Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Sep 2012
Comparative StudyThe French airbridge for circulatory support in the Carribean.
We report the assessment and the activities for the first year of our airborne circulatory support mobile unit (CSMU) in the French Caribbean. ⋯ CSMUs can be very efficient in providing support to patients in refractory shock, when remote from a cardiac surgery centre. The airborne transfer of patients on ECMO/ECLS can be achieved safely, even over long distances.
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Interact Cardiovasc Thorac Surg · Aug 2012
Case ReportsEndovascular stenting for type B dissection involving a right-sided aortic arch.
Endovascular stent-graft repair is emerging as the treatment of choice for complicated type B aortic dissection. In this report we describe a patient who presented with type B aortic dissection involving a right-sided aortic arch (RAA), a rare congenital vascular anomaly. ⋯ Given the greater complexity of conventional surgical repair and the limited experience with this rare malformation, endovascular repair was preferred and successfully performed. We report the first case of endovascular repair of type B dissection involving RAA, confirming that endovascular treatment is technically feasible also when the dissection involves this unusual vascular malformation.
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Interact Cardiovasc Thorac Surg · Aug 2012
Case ReportsVenous thoracic outlet syndrome caused by a congenital rib malformation.
Venous thoracic outlet syndrome (VTOS) represents a rare disorder. Hypertrophy of the anterior scalene musculature is the cause of the compression syndrome in most cases. To our knowledge, we describe the first reported case worldwide of a venous compression syndrome caused by a congenital malformation of the 1st and 2nd ribs. Treatment by transaxillary partial rib resection was necessary and a very good postoperative result was achieved.
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Interact Cardiovasc Thorac Surg · Aug 2012
Case ReportsLeft tilt position for easy extracorporeal membrane oxygenation cannula insertion in late pregnancy patients.
The aim was to describe how to avoid technical difficulties during venous femoral cannula insertion for extracorporeal membrane oxygenation (ECMO) in a woman in late pregnancy. A 28-year old pregnant woman presented at 32 weeks of gestation after developing an acute respiratory distress syndrome (ARDS) of an unknown origin that required venovenous ECMO insertion via the femoral vein. ⋯ We proposed a systematic 15°-30° left lateral tilt position during the ECMO femoral cannula insertion in late pregnancy cases needing ECMO. This precaution should avoid an injury to the vessels due to multiple insertion attempts.
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Interact Cardiovasc Thorac Surg · Aug 2012
Case ReportsSpontaneous ascending aortic intramural haematoma in a patient on dabigatran.
A patient on oral anticoagulation with dabigatran presented with chest pain and dyspnoea. A CT scan of the chest revealed an intramural haematoma of the ascending aorta with a large pericardial effusion. The patient underwent a modified Bentall procedure. In the absence of a specific antidote for this novel oral anticoagulant medication, even in an emergency situation, successful surgical treatment was possible with an aggressive use of available prohaemostatic agents.