aim to highlight special considerations and discuss the effects of cooling, rewarming and the use of cardiopulmonary bypass (CPB) during extensive surgery in a patient with LDS and beta thalassemia minor.
MeSH term(s)	Humans ; Female ; Adult ; Loeys-Dietz Syndrome/complications ; Loeys-Dietz Syndrome/surgery ; beta-Thalassemia/complications ; Hypothermia ; Aorta ; Aortic Valve Insufficiency
Language	English
Publishing date	2023-08-27
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2227224-0
ISSN	1749-8090 ; 1749-8090
ISSN (online)	1749-8090
ISSN	1749-8090
DOI	10.1186/s13019-023-02347-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Replacement of a Stenotic Quadricuspid Aortic Valve With a Sutureless Prosthesis.

Freystaetter, Kathrin / Özalp, Faruk

The Annals of thoracic surgery

2018 Volume 105, Issue 6, Page(s) e249–e250

Abstract: Quadricuspid aortic valve is a rare occurrence, usually presenting with insufficiency rather than stenosis. We report an aortic valve replacement in a septuagenarian with a stenotic quadricuspid aortic valve, achieving a good result with a Perceval ( ... ...

Abstract	Quadricuspid aortic valve is a rare occurrence, usually presenting with insufficiency rather than stenosis. We report an aortic valve replacement in a septuagenarian with a stenotic quadricuspid aortic valve, achieving a good result with a Perceval (Sorin Biomedica Cardio Srl, Sallugia, Italy) sutureless bioprosthesis. We emphasize the particular technique of implantation and possible pitfalls. Sutureless bioprosthetic valves present a feasible option for aortic valve replacement in patients with uncommon valve morphologies, aiming to reduce operative time.
MeSH term(s)	Aged ; Aortic Valve/abnormalities ; Aortic Valve/surgery ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/surgery ; Female ; Heart Defects, Congenital/surgery ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/methods ; Humans ; Prosthesis Design
Language	English
Publishing date	2018-01-31
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2017.12.027
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Article: Surgeon-Powered Robotics in Thoracic Surgery; An Era of Surgical Innovation and Its Benefits for the Patient and Beyond.

Trevis, Jason / Chilvers, Nicholas / Freystaetter, Kathrin / Dunning, Joel

Frontiers in surgery

2020 Volume 7, Page(s) 589565

Abstract: Following its introduction in 1992, the growth of minimally invasive thoracic surgery was initially hampered by the lack of specialized instruments, impeded visualization and stapling. However, in subsequent years these challenges were somewhat overcome ... ...

Abstract	Following its introduction in 1992, the growth of minimally invasive thoracic surgery was initially hampered by the lack of specialized instruments, impeded visualization and stapling. However, in subsequent years these challenges were somewhat overcome and video-assisted thoracoscopic surgery (VATS) became the preferred modality of many centers. More recently, robotic surgery has come to the fore. Whilst it offers outstanding precision via robotic wristed instruments, robotic surgery is expensive and has safety implications as the surgeon is away from the patient's side. Wristed VATS instruments offer a new, exciting alternative. By placing the robotic-like wristed instruments in the hands of the surgeon, a concept we call surgeon-powered robotics, the benefits of robotic surgery can be achieved by the patient's side. We describe our experience of the ArtiSential® wristed instruments and discuss the benefits and challenges of this technology. By combining wristed instruments with the latest surgeon-controlled 3D camera technology, surgeon-powered robotics is an affordable reality.
Language	English
Publishing date	2020-11-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2020.589565
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Article ; Online: Do older surgeons have safer hands? A retrospective cohort study.

Rizzo, Victoria / Caruana, Edward J / Freystaetter, Kathrin / Parry, Gareth / Clark, Stephen C

Journal of cardiothoracic surgery

2022 Volume 17, Issue 1, Page(s) 223

Abstract: Background: For complex surgical procedures a volume-outcome relationship can often be demonstrated implicating multiple factors at a unit and surgeon specific level. This study aims to investigate this phenomenon in lung transplantation over a 30-year ... ...

Abstract	Background: For complex surgical procedures a volume-outcome relationship can often be demonstrated implicating multiple factors at a unit and surgeon specific level. This study aims to investigate this phenomenon in lung transplantation over a 30-year period with particular reference to surgeon age and experience, cumulative unit activity and time/day of transplant. Methods: Prospective databases identified adult patients undergoing isolated lung transplantation at a single UK centre between June 1987 and October 2017. Mortality data was acquired from NHS Spine. Individual surgeon demographics were obtained from the General Medical Council. Student t-test, Pearson's Chi-squared, Logistic Regression, and Kaplan-Meier Survival analyses were performed using Analyse-it package for MicrosoftExcel and STATA/IC. Results: 954 transplants (55.9% male, age 44.4 ± 13.8 years, 67.9% bilateral lung) were performed, with a median survival to follow-up of 4.37 years. There was no difference in survival by recipient gender (p = 0.661), between individual surgeons (p = 0.224), or between weekday/weekend procedures (p = 0.327). Increasing centre experience with lung transplantation (OR1.001, 95%CI: 1.000-1.001, p = 0.03) and successive calendar years (OR1.028, 95%CI: 1.005-1.052, p = 0.017) was associated with improved 5-year survival. Advancing surgeon age at the time of transplant (mean, 48.8 ± 6.6 years) was associated with improved 30-day survival (OR1.062, 95%CI: 1.019 to1.106, p = 0.003), which persisted 5 years post-transplant (OR1.043, 95%CI: 1.014-1.073, p = 0.003). Individual surgeon experience, measured by the number of previous lung transplants performed, showed a trend towards improved outcomes at 30 days (p = 0.0413) with no difference in 5-year survival (p = 0.192). Conclusions: Our study demonstrates a relationship between unit volume, increasing surgeon age and survival after lung transplantation. A transplant volume: outcome relationship was not seen for individual surgeons.
MeSH term(s)	Adult ; Female ; Humans ; Kaplan-Meier Estimate ; Lung ; Lung Transplantation ; Male ; Middle Aged ; Retrospective Studies ; Surgeons ; Treatment Outcome
Language	English
Publishing date	2022-09-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2227224-0
ISSN	1749-8090 ; 1749-8090
ISSN (online)	1749-8090
ISSN	1749-8090
DOI	10.1186/s13019-022-01943-2
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Article ; Online: Battle of the sexes.

Freystaetter, Kathrin / Vidanapathirana, Puwalani / Kenny, Louise

The Journal of thoracic and cardiovascular surgery

2019 Volume 157, Issue 6, Page(s) e393

MeSH term(s)	Operating Rooms
Language	English
Publishing date	2019-02-25
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2019.01.061
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Article ; Online: Radical Surgery for Recurrent Pulmonary Artery Sarcoma With 4-Year Survival.

Freystaetter, Kathrin / Ismailbaev, Alisher / Simonyan, Ashot / Chernyavskiy, Stanislav / Goodwin, Andrew / Komarov, Roman

The Annals of thoracic surgery

2021 Volume 113, Issue 5, Page(s) e331–e334

Abstract: Primary pulmonary artery sarcoma is a rare disease with poor prognosis. Radical resection provides the best curative chances. Our 60-year old male patient underwent pulmonary artery sarcoma excision with pericardial patch repair of the main pulmonary ... ...

Abstract	Primary pulmonary artery sarcoma is a rare disease with poor prognosis. Radical resection provides the best curative chances. Our 60-year old male patient underwent pulmonary artery sarcoma excision with pericardial patch repair of the main pulmonary artery in 2017, but required reoperation in 2019 due to recurrence. Total pulmonary artery bifurcation replacement was performed using a handmade 2-limbed bovine pericardial tube graft. This technique is safe and reproducible, and may offer a valuable alternative surgical strategy for this patient cohort. Our patient is still alive 4 years after initial presentation.
MeSH term(s)	Animals ; Cattle ; Humans ; Lung Neoplasms ; Male ; Middle Aged ; Neoplasms, Vascular Tissue ; Pulmonary Artery/diagnostic imaging ; Pulmonary Artery/surgery ; Sarcoma/surgery ; Vascular Neoplasms/surgery
Language	English
Publishing date	2021-07-17
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2021.06.040
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Zs.A 252: Show issues

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Article ; Online: Accelerated acute severe antibody-mediated graft failure related to a Ross procedure 17 years earlier.

Andreas, Martin / Freystaetter, Kathrin / Bernardi, Martin H / Zuckermann, Andreas

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2018 Volume 54, Issue 2, Page(s) 402–403

Abstract: A 31-year-old male patient underwent a heart transplantation due to dilated cardiomyopathy. He experienced accelerated acute antibody-mediated rejection despite being negative for human leukocyte antigen antibodies (0% panel-reactive antibodies prior to ... ...

Abstract	A 31-year-old male patient underwent a heart transplantation due to dilated cardiomyopathy. He experienced accelerated acute antibody-mediated rejection despite being negative for human leukocyte antigen antibodies (0% panel-reactive antibodies prior to surgery). Further assessment revealed a common antigen between a homograft implanted 17 years earlier during the Ross procedure and the heart donor. The homograft likely induced specific antibody formation. Interestingly, panel-reactive antibody levels measured 7 years prior to transplantation were 7%. Because of the long time span between the Ross procedure and heart transplantation, no circulating antibodies could be detected in 2015, but reactivation of memory cells might potentially have led to this fulminant rejection episode. For future cases, particular attention should be given to patients with homografts.
MeSH term(s)	Adult ; Antibodies ; Cardiomyopathy, Dilated/surgery ; Graft Rejection/immunology ; HLA Antigens/immunology ; Heart Transplantation/adverse effects ; Humans ; Immunosuppression ; Male ; Transplants/immunology
Chemical Substances	Antibodies ; HLA Antigens
Language	English
Publishing date	2018-04-14
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezy052
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Zs.A 2303: Show issues

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Article: The Importance of Culture Change Associated With Novel Surgical Approaches and Innovation: Does Perioperative Care Transcend Technical Considerations for Pulmonary Lobectomy?

Freystaetter, Kathrin / Waterhouse, Benjamin R / Chilvers, Nicholas / Trevis, Jason / Ferguson, Jonathan / Paul, Ian / Dunning, Joel

Frontiers in surgery

2021 Volume 8, Page(s) 597410

Abstract: Robotic thoracic surgery for pulmonary lobectomy was introduced at our unit in 2015, along with enhanced perioperative patient care pathways. We evaluated the effect of this practice change on short-term outcomes. Data on all adult patients who underwent ...

Abstract	Robotic thoracic surgery for pulmonary lobectomy was introduced at our unit in 2015, along with enhanced perioperative patient care pathways. We evaluated the effect of this practice change on short-term outcomes. Data on all adult patients who underwent a lobectomy in our unit between 2015 and 2019 were obtained retrospectively from our surgical database. Patients fell into three groups: conventional open surgery via thoracotomy, video-assisted thoracoscopic surgery (VATS), and robot-assisted thoracoscopic surgery (RATS). Survival was defined as survival to discharge. Our cohort included 722 patients. Three hundred and ninety-two patients (54.3%) underwent an open operation, 259 patients (35.9%) underwent VATS surgery, and 71 patients (9.8%) underwent a robotic procedure. Comparing these surgical approaches, there was no statistically significant difference in the overall incidence of post-operative complications (
Language	English
Publishing date	2021-05-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2021.597410
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Article ; Online: Dissecting the Management and Outcomes of Thoracic Aortovascular Disease During the COVID-19 Pandemic.

McPherson, Iain / Chilvers, Nicholas / Freystaetter, Kathrin / Sivaharan, Ashwin / Kanani, Mazyar / Williams, Robin / McCaslin, James / Nandhra, Sandip / Booth, Karen

Annals of vascular surgery

2021 Volume 75, Page(s) 120–127

Abstract: Objective: The COVID-19 pandemic has forced the cancellation of planned surgery and led to significant surgical service reductions. Early intervention in aortovascular disease is often critical and cannot be deferred despite these reductions. There is ... ...

Abstract	Objective: The COVID-19 pandemic has forced the cancellation of planned surgery and led to significant surgical service reductions. Early intervention in aortovascular disease is often critical and cannot be deferred despite these reductions. There is urgent need to evaluate the provision and outcomes of thoracic aortovascular intervention during the peak of the pandemic. Methods: Prospective data was collected for patients receiving open and endovascular thoracic aortovascular intervention over two-time points; January-May 2020 and January-May 2019 at three tertiary cardiovascular centres. Baseline demographics, cardiovascular risk and COVID-19 screening results were noted. Primary outcomes were median length of intensive care unit and hospital stay, intra-operative mortality, 30-day mortality, post-operative stroke, and spinal cord injury. Results: Patients operated in 2020 (41) had significantly higher median EuroSCORE II than 2019 (53) (7.44 vs. 5.86, P = 0.032) and rates of previous cardiac (19.5% vs. 3.8%, P = 0.019), aortic (14.6% vs. 1.9%, P = 0.041), and endovascular (22.0% vs. 3.8%, P = 0.009) intervention. There was an increase in proportion of urgent cases in 2020 (31.7% vs. 18.9%). There were no intra-operative deaths in 2020 and 1 in 2019 (P = 1.00). There were no significant differences (P ≥ 0.05) in 30-day mortality (4.9% vs. 13.2%), median intensive care unit length of stay (72 vs. 70 hr), median hospital length of stay (8 vs. 9 days), post-operative stroke (3 vs. 6), or spinal cord injury (2 vs. 1) between 2020 and 2019 respectively. Conclusions: Despite the increased mortality risk of patients and urgency of cases during COVID-19, complicated by the introduction of cohorting and screening regimens, thoracic aortovascular intervention remained safe with comparable in outcomes to pre-COVID-19.
MeSH term(s)	Aged ; Aged, 80 and over ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/surgery ; Aortic Diseases/diagnostic imaging ; Aortic Diseases/mortality ; Aortic Diseases/surgery ; COVID-19/diagnosis ; COVID-19/mortality ; COVID-19/prevention & control ; COVID-19/transmission ; COVID-19 Testing ; Databases, Factual ; England ; Female ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Middle Aged ; Patient Safety ; Postoperative Complications/etiology ; Prospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Vascular Surgical Procedures/adverse effects ; Vascular Surgical Procedures/mortality
Language	English
Publishing date	2021-04-24
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2021.04.008
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Zs.A 2882: Show issues

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Article ; Online: Training cardiothoracic surgeons of the future: The UK experience.

Kenny, Louise / Booth, Karen / Freystaetter, Kathrin / Wood, Greta / Reynolds, Gary / Rathinam, Sridhar / Moorjani, Narain

The Journal of thoracic and cardiovascular surgery

2018 Volume 155, Issue 6, Page(s) 2526–2538.e2

Abstract: Objective: The study aimed to assess targeted simulation courses, including live animal operating, as complementary training tools with regard to 2 key surgical skills in early cardiothoracic surgeon training.: Methods: Twenty UK surgical trainees ( ... ...

Abstract	Objective: The study aimed to assess targeted simulation courses, including live animal operating, as complementary training tools with regard to 2 key surgical skills in early cardiothoracic surgeon training. Methods: Twenty UK surgical trainees (equivalent to cardiothoracic surgery resident physicians in the United States) in their first year of residency training were evaluated. Assessment of skills in pulmonary wedge resection and cardiopulmonary bypass were undertaken before and after 2 boot camp-style courses, including live animal operating (boot camp 1 and boot camp 2). Resident performance was evaluated by surgical trainers using objective structured assessment of technical skills matrices. Trainers completed a survey on skill development and trainer confidence in the trainee precourse and postcourse. Results: Trainee assessment scores pre- and postcourses were analyzed using a 2-tailed Wilcoxon signed-rank test demonstrating a significant improvement in trainee performance in boot camp 1 in performing cardiopulmonary bypass (median score, 21 precourse and 28 postcourse; P = .001) and pulmonary wedge resection (median score, 25 precourse and 32 postcourse; P = .012), and in boot camp 2, in performing cardiopulmonary bypass (median score, 28 precourse and 30.5 postcourse; P = .018) and pulmonary wedge resection (median score, 31.5 precourse and 37 postcourse; P = .018). Trainers reported increased confidence and decision-making competency of residents and increased confidence of trainers to allow more participation in management. It was found that 83.3% of trainers would support trainee attendance in subsequent years. Conclusions: Live animal operating as a component of targeted cardiothoracic surgery skill training courses significantly improves technical skills, builds confidence of surgical trainers in resident physicians' practice, and should be supported by the surgery community.
MeSH term(s)	Animals ; Cardiac Surgical Procedures/education ; Clinical Competence ; Education, Medical, Graduate/methods ; Educational Measurement ; Humans ; Internship and Residency ; Models, Animal ; Surgeons/education ; Thoracic Surgery/education ; United Kingdom
Language	English
Publishing date	2018-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2018.01.088
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