Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsIsolated aortic root dilatation following sinotubular junction reduction using prosthetic rings.
'Comprehensive Aortic Root and Valve Reconstruction' technique, which was first introduced in 2005 involves aortic root reduction using prosthetic rings in order to preserve the native aortic sinuses in patients having aortic regurgitation associated with aortic root dilatation. We report a case of isolated aortic sinus aneurysm in a Marfan syndrome patient following the aortic root preserving surgery in the presence of ascending aorta aneurysm and annuloaortic ectasia. Re-operation consisted of aortic sinus resection and replacement with an artificial graft, and coronary reimplantation using a button technique. Close follow-up is essential for patients who underwent aortic root preserving surgery to appropriately manage this kind of complication.
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Interact Cardiovasc Thorac Surg · May 2012
Insertion of paravertebral block catheters intraoperatively to reduce incidence of block failure.
Paravertebral block catheters are a recognized method of regional pain control after a thoractomy. We describe a technique of insertion with the belief that it provides a superior positioning of the paravertebral (extra-pleural) catheter resulting in a better distribution of the local anaesthetic and better pain control.
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsSuccessful thrombolysis of major pulmonary embolism 5 days after lobectomy.
Aggressive intravenous thrombolysis of pulmonary emboli after major thoracic surgery has rarely been reported and is controversial because of an assumed risk of fatal bleeding. We report a 62-year old female who underwent left upper lobectomy. Her postoperative course was complicated with symptomatic pulmonary embolism and on postoperative day 5 she was successfully treated with intravenous thrombolysis using alteplase (Actilyse(®)) without signs of bleeding. She was discharged from the hospital 12 days postoperatively.