Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jan 2010
Case ReportsSpontaneous rupture of an intercostal artery in a patient with neurofibromatosis type 1.
A 48-year-old man with neurofibromatosis type 1 (NF1) presented with a right pleural effusion. A 3D computed tomography (CT) angiogram showed an aneurysm of the right 11th intercostal artery. He had no history of chest trauma so we diagnosed a spontaneous rupture of the aneurysm causing a massive effusion. ⋯ Magnetic resonance imaging (MRI) showed spinal cord compression at the level of the 9th and 10th vertebrae. We evacuated the cellulose and coagulum. The patient's paraplegia improved and within six months he was walking without a crutch.
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Interact Cardiovasc Thorac Surg · Jan 2010
Case ReportsWarm, beating heart aortic valve replacement in a sickle cell patient.
Patients with sickle cell abnormalities undergoing surgery are generally considered to be at greater risk for perioperative complications. We present a 25-year-old woman with sickle cell disease (SCD) and severe aortic insufficiency. A minimally invasive, warm, beating heart approach was adopted to try and minimize the risk of sickling due to cardiopulmonary bypass (CPB), low-flow states, cold cardioplegia and aortic cross-clamping. Compared to classical methods, we believe our technique further reduces the risk of systemic and organ hypothermia and thus, sickling.