Interactive cardiovascular and thoracic surgery
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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 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
Case ReportsPost-traumatic left ventricular pseudoaneurysm.
Left ventricular pseudoaneurysms (LVPs) occur as a complication of myocardial infarction, cardiac surgery and, rarely, due to thoracic trauma, infective pericarditis or iatrogenisis due to accidental perforation of the myocardium. Ventricular pseudoaneurysms are acquired by blood-filled spaces outside the cardiac chambers communicating with the ventricle. We present a case of LVP presented after a blunt non-penetrating chest injury. The patient underwent successful aneurysmorrhaphy.
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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 · Feb 2012
ReviewDoes the use of extended criteria donors influence early and long-term results of lung transplantation?
A best evidence topic was constructed according to a structured protocol. The question addressed was whether the presence of extended criteria donors influences the early and long-term results in patients referred for lung transplantation. Of the 30 papers found using a report search, 14 presented the best evidence to answer the clinical question. ⋯ Finally, the importance of avoiding the donation of the lung from an MD to a high-risk recipient emerged, whereas the association with single or bilateral transplants remains more controversial. Hence, current evidence suggests that there are no contraindications-given the absence of negative impact on survival-for the use of MDs for the transplant of a proposed standard receiver. However, given the low level of evidence of published studies, caution is necessary in order to avoid organ shortage, despite these encouraging results.