Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2013
Comparative StudyCavopulmonary anastomosis without cardiopulmonary bypass.
There is an increasing trend to perform the bidirectional superior cavopulmonary (Glenn) anastomosis without cardiopulmonary bypass. In this report, we present our results of off-pump bidirectional Glenn operation done without using a venoatrial shunt to decompress the superior vena cava during clamping. [corrected]. ⋯ Off-pump bidirectional Glenn operation without caval decompression is a safe, simple and more economic procedure.
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Interact Cardiovasc Thorac Surg · May 2013
Case ReportsHybrid treatment of a dislocated atrial septal occluder device at the bifurcation of the left and right common iliac artery.
Percutaneous closure of secundum atrial septal defects (ASDs) with atrial septal occluders (ASOs) avoids sternotomy and cardiopulmonary bypass, and thus is commonly preferred to open heart surgery. However, rare reports of dislocation of the ASO into the systemic circulation do exist. We report the use of an emergent hybrid procedure in the dislocation of an ASO at the bifurcation of the left and right common iliac artery. The dislocation was diagnosed 7 days after percutaneous closure of an ASD.
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Interact Cardiovasc Thorac Surg · May 2013
Wound complications after median sternotomy: a single-centre study.
Sternal wound complications following median sternotomy remain a challenge in cardiac surgery. Changes in both patient profile and type of operations have been observed in recent years. Therefore, we analysed current wound healing complications after median sternotomy at our centre. ⋯ Wound complications following median sternotomy remain a challenge to cardiac surgery. Redo and emergency operations are the most important risk factors in this contemporary series. More efforts seem mandatory to decrease this arduous morbidity and the costs of prolonged treatment.
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Interact Cardiovasc Thorac Surg · May 2013
Simplified model for end-stage liver disease score predicts mortality for tricuspid valve surgery.
The model for end-stage liver disease score (MELD = 3.8*LN[total bilirubin] + 9.6*LN[creatinine] + 11.2*[PT-INR] + 6.4) predicts mortality for tricuspid valve surgery. However, the MELD is problematic in patients undergoing warfarin therapy, as warfarin affects the international normalized ratio (INR). This study aimed to determine whether a simplified MELD score that does not require the INR for calculation could predict mortality for patients undergoing tricuspid valve surgery. Simplified MELD score = 3.8*LN[total bilirubin] + 9.6*LN[creatinine] + 6.4. ⋯ The simplified MELD score predicts mortality in patients undergoing tricuspid valve surgery. This model requires only total bilirubin and creatinine and is therefore applicable in patients undergoing warfarin therapy.
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Interact Cardiovasc Thorac Surg · May 2013
Case ReportsTwo-patch repair of a bicuspid aortic valve with vegetation on its raphe.
We report the successful repair of a bicuspid aortic valve with vegetation on its thickened raphe by using two pericardial patches. After excising the vegetation and thickened raphe, the first patch was sewn between the remaining leaflets. Another patch was then sewn at the base of the cusp to create sufficient geometrical height for good coaptation. Our two-patch technique may facilitate intraoperative accommodation of the 3-D shape of the new cusp.