Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsSurgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique.
A 50-year-old man was diagnosed with Stanford type A acute aortic dissection with cerebral malperfusion and unconsciousness. This clinical presentation was investigated by computed tomography which revealed a severe type A dissection involving all limb arteries. Successful operative treatment based on the direct arterial cannulation of the real lumen of dissected aorta at the level of Botallo's ligament by Seldinger technique achieves an appropriate perfusion and rapid cooling of the instable patient. To our knowledge this is the first reported case in the literature.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsGiant left coronary ostial aneurysm after modified Bentall procedure in a Marfan patient.
We performed surgical repair of a giant left coronary ostial aneurysm after aortic root replacement using composite valve graft (modified Bentall procedure) in a patient with Marfan syndrome. Aneurysmal formation in the left main stem itself is very rare. ⋯ In aortic root surgeries in Marfan patients, the size of the side hole on the composite graft should be kept relatively small to fit the diameter of the native coronary arteries for prevention of coronary buttons from forming aneurysms at the level of the coronary button anastomosis. In addition, close observation to the coronary button anastomosis is indispensable in postoperative check-up.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsUpper limb ischemia in a patient with Wegener's granulomatosis.
We report a clinical case of a small-vessel vasculitis with ischemia of the left upper limb. ⋯ Classic Wegener's granulomatosis is a form of vasculitis that primarily involves the upper and/or lower respiratory tract and kidney. The amount of clinical symptoms is enormous and the diagnosis, arduous. In the literature there are only a few clinical cases referring to limb ischemia in a setting of Wegener's granulomatosis. This is a unique case report of upper limb ischemia due to involvement of a medium-large size artery in a patient with Wegener's granulomatosis.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsPost-esophagectomy chylous leakage from a duplicated left-sided thoracic duct ligated successfully with left-sided video-assisted thoracoscopic surgery.
Three months after esophagectomy for esophageal cancer, a 58-year-old man presented with fluid trapped in his upper mediastinum due to chylous leakage from a duplicated left-sided thoracic duct that remained after excision of the main thoracic duct. Classical lymphangiography using lipiodol confirmed the presence of duplicated thoracic ducts. ⋯ Anatomic variations of the thoracic duct can result in chylous leakage after thoracic surgery. Even if the patient has anomaly of the thoracic duct, classical lymphangiography is useful for detecting locations of the thoracic duct precisely, allowing for certain ligation of the duct with video-assisted thoracoscopic surgery.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsIsolated absence of the right pulmonary artery as a cause of massive hemoptysis.
Isolated absence of a pulmonary artery is a rare cause of massive hemoptysis. We report a case of unilateral absence of the right pulmonary artery in an adult without any other cardiovascular anomalies. The patient presented massive hemoptysis, which was successfully treated with a right pneumonectomy.