The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Feb 1997
Case ReportsPostpartum pulmonary embolectomy; a surgical challenge and favourable outcome.
A 23-year-old female underwent uneventful caesarian section, which was followed by massive pulmonary embolism. Pulmonary embolectomy on cardiopulmonary bypass was performed, and was complicated by massive intraabdominal haemorrhage due to a hepatic subcapsular rupture. To our knowledge, this is the first surgically orientated case of postpartum pulmonary embolectomy to be reported in the literature.
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Thorac Cardiovasc Surg · Dec 1996
Case ReportsPericardiectomy for constrictive pericarditis using a percutaneous heparin-coated cardiopulmonary support system.
We report a case in which a percutaneous heparin-coated cardiopulmonary support system enabled a safe and effective pericardiectomy to be performed. It was employed when severe hypotension suddenly arose during the operation to treat constrictive pericarditis.
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Thorac Cardiovasc Surg · Oct 1996
Early administration of intrapleural streptokinase in the treatment of multiloculated pleural effusions and pleural empyemas.
In the treatment of multiloculated pleural effusions and empyemas tube thoracostomy often fails and more aggressive surgical therapy is required. Intrapleural administration of fibrinolytics is a valuable alternative. Between October 1994 and December 1995 28 patients (aged 22 to 62 years) with multiloculated pleural effusions were treated with intrapleural instillations of streptokinase after unsuccessful conventional chest tube drainage. ⋯ Eight patients needed further surgical treatment, e.g. decortication, in 5 cases together with wedge lung resection. Eleven patients experienced some adverse effects of streptokinase therapy, most frequently chest pain and elevation of body temperature in one case pleural effusion became hemorrhagic, and one patient had nasal bleeding. We conclude that usage of intrapleural streptokinase in the treatment of multiloculated pleural effusions (including pleural empyemas) reduces the need for major surgical interventions in quite a large group of patients.
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Thorac Cardiovasc Surg · Aug 1996
Case ReportsSupravalvular aortic stenosis without Williams syndrome.
In this article, the case of a 30-years-old female patient with supravalvular aortic stenosis is reported. Her clinical picture was otherwise completely different from Williams syndrome. Since supravalvular aortic stenosis is rarely seen, its forms are discussed and it is concluded that supravalvular aortic stenosis can be present without Williams syndrome.
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Thorac Cardiovasc Surg · Jun 1996
The impact of arterial hypertension on the results of coronary artery bypass grafting.
Arterial hypertension is though to be associated with reduced coronary vasodilator reserve in the coronary microcirculation. Increased ventricular mass and coronary arteriolar abnormalities are the dominant features in patients with severe hypertension, while large-vessel coronary disease is the predominant feature in patients with mild hypertension. In the present study we have evaluated how hypertension influences the outcome of coronary artery bypass grafting (CABG), with emphasis on patients with preoperative left-ventricular ejection fraction (LVEF) < or = 25%. ⋯ Hypertensive patients also had a better improvement of their left-ventricular function and CCS class than normotensiven. Left-ventricular hypertrophy and previous myocardial infarction were predictors for mortality in patients with LVEF > 25%. Patients with LVEF < or = 25% showed the same tendency, though not statistically significant.