Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2013
Case ReportsBlunt traumatic aortic rupture of the proximal ascending aorta repaired by resection and direct anastomosis.
Traumatic aortic injury represents 15% of motor vehicle related deaths with death occurring at the scene in 85% of the cases. Aortic disruptions usually occur at the isthmus in a transverse fashion with all three of the aortic layers being involved. Herein, we report the case of a 68-year old man with no prior medical history who was struck by a vehicle while riding his bicycle. ⋯ The case here discussed demonstrates a rare presentation of blunt aortic injury. The proximal ascending aorta is an unusual site of transection following blunt trauma with few reports in the literature. We were able to repair the aorta with direct suture, thus avoiding the use of artificial material.
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Interact Cardiovasc Thorac Surg · Oct 2013
Analysis of aortic valve commissural fusion after support with continuous-flow left ventricular assist device.
Continuous-flow left ventricular assist devices (cf-LVADs) may induce commissural fusion of the aortic valve leaflets. Factors associated with this occurrence of commissural fusion are unknown. The aim of this study was to examine histological characteristics of cf-LVAD-induced commissural fusion in relation to clinical variables. ⋯ Aortic valve commissural fusion after support with cf-LVADs is a non-inflammatory process leading to changes in valve layer structure that can be observed in >50% of cf-LVAD patients. This is the first study showing that patients receiving full cf-LVAD support without opening of the valve have a significantly higher risk of developing commissural fusion than patients on partial support.
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Interact Cardiovasc Thorac Surg · Oct 2013
Case ReportsMediastinal infectious complication after endobronchial ultrasound-guided transbronchial needle aspiration.
We report here a mediastinal infectious complication after endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) that was successfully treated using intravenous antibiotic therapy. EBUS-TBNA was performed for a 59-year old man with mediastinal adenopathy 8 years after left pneumonectomy for squamous cell carcinoma of the lung. ⋯ The procedure itself was uneventful, but the patient developed a nightly fever after the biopsy. Finally, he was readmitted, and intravenous antibiotic therapy was required for 4 weeks to treat a mediastinal infection after EBUS-TBNA before chemotherapy for small-cell lung cancer.
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Interact Cardiovasc Thorac Surg · Oct 2013
Case ReportsTuberculous ascending aortic pseudoaneurysm.
Pseudoaneurysms of the ascending aorta due to infective organisms are a rare but challenging entity with a risk of high morbidity and mortality. Previous cardiac surgery is an attributing factor, but they can present without previous surgical interventions. Various micro-organisms are responsible for this pathology. ⋯ We report a case of a 25-year old man who presented to us with shortness of breath and recurrent haemoptysis. After preoperative evaluation including clinical and radiological assessment and echocardiography, he underwent successful repair of a pseudoaneurysm of the ascending aorta by excision and replacement of the diseased aorta with a Dacron tube graft using cardiopulmonary bypass. Postoperatively, he was started on antituberculous chemotherapy based on histological findings.