Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Mar 2012
Case ReportsRepair of a penetrating aortic arch injury using deep hypothermic circulatory arrest and retrograde cerebral perfusion.
The traumatic rupture of the thoracic aorta is a severe and life-threatening entity. The incidence of penetrating trauma to the aortic arch is not known, because most patients die of haemorrhage even before they receive adequate treatment. Clinical signs of such injuries include external or internal haemorrhage, bruit, distal pulse deficit, neurological deficit and shock. We present a 42-year old female with a penetrating aortic arch injury successfully repaired using deep hypothermic circulatory arrest and retrograde cerebral perfusion.
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Interact Cardiovasc Thorac Surg · Mar 2012
Case ReportsNeedlescopic video-assisted thoracic surgery for reversal of thoracic sympathectomy.
Thoracic sympathectomy is a commonly performed surgical procedure for the treatment of palmar hyperhidrosis. However, one major complication of such a procedure is compensatory truncal hyperhidrosis. ⋯ Bilateral reoperative needlescopic video-assisted thoracic surgery was performed for the reversal of thoracic sympathectomy with an interposition intercostal nerve graft. The patient's truncal hyperhidrosis resolved gradually over 1 month following the reversal procedure.
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Interact Cardiovasc Thorac Surg · Mar 2012
Comparative StudyNon-invasive cerebral oxygenation reflects mixed venous oxygen saturation during the varying haemodynamic conditions in patients undergoing transapical transcatheter aortic valve implantation.
Transapical transcatheter aortic valve implantation (TA-TAVI) is increasingly used to treat aortic valve stenosis in high-risk patients. Mixed venous oxygen saturation (SvO(2)) is still the 'gold standard' for the determination of the systemic oxygen delivery to consumption ratio in cardiac surgery patients. Recent data suggest that regional cerebral oxygen saturation (rScO(2)) determined by near-infrared spectroscopy is closely related to SvO(2). ⋯ At all predefined time points correlation was moderate (r(2 )= 0.50) to close (r = 0.84), and the percentage error was <24%. RScO(2) determined by near-infrared spectroscopy is correlated to SvO(2) during varying haemodynamic conditions in patients undergoing TA-TAVI. This suggests that rScO(2) is reflective not only of the cerebral, but also of the systemic oxygen balance.
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Interact Cardiovasc Thorac Surg · Mar 2012
Histological and genetic studies in patients with bicuspid aortic valve and ascending aorta complications.
Aneurysm diameter and growing rate does not represent a definite parameter for operation in bicuspid aortic valve (BAV), ascending aortic aneurysm and normal root patients. Thus, we investigated histological and immunohistochemical aspects of different segments of ascending aorta (precisely, aortic root without dilatation, aneurysmatic tubular portion, dissected ascending aorta) and genetic features of patients with BAV and ascending aorta complication (aneurysm or dissection). ⋯ Based on our histological and genetic data, we underline that a surgical approach in patients with BAV, ascending aortic aneurysm and normal root, should consider not only the diameter of the aneurysmatic aortic portion but also the histological features of the whole ascending aorta and the genetic risk profile.
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Interact Cardiovasc Thorac Surg · Mar 2012
Case ReportsA right-sided aortic arch and aberrant left subclavian artery with proximal segment hypoplasia.
The right-sided thoracic aortic arch is a rare congenital malformation occurring during embryologic development. A majority of the cases present with two anatomic variations, one of which is an aberrant left subclavian artery (LSA) originating off the distal descending aortic arch. ⋯ This thoracic aneurysm is commonly known as Kommerell's diverticulum. This paper presents a case of an aberrant LSA originating off Kommerell's diverticulum with a proximal long-segment hypoplasia, a very rare anatomic variation.