Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsDiscrete subaortic stenosis 37 years after repair of a ventricular septal defect.
Discrete subaortic stenosis (DSS) is uncommon in adults after surgical correction of congenital heart defects. There are only a few published reports on the occurrence of DSS in adults. ⋯ Thirty-seven years later, she presented with congestive heart failure associated with severe subaortic membranous stenosis and atrial fibrillation (AF) that required surgical repair. We report successful surgical treatment of this adult patient with DSS and AF 37 years after repair of a VSD.
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Interact Cardiovasc Thorac Surg · May 2012
Insertion of paravertebral block catheters intraoperatively to reduce incidence of block failure.
Paravertebral block catheters are a recognized method of regional pain control after a thoractomy. We describe a technique of insertion with the belief that it provides a superior positioning of the paravertebral (extra-pleural) catheter resulting in a better distribution of the local anaesthetic and better pain control.
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsSuccessful thrombolysis of major pulmonary embolism 5 days after lobectomy.
Aggressive intravenous thrombolysis of pulmonary emboli after major thoracic surgery has rarely been reported and is controversial because of an assumed risk of fatal bleeding. We report a 62-year old female who underwent left upper lobectomy. Her postoperative course was complicated with symptomatic pulmonary embolism and on postoperative day 5 she was successfully treated with intravenous thrombolysis using alteplase (Actilyse(®)) without signs of bleeding. She was discharged from the hospital 12 days postoperatively.
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Interact Cardiovasc Thorac Surg · Apr 2012
Sternal wire-grip: a new device in the surgical armamentarium.
We describe a new wire-grip that enhances the surgeon's grip on sternal wires and facilitates their tightening with minimal risk of slips. This wire-grip should protect against operating room personnel injury during sternal re-approximation.
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Interact Cardiovasc Thorac Surg · Apr 2012
Current practice of antiplatelet and anticoagulation management in post-cardiac surgery patients: a national audit.
The Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery recently published a guideline on antiplatelet and anticoagulation management in cardiac surgery. We aimed to assess the awareness of the current guideline and adherence to it in the National Health Service through this National Audit. We designed a questionnaire consisting of nine questions covering various aspects of antiplatelet and anticoagulation management in post-cardiac surgery patients. ⋯ Low-dose aspirin is commonly used despite the recommendation of 150-300 mg. The loading dose of aspirin within 24 h as recommended by the guideline is followed only by 60.7% of surgeons. There was not much deviation from the guideline with respect to the anticoagulation therapy.