Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2015
Technical and anatomical factors affecting the size of the branch pulmonary arteries following first-stage Norwood palliation for hypoplastic left heart syndrome.
Branch pulmonary artery (BPA) size is one of the factors that influence the efficacy of the Fontan circulation. Central pulmonary artery stenosis and small left pulmonary artery (LPA) are well-known problems following Norwood palliation for hypoplastic left heart syndrome (HLHS). We investigated anatomical and technical factors that may stand behind these problems. ⋯ Of all studied factors, IAR and the size and position of the pulmonary artery bifurcation plays the main role in LPA growth and central BPA stenosis.
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Interact Cardiovasc Thorac Surg · May 2015
Review Case Reports Comparative StudyDoes a skeletonized internal thoracic artery give fewer postoperative complications than a pedicled artery for patients undergoing coronary artery bypass grafting?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Does a skeletonized internal thoracic artery (ITA) give fewer postoperative complications than a pedicled artery for patients undergoing coronary artery bypass grafting?' Altogether, 98 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. Papers about patency of skeletonized versus pedicled internal thoracic artery were excluded. ⋯ The hospital stay was shorter for three studies conducted on this subject. One study about pulmonary function reported a better ratio of pre- versus postoperative values of forced vital capacity. Despite longer operating times, skeletonization leads to fewer wound infections, reduced chest pain, allows a shorter hospital stay and better preserves pulmonary function.
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Interact Cardiovasc Thorac Surg · May 2015
Case ReportsEmergency surgical extraction of rota ablator from the stent in the left anterior descending artery.
Trapping of interventional devices used to treat in-stent restenosis is rarely reported in the literature. Among those is a trapped rota ablation wire causing longitudinal stent deformation, sometime requiring another stent deployment onto the collapse stent. ⋯ During the procedure, the rota ablator got stuck into the stent resulting in haemodynamic compromise. To our knowledge, this is the first case where a rota ablator got stuck into the stent requiring surgical intervention.