The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Mar 2008
Case ReportsUnsuspected location of a ventricular septal defect after blunt chest trauma.
A 40-year-old woman, without previous cardiac symptoms, was referred to our hospital from a local hospital with a subpulmonary ventricular septal defect following blunt chest trauma. The patient was in cardiogenic shock and emergency repair was mandatory. ⋯ Echocardiography is very important for rapid detection. Early repair is necessary and constitutes a lifesaving procedure when hemodynamic instability is present.
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Thorac Cardiovasc Surg · Mar 2008
Correction of coarctation of aorta in adult patients--impact of corrective procedure on long-term recoarctation and systolic hypertension.
Uncorrected coarctation of the aorta in adults predisposes to congestive failure, aortic rupture, stroke and endocarditis. Surgical correction of this condition is fraught with technical difficulties due to the complexity of the lesion, associated anomalies and extensive collaterals. The optimal surgical technique has not yet been well defined in adults. We describe our experience with adult coarctation and the long-term outcome with regard to recoarctation and systolic hypertension. ⋯ Surgical correction of coarctation of aorta in adults can be achieved with an acceptable morbidity. A variety of options are available for the surgical management of coarctation of the aorta in adults. Prosthetic graft and patch repair are associated with good short and long-term results. Use of balloon angioplasty without stenting as the primary therapy requires further clarification. Hypertension is well controlled in most patients.
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Thorac Cardiovasc Surg · Feb 2008
Case ReportsCreation of a self-made total artificial heart using combined components of available ventricular assist devices.
We describe the case of a 39-year-old woman who received a self-made total artificial heart built of components from the Thoratec and ExCor Berlin Heart systems. The patient had a severe aortic/myocardial infection following replacement of the ascending aorta with a Shelhigh conduit due to type A aortic dissection. The surgical technique is described in detail in this article. This technique is feasible if a total artificial heart is not available and implantation of a biventricular assist device is not possible.
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Only a few simulators are available which offer training in video-assisted thoracic surgery (VATS). We have developed a VATS training model for surgeons. ⋯ Our unique trainer may enhance the skill of VATS surgeons at a national level.
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Thorac Cardiovasc Surg · Dec 2007
Comparative StudyIs extreme obesity a risk factor for increased in-hospital mortality and postoperative morbidity after cardiac surgery? Results of 2251 obese patients with BMI of 30 to 50.
The number of patients with extreme obesity requiring cardiac surgery is increasing. The aim of the present study was to evaluate the perioperative outcome, complication rate and 30-day mortality of these patients. ⋯ Severe obesity does not PER SE enhance perioperative mortality. A BMI of 30 to 50 combined with diabetes mellitus and bilateral ITA grafting increases the risk for sternal complications.