Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Feb 2009
Case ReportsSurgical repair of coronary sinus atrial septal defect and supraventricular tachycardia.
A 67-year-old female had suffered from fatigue and palpitation. Cardiac examination revealed coronary sinus atrial septal defect, moderate mitral and tricuspid regurgitation, coronary artery disease, and supraventricular tachycardia with paroxysmal atrial fibrillation. Surgical repair of the anomaly, regurgitant valves, and arrhythmia associated with coronary revascularization was successfully performed and the patient has been doing well in normal sinus rhythm.
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Interact Cardiovasc Thorac Surg · Feb 2009
Impact of 3-mm Blalock-Taussig shunt in neonates and infants with a functionally single ventricle.
Functionally single ventricle (f-SV) is susceptible to volume overload. Atrioventricular valve regurgitation (AVVR) tends to develop and ventricular function deteriorates due to excessive pulmonary blood flow following modified Blalock-Taussig shunt (mBTS). On the other hand, a small caliber graft has risks of early obstruction and poor growth of pulmonary vascular beds. ⋯ The AVVR remained mild or less. Ventricular end-diastolic volume and ejection fraction were 171+/-61% of the normal value and 64+/-6%, respectively. We conclude that a 3-mm mBTS was useful in preventing f-SV from volume overload and was effective for growing good pulmonary vasculature and achieving a right heart bypass.
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Interact Cardiovasc Thorac Surg · Feb 2009
Case ReportsIntraoperative retrograde type I aortic dissection in a patient with chronic type IIIb dissecting aneurysm.
Iatrogenic acute aortic dissection of the ascending aorta during cardiac surgery is a rare but potentially fatal complication. We describe the emergency repair of iatrogenic acute aortic dissection of the ascending aorta during distal arch replacement in a patient with a chronic type IIIb dissecting aneurysm. We scheduled distal arch and descending aortic aneurysm repair through a left anterolateral thoracotomy with a femoro-femoral bypass. ⋯ The patient recovered uneventfully after extensive surgical replacement of the thoracic aorta and remains asymptomatic at two years after the procedure. To prevent possible neurological complications, this patient was managed by selective antegrade cerebral perfusion at 31 degrees C because we could not afford to wait for the induction of deep hypothermia. Successful management of iatrogenic acute aortic dissection depends on immediate recognition and the appropriate choice of surgical repair.
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Interact Cardiovasc Thorac Surg · Feb 2009
Case ReportsSystemic air embolism in a patient with ingestion of a foreign body.
Air embolism is defined as the entry of gas into a vascular structure. Frequently it is iatrogenic and can result in serious morbidity and mortality. We describe the case of a 59-year-old woman who presented with mediastinitis as a result of ingestion of a fishbone. Mediastinal debridement was performed which was complicated in the postoperative period by a systemic air embolism, as documented by computed tomography and clinical features.