Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jul 2012
Case ReportsA successful third resection-anastomosis in a tracheal restenosis.
Reoperation due to recurrence after tracheal resection and reconstruction still seems challenging. Although recurrence may lead to serious morbidity, an appropriate surgical technique plays a significant role in the cure of these patients. ⋯ We believe that the number of previous operations is not a contraindication by itself against reoperating on a patient with restenosis. Also the success rate might be acceptably high if a sufficiently healthy tracheal length remains.
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Interact Cardiovasc Thorac Surg · Jul 2012
The impact of major perioperative renal insult on long-term renal function and survival after cardiac surgery.
Temporary renal replacement therapy (RRT) facilitates recovery from a major perioperative renal injury and, although RRT can improve the hospital outcome, it is not known as to whether it mitigates long-term renal sequelae. Therefore, we investigated the risk of long-term dialysis after RRT post-cardiac surgery. We analysed prospectively the data collected for all hospital survivors who received RRT following cardiac surgery between March 1996 and July 2010, excluding those on dialysis preoperatively or with a functioning renal transplant. ⋯ Only three patients with severe preoperative renal dysfunction received dialysis. The Kaplan-Meier 5- and 7-year survival rates for this patient cohort were 54% and 38%, respectively. In conclusion, a major renal insult requiring temporary RRT after cardiac surgery does not increase the risk for renal dialysis in the long term for patients with normal renal function preoperatively.
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Interact Cardiovasc Thorac Surg · Jul 2012
Case ReportsSuccessful surgical repair of platypnea-orthodeoxia syndrome in a patient with cerebral infarction.
Platypnea-orthodeoxia syndrome is a rare condition characterized by hypoxaemia in the upright position and arterial hypoxaemia induced by the upright position, and the syndrome is relieved by recumbency. We encountered a cerebral infarction patient who presented with low SpO(2) levels in the upright position. ⋯ The surgical closure of the foramen and shortening of the ascending aorta improved the patient's clinical condition. To our knowledge, there have been few reports of clinical conditions of this kind.
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Interact Cardiovasc Thorac Surg · Jul 2012
Surgical treatment for pulmonary aspergilloma: a 35-year experience in the Chinese population.
The surgical treatment of pulmonary aspergilloma is challenging and controversial. This study was designed to evaluate the clinical profile, indications and surgical outcomes of pulmonary aspergilloma operated on in our institute. A total of 256 patients with pulmonary aspergilloma underwent surgical treatment from 1975 to 2010. ⋯ The overall mortality within 30 days post-operation was 1.2%, occurring only in Group B. There was no statistically significant difference in the postoperative morbidity between Groups A and B (P = 0.27). With the good selection of patients, meticulous surgical techniques and good postoperative management, aggressive surgical treatment with anti-fungal therapy for pulmonary aspergilloma is safe and effective, and can achieve favourable outcomes.