Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Mar 2012
Case ReportsA right-sided aortic arch and aberrant left subclavian artery with proximal segment hypoplasia.
The right-sided thoracic aortic arch is a rare congenital malformation occurring during embryologic development. A majority of the cases present with two anatomic variations, one of which is an aberrant left subclavian artery (LSA) originating off the distal descending aortic arch. ⋯ This thoracic aneurysm is commonly known as Kommerell's diverticulum. This paper presents a case of an aberrant LSA originating off Kommerell's diverticulum with a proximal long-segment hypoplasia, a very rare anatomic variation.
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Interact Cardiovasc Thorac Surg · Mar 2012
Comparative StudyNon-invasive cerebral oxygenation reflects mixed venous oxygen saturation during the varying haemodynamic conditions in patients undergoing transapical transcatheter aortic valve implantation.
Transapical transcatheter aortic valve implantation (TA-TAVI) is increasingly used to treat aortic valve stenosis in high-risk patients. Mixed venous oxygen saturation (SvO(2)) is still the 'gold standard' for the determination of the systemic oxygen delivery to consumption ratio in cardiac surgery patients. Recent data suggest that regional cerebral oxygen saturation (rScO(2)) determined by near-infrared spectroscopy is closely related to SvO(2). ⋯ At all predefined time points correlation was moderate (r(2 )= 0.50) to close (r = 0.84), and the percentage error was <24%. RScO(2) determined by near-infrared spectroscopy is correlated to SvO(2) during varying haemodynamic conditions in patients undergoing TA-TAVI. This suggests that rScO(2) is reflective not only of the cerebral, but also of the systemic oxygen balance.
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Interact Cardiovasc Thorac Surg · Mar 2012
Case ReportsCavitary lung cancer presenting as subcutaneous emphysema on the contralateral side.
Bronchocutaneous fistula is an extremely rare complication of lung cancer and is frequently seen following biopsy or radiotherapy. A 67-year old male patient was administered to our hospital due to sudden onset of shortness of breath and subcutaneous emphysema on the right side. ⋯ The patient was referred for adjuvant therapy to local oncology hospital. He passed away 9 months following diagnosis.
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Interact Cardiovasc Thorac Surg · Mar 2012
Case ReportsDiagnostic enigma: primary pulmonary artery sarcoma.
Primary angiosarcoma of pulmonary artery is a very rare lesion. We present a case of primary angiosarcoma that was initially misdiagnosed as a subacute massive pulmonary thromboembolism in a 30-year-old man. ⋯ Although the incidence of pulmonary artery angiosarcoma is very low, our case demonstrates that this disease entity should be included in the differential diagnosis of pulmonary thromboembolism. Patients with early identification can have curative potential with aggressive surgical intervention.
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Interact Cardiovasc Thorac Surg · Mar 2012
Multicenter Study Comparative StudyPolicies of withholding and withdrawal of life-sustaining treatment in critically ill patients on cardiac intensive care units in Germany: a national survey.
To determine the decision-making process of withholding and/or withdrawal (WH/WD) of life-sustaining treatment in cardiac intensive care units (ICUs) in Germany. ⋯ This survey is a step towards creating standards of end-of-life care in cardiac ICUs, which may contribute to build consensus and avoid conflicts among caregivers, patients and families at each step of the decision-making process.