Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Sep 2011
Surgery for hemoptysis in various pulmonary tuberculous lesions: a prospective study.
Hemoptysis due to pulmonary tuberculous lesions is a common cause of morbidity, and occasionally mortality. The aim of this study is to evaluate the surgical outcome of hemoptysis in patients with various tuberculous pulmonary lesions. A total of 45 cases who underwent surgical procedures for various pulmonary tuberculous lesions with hemoptysis were included in this study. ⋯ There was one case (6.2%) of mortality in group A. Tuberculous cavity is the common pulmonary lesion which can result in major and massive hemoptysis, therefore, we recommend early surgical resection of tuberculous cavities to avoid life-threatening hemoptysis. Limited resection should be avoided to prevent recurrence.
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Interact Cardiovasc Thorac Surg · Sep 2011
Comparative StudyComparing the outcome of on-pump versus off-pump coronary artery bypass grafting in patients with preoperative atrial fibrillation.
Around 5-15% of patients undergoing coronary artery bypass grafting (CABG) suffer from preoperative/pre-existing atrial fibrillation (PAF). This is a benign arrhythmia but can affect the outcome of the surgery. The aim of this study was to assess the effect of PAF on the immediate postoperative course of patients undergoing on-pump (ONCAB) vs. off-pump (OPCAB) CABG. ⋯ PAF is associated with a higher incidence of postoperative complications. Our results have demonstrated that patients in PAF undergoing ONCAB are more susceptible to the postoperative complications compared to those in SR. However, there were no differences in mid- and long-term outcomes.
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Interact Cardiovasc Thorac Surg · Sep 2011
Left ventricle unloading by percutaneous pigtail during extracorporeal membrane oxygenation.
Arterial-venous extracorporeal membrane oxygenation (ECMO) is more and more used as first line mechanical support in acute cardiopulmonary failure. Important pitfall of this technique is the inappropriate unloading of left ventricle (LV) in case of myocardial insufficiency, leading to pulmonary stasis and inadequate myocardial recovery. ⋯ Echographic guidance is sufficient to pigtail positioning and follow-up monitoring avoiding catheterization laboratory transport. With this approach we were able to support three different patients, resolving LV distension and preventing lung congestion, without major complication.
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Interact Cardiovasc Thorac Surg · Sep 2011
Case ReportsTotal cricoidectomy and laryngotracheal reconstruction for subglottic stenosis with glottic involvement.
We present a case of subglottic stenosis involving the glottis with inflammatory destruction of the cricoid cartilage after prolonged endotracheal intubation. Total cricoidectomy and laryngotracheal anastomosis were performed with T-tube placement that was retained for five months postoperatively. ⋯ Good respiratory and phonatory results were obtained during normal daily activity, although a slightly hoarse voice was present, but no aspiration was observed. Total cricoidectomy and laryngotracheal reconstruction may be considered suitable for subglottic stenosis with glottic involvement, if accompanied by inflammatory destruction of the cricoid cartilage.
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Interact Cardiovasc Thorac Surg · Sep 2011
Case ReportsA unique nail gun injury to the heart with a delayed presentation.
We describe a 24-year-old construction worker who was unaware that he had been shot by a pneumatic nail gun in the chest during work. After returning home, he felt some palpitations and mild shortness of breath, and in the mirror discovered a non-bleeding pinpoint skin wound in his upper chest. ⋯ Transthoracic echocardiography and chest computed tomography were done, and the patient was transported to the operating room. After the nail had been removed and the mitral valve repaired, the patient was discharged on the fifth postoperative day without any complications.