Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2011
Cardiac displacement during off-pump coronary artery bypass grafting surgery: effect on sublingual microcirculation and cerebral oxygenation.
Cardiac displacement during off-pump coronary artery bypass (OPCAB) surgery causes a fall in cardiac output. Here, we investigate how this drop in systemic perfusion is transferred to the oxygenation of sublingual and cerebral tissue. Sublingual microcirculatory perfusion or microcirculatory hemoglobin oxygen saturation (μHbSO(2)) measurements were performed using sidestream dark-field imaging and reflectance spectrophotometry, respectively (both n = 12). ⋯ After repositioning of the heart, all the values returned to baseline. Our data suggest that systemic hemodynamic alterations during cardiac displacement in OPCAB surgery reduce sublingual and cerebral tissue oxygenation. These findings are particularly important for patients at risk for the consequences of cerebral ischemia.
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Interact Cardiovasc Thorac Surg · Dec 2011
Case ReportsSuccessful conservative management of blunt right ventricular rupture in a patient with prior cardiac surgery.
Blunt cardiac trauma is one of the leading causes of death on site in motor vehicle accidents and frequently requires an emergent surgical intervention if the patient reaches the hospital. We experienced a rare case of blunt right ventricular disruption that was successfully managed by conservative therapy without surgery.
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Interact Cardiovasc Thorac Surg · Dec 2011
Case ReportsAortic valve regurgitation with aorto-right ventricular fistula following penetrating cardiac injury.
Aortic valve perforation due to a penetrating cardiac injury is extremely rare, especially with an associated shunt between the right ventricle and the aortic valve. We report here the case of an 18-year-old male, who after suffering a chest stab injury, was seen at another institution where he underwent an emergency left anterolateral thoracotomy and right ventricular suture. ⋯ Workup confirmed the presence of an acute aortic regurgitation due to perforation of the right coronary leaflet with an interventricular shunt. After implementing appropriate medical treatment, the valve was replaced with a mechanical prosthesis and the shunt was closed with an autologous pericardial patch.
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Interact Cardiovasc Thorac Surg · Dec 2011
Preliminary experience in the use of an extracellular matrix to repair congenital heart diseases.
Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain the maximum potential for growth. The quest for the ideal material for cardiac tissue repair is still ongoing. Here, we describe our preliminary experience with an extracellular matrix for cardiac and vascular tissue repair. ⋯ In the last 25 months, we used an extracellular matrix for cardiac and vascular tissue repair. The patch is advocated to induce the patient's own tissue regeneration. The early results are encouraging, but a longer follow-up is needed to understand the real potential of this material.