Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jul 2013
Case ReportsTherapeutic hypothermia for severe cerebral air embolism complicating pleural lavage for empyema.
Cerebral air embolism during pleural lavage is a rare, but potentially fatal complication. We present a case of severe cerebral air embolism that developed during pleural lavage for empyema and was successfully treated by therapeutic hypothermia. ⋯ Cranial computed tomography and cranial magnetic resonance imaging showed many small bubbles and widespread infarction in the territory of the right middle cerebral artery. The patient received therapeutic hypothermia maintained at 33°C for 24 h and could leave the hospital without delayed sequelae.
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Interact Cardiovasc Thorac Surg · Jul 2013
Case ReportsRecurrent upper limb ischaemia due to a crutch-induced brachial artery aneurysm.
An 83-year old man who had used bilateral axillary crutches for 67 years was referred to our hospital for acute left upper limb ischaemia. He underwent successful recanalization through emergent catheter thromboembolectomy. ⋯ Therefore, we performed aneurysm exclusion and subsequent saphenous vein bypass grafting. When a crutch user presents with upper limb ischaemia, a high index of suspicion and early identification of the crutch induced vascular injury are mandatory for appropriate treatment.
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Interact Cardiovasc Thorac Surg · Jul 2013
Case ReportsPartial sternotomy coronary surgery with triple-vessel disease in dextrocardia and situs inversus totalis.
Dextrocardia associated with situs inversus totalis is a rare congenital condition. A small number of cases with these conditions have been reported who underwent myocardial revascularization via the on-pump or off-pump techniques. ⋯ We describe the case of a 65-year old female patient with triple-vessel obstructive coronary diseases who was successfully revascularized with three grafts using a minimally invasive technique. This was achieved via partial sternotomy and employing off-pump coronary artery bypass grafting.
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Interact Cardiovasc Thorac Surg · Jul 2013
Self-expandable transcatheter aortic valve implantation for aortic stenosis after mitral valve surgery.
Transcatheter aortic valve implantation has emerged as a valuable option to treat patients with symptomatic severe aortic stenosis, who are not being considered for surgery because of significant comorbidities. Concerns exist over treating patients who have previously undergone mitral valve surgery for possible interference between the percutaneous aortic valve and the mitral prosthesis or ring. ⋯ Our experience confirms the feasibility of CoreValve implantation in patients with mechanical mitral valves or mitral annuloplasty ring.