The Annals of thoracic surgery
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A young woman of the Jehovah's Witness faith presented with a rupturing aneurysm of the ascending aorta and transverse aortic arch. She had Marfan syndrome and previous aortic valve replacement. Despite reoperation conditions, successful operation via median sternotomy was carried out using deep hypothermia and circulatory arrest.
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Case Reports
Left ventricular outflow tract obstruction and hemolytic anemia after mitral valve repair with a Duran ring.
We report a case of mitral valve repair with a Duran ring that was complicated by left ventricular outflow tract obstruction, mitral regurgitation, and hemolytic anemia. A 59-year-old man with severe mitral valve regurgitation underwent mitral valve repair, including a Duran ring annuloplasty. ⋯ The patient then underwent mitral valve replacement with a 29-mm St. Jude valve.
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Gastrobronchial fistula is an extremely rare condition. A case of gastrobronchial fistula secondary to a benign gastric ulcer 9 years after esophagectomy and gastric pull-up for treatment of esophageal carcinoma is described. A review of the literature is provided.
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Physiologists could keep animals alive with an open chest long before surgeons set about doing the same thing in patients. Why was there not an orderly transfer of knowledge and technique?
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In 12 patients who had had composite replacement of the aortic valve and ascending aorta, infective endocarditis developed 2 months to 17 years after operation. Six patients had mechanical valves and 6 had biological ones (four homograft and two porcine valves). All patients needed operation because of shock, heart failure, persistent sepsis in spite of adequate antibiotic therapy, or the development of a paravalvular false aneurysm. ⋯ Operative survivors were followed up from 3 to 156 months (mean, 42 months). One patient died 35 months postoperatively due to bleeding complications of anticoagulation; 1 patient suffered a cardiac arrest at home 2 months after operation, sustained permanent cerebral damage, and died 4 months later. The remaining patients are asymptomatic from the cardiovascular viewpoint.(ABSTRACT TRUNCATED AT 250 WORDS)