Interactive cardiovascular and thoracic surgery
-
Interact Cardiovasc Thorac Surg · Oct 2017
Review Case ReportsRapid resolution of Ortner's syndrome with giant left atrium after double-valve replacement surgery.
Hoarseness of voice due to recurrent laryngeal nerve palsy is an uncommon manifestation of cardiothoracic disease. Ortner's syndrome is hoarseness attributed to mechanical compression of the left recurrent laryngeal nerve in association with several cardiopulmonary disease states. We here describe a rare case of Ortner's syndrome developing in a 60-year-old woman with a giant left atrium in the context of rheumatic mitral valve stenosis. The remarkable resolution of her voice hoarseness within 1 week of valve replacement surgery has not been reported in similar cases to date.
-
Interact Cardiovasc Thorac Surg · Oct 2017
Use of an intraoperative checklist to decrease the incidence of re-exploration for postoperative bleeding after cardiac surgery.
We have implemented an intraoperative checklist aiming to reduce the incidence of re-exploration for bleeding after cardiac surgery. The present report addresses the results of adopting such a checklist regarding the incidence of postoperative bleeding. ⋯ An intraoperative checklist is feasible to implement, low cost, quick and simple to measure with a significant reduction in the incidence of re-exploration for bleeding. This report shows an example of the positive effects of transparency in publishing outcomes' data in cardiac surgery.
-
Interact Cardiovasc Thorac Surg · Oct 2017
First results of HeartWare left ventricular assist device implantation with tunnelling of the outflow graft through the transverse sinus.
The number of left ventricular assist device (LVAD) implants for the treatment of advanced heart failure is increasing tremendously. The main therapeutic goal of this operation is to provide a bridge to transplant for patients awaiting a donor heart. In 2011, we developed a novel, minimally invasive surgical technique for LVAD implantation. To avoid possible outflow graft injuries during redo sternotomies as well as to provide a more physiological outflow towards the aortic arch, a further modification of this approach was made with outflow graft tunnelling through the transverse sinus. ⋯ LVAD implantation with outflow graft tunnelling through the transverse sinus is an innovative technique to prevent outflow graft damage in case of cardiac resternotomy. The results of this study show that there are no significant differences in pump speed or flow, adverse events or patient outcomes compared with the standard implant techniques. The theoretical benefits of this novel technique are the reduced risk in redo cases and the physiological direction of blood flow. Consequently, this procedure might be particularly suitable for younger patients who received an LVAD as a bridge-to-transplant option.
-
Interact Cardiovasc Thorac Surg · Oct 2017
Trans-right axillary aortic valve replacement: propensity-matched comparison with standard sternotomy approach.
We developed trans-right axillary aortic valve replacement (TAX-AVR) as a more cosmetically superior approach to minimally invasive AVR. We herein retrospectively compared the safety and invasiveness between TAX-AVR and conventional AVR (C-AVR). ⋯ TAX-AVR is as safe as C-AVR and less invasive in terms of a shorter recovery period.
-
Interact Cardiovasc Thorac Surg · Oct 2017
Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients over 85 years old.
Surgical aortic valve replacement (SAVR) for the treatment of in very old patients with severe aortic stenosis is associated with a high risk of morbidity and mortality. Transcatheter aortic valve implantation (TAVI) has become the preferred alternative. Therefore, we sought to evaluate outcomes in very old patients who underwent SAVR versus TAVI. ⋯ In patients 85 years and older, SAVR seems to offer good short- and mid-term clinical outcomes compared to TAVI. Advanced age alone would not be an indication for TAVI in old-old patients.