Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jun 2013
Case ReportsSuccessful simultaneous repair of traumatic aortic and right atrium ruptures.
A 63-year old woman was transferred to our hospital due to a motor vehicle accident. Enhanced computed tomography showed aortic arch intramural haematoma and pericardial effusion. The patient lost consciousness, and we thought that the cardiac tamponade was indeed due to intrapericardial rupture of the aorta. ⋯ Next, total arch replacement with a four-branched knitted prosthetic graft was performed. Over two-thirds of the intima was circumferentially ruptured at the level of the aortic isthmus. Postoperative neurological complications did not arise.
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Interact Cardiovasc Thorac Surg · Jun 2013
Comparative StudySternal closure after median sternotomy: a new technique using titanium hooks and wires applied parasternally.
Osteosynthetic closure of the chest after median sternotomy is usually performed with steel wires. We describe, for the first time, a case series in which titanium hooks were implanted from the sternal surface in patients who required secondary or additional stabilization. In comparison to the classic wires, the diameters of the hooks are approximately three times bigger and therefore reduce the risk of cutting through the bones. Additionally, there is no need to dissect retrosternal adhesions, which may reduce the risk of injuring mediastinal tissues. ⋯ This sternal closure system using titanium hooks inserted parasternally is an effective alternative to conventional techniques and may increase stability of the breastbone and reduce the risk of injury to retrosternal tissues.
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Interact Cardiovasc Thorac Surg · Jun 2013
Aortic valve reconstruction with autologous pericardium for dialysis patients.
This study aimed to report on original aortic valve reconstruction for patients on dialysis. ⋯ Medium-term results are excellent. Since warfarin for dialysis patients becomes problematic, a postoperative warfarin-free status is desirable. Aortic valve reconstruction can provide patients with a better quality of life without warfarin.
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Interact Cardiovasc Thorac Surg · Jun 2013
Case ReportsStaged repair for aortic arch reconstruction and intracardiac repair following bilateral pulmonary artery banding in 3 critical patients.
Bilateral pulmonary artery banding has been performed as a first palliation for hypoplastic left heart syndrome with a poor preoperative condition. We report 3 patients with aortic arch reconstruction and intracardiac repair following bilateral pulmonary artery banding in moribund patients after birth. ⋯ More than 75% of cerebral oxygenation may provide higher urinary output due to higher renal blood flow through collateral circulation. This technique reduces the risk of perioperative neurological damage.
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Interact Cardiovasc Thorac Surg · Jun 2013
Liberal use of axillary artery cannulation for aortic and complex cardiac surgery.
Axillary artery cannulation for cardiopulmonary bypass has been described previously as a safe and reliable technique, with a low risk of atheroemboli, avoidance of malperfusion in aortic dissection and facilitation of selective antegrade cerebral perfusion during hypothermic circulatory arrest. The aim of this study was to document the broad applicability of axillary cannulation and its associated morbidity and identify where it was not possible to use planned axillary cannulation. ⋯ Axillary artery cannulation is an ideal arterial inflow site in cases where the ascending aorta is unsuitable as it is safe, reliable and reduces the risks of atheroembolization and malperfusion. Major complications are rare with this meticulous technique and it is our standard practice in complex cardiac and aortic surgery.