Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Sep 2011
Case ReportsTotal cricoidectomy and laryngotracheal reconstruction for subglottic stenosis with glottic involvement.
We present a case of subglottic stenosis involving the glottis with inflammatory destruction of the cricoid cartilage after prolonged endotracheal intubation. Total cricoidectomy and laryngotracheal anastomosis were performed with T-tube placement that was retained for five months postoperatively. ⋯ Good respiratory and phonatory results were obtained during normal daily activity, although a slightly hoarse voice was present, but no aspiration was observed. Total cricoidectomy and laryngotracheal reconstruction may be considered suitable for subglottic stenosis with glottic involvement, if accompanied by inflammatory destruction of the cricoid cartilage.
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Interact Cardiovasc Thorac Surg · Sep 2011
Case ReportsA unique nail gun injury to the heart with a delayed presentation.
We describe a 24-year-old construction worker who was unaware that he had been shot by a pneumatic nail gun in the chest during work. After returning home, he felt some palpitations and mild shortness of breath, and in the mirror discovered a non-bleeding pinpoint skin wound in his upper chest. ⋯ Transthoracic echocardiography and chest computed tomography were done, and the patient was transported to the operating room. After the nail had been removed and the mitral valve repaired, the patient was discharged on the fifth postoperative day without any complications.
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Interact Cardiovasc Thorac Surg · Sep 2011
Triclosan-coated sutures for the reduction of sternal wound infections? A retrospective observational analysis.
Sternal wound infections are an infrequent but serious complication of cardiac surgery, leading to a prolonged hospital stay, increased costs and greater morbidity. To prevent bacterial colonisation of the suture material, which disables local mechanisms of wound decontamination, sutures coated with triclosan were developed. The current study set out to evaluate the effectiveness of such sutures against the development of sternal wound infections after cardiac surgery. ⋯ Triclosan-coated sutures therefore showed no advantage in avoiding or reducing sternal wound infections. As the cost of these new materials is higher, the rationale for using these sutures remains to be determined.
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Interact Cardiovasc Thorac Surg · Sep 2011
ReviewIs surgery indicated in patients with stage IIIa lung cancer and mediastinal nodal involvement?
The role of surgery in the treatment of patients with stage IIIa non-small cell lung cancer (NSCLC) and mediastinal node involvement is examined in this best evidence topic according to a structured protocol. A total of 579 papers were identified using the outlined search, 12 of which were deemed to represent the best available evidence. From the data summarized, we conclude that surgery, as part of a multimodality therapeutic approach, offers a survival benefit for patients with resectable N2 NSCLC. ⋯ All studies evaluated reported a better outcome in patients with ypN0 (i.e. postinduction N0 disease). However, surgery should not be denied to patients with ypN1-N2, as there is evidence to demonstrate a significant improvement in survival time in all patients able to undergo surgery after induction chemo-radiotherapy. In conclusion, although some of the evidence available is equivocal regarding the survival benefit of resection for stage IIIa N2 disease, the authors believe surgery should be considered as part of a multimodality therapeutic strategy for patients with advanced nodal disease.
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Interact Cardiovasc Thorac Surg · Sep 2011
Case ReportsEarly stenotic prosthesis failure after implantation of a stentless porcine aortic valve prosthesis.
Stentless biological aortic prostheses are used routinely in aortic valve replacement surgery, offering beneficial hemodynamics compared to stented biological valves of similar size. We report here a rare case of early stenotic prosthesis failure of a RootElan stentless porcine aortic valve prosthesis due to swelling at the bottom of the right coronary cusp of the prosthesis.