Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2017
Case ReportsSurgical treatment of a pericardio-oesophageal fistula using a right lower lobe pulmonary tissue patch.
A 58-year-old man presented with fever and chest pain 11 days after atrial fibrillation catheter ablation. The diagnosis of pericardio-oesophageal fistula was made. ⋯ The patient was discharged from hospital approximately 2 months later. The use of a pulmonary patch is a rare but a highly effective technique that can be used in this indication.
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Interact Cardiovasc Thorac Surg · Nov 2017
Early- and mid-term aortic remodelling after the frozen elephant trunk technique for retrograde type A acute aortic dissection using the new Japanese J Graft open stent graft.
We previously performed the frozen elephant trunk (FET) technique for acute type A aortic dissection to try to improve the long-term prognosis. In this study, we report the mid-term results of the FET technique for treating retrograde type A acute aortic dissection using a new device, the J Graft open stent graft (JOSG). ⋯ The use of the FET technique with the JOSG for retrograde type A acute aortic dissection provides good outcomes. With the proper use of the JOSG, it is possible to expand the true lumen and eliminate antegrade false-lumen flow, resulting in good aortic remodelling. Furthermore, there should be obliteration of the false lumen from the stent graft to the aortic valve, and this might reduce long-term complications.
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Interact Cardiovasc Thorac Surg · Oct 2017
Review Case ReportsRapid resolution of Ortner's syndrome with giant left atrium after double-valve replacement surgery.
Hoarseness of voice due to recurrent laryngeal nerve palsy is an uncommon manifestation of cardiothoracic disease. Ortner's syndrome is hoarseness attributed to mechanical compression of the left recurrent laryngeal nerve in association with several cardiopulmonary disease states. We here describe a rare case of Ortner's syndrome developing in a 60-year-old woman with a giant left atrium in the context of rheumatic mitral valve stenosis. The remarkable resolution of her voice hoarseness within 1 week of valve replacement surgery has not been reported in similar cases to date.
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Interact Cardiovasc Thorac Surg · Oct 2017
Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients over 85 years old.
Surgical aortic valve replacement (SAVR) for the treatment of in very old patients with severe aortic stenosis is associated with a high risk of morbidity and mortality. Transcatheter aortic valve implantation (TAVI) has become the preferred alternative. Therefore, we sought to evaluate outcomes in very old patients who underwent SAVR versus TAVI. ⋯ In patients 85 years and older, SAVR seems to offer good short- and mid-term clinical outcomes compared to TAVI. Advanced age alone would not be an indication for TAVI in old-old patients.
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Interact Cardiovasc Thorac Surg · Oct 2017
Review Meta AnalysisMinimal access versus conventional aortic valve replacement: a meta-analysis of propensity-matched studies.
Conventional aortic valve replacement (CAVR) via a full sternotomy is the standard surgical approach for aortic valve replacement. Minimal access aortic valve replacement (MAAVR) is commonly performed via a partial sternotomy and a right minithoracotomy. Such procedures aim not only to reduce the invasiveness but to offer the same quality, safety and results of the conventional approach. ⋯ In summary, even though MAAVR procedure, either through partial sternotomy or right minithoracotomy, provides patient satisfaction due to the smaller incision and better cosmetics, MAAVR is as safe as the CAVR procedure. Although MAAVR takes slightly longer, it was not associated with greater cardiopulmonary bypass-related adverse effects. Interestingly, MAAVR shows a lower incidence of low cardiac output syndrome and atrial fibrillation.