The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Feb 2006
Tracheal rupture after endotracheal intubation: experience with management in 13 cases.
Tracheal rupture is a rare complication of endotracheal intubation. Potential causes, diagnosis, management, and outcome of cases treated at an university hospital are analysed. ⋯ Prognosis of tracheal ruptures depends both on the underlying disease and general condition of the patient and on the rapidity of diagnosis and treatment. Surgical therapy is preferred as it allows reconstruction of the trachea and drainage of the mediastinum. Conservative management appears to be justified for small ruptures in the upper third of the trachea without mediastinitis.
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Thorac Cardiovasc Surg · Feb 2006
Case ReportsPerforation of the ascending aorta: a late complication of superior vena cava stenting.
Intravascular stenting of the superior vena cava (SVC) is an established therapy in patients with SVC syndrome. Late complications include re-occlusion, stent infection, migration, and perforation. ⋯ Surgical therapy included excision of the aortic lesion and pericardial patch repair. This case illustrates successful management of a complication after palliative stenting of the SVC.
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Thorac Cardiovasc Surg · Feb 2006
Current management of late failure after classic Fontan modifications: Fontan conversion.
Re-establishment of Fontan circulation by eliminating the drawbacks of classic Fontan modifications has been proposed recently to improve the functional class and quality of life of patients with failed Fontan circulation. ⋯ We suggest that Fontan conversion should be considered in patients with previous atrio-pulmonary anastomosis, when right atrial dilatation or intractable atrial arrhythmias with deteriorating functional status develops. Redirection of hepatic venous flow to lungs induces regression of pulmonary arteriovenous fistulas and improves arterial saturation in patients with previous Kawashima operation.
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Acquired chest wall deformities are difficult to describe and to classify. We propose the following classification and treatment options. ⋯ To prevent AD formation and to protect thoracic growth and mobility, costosternal and costochondral junctions should be preserved during cartilage resection. Substernal suturing of the perichondrium should be avoided.
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Thorac Cardiovasc Surg · Dec 2005
Cardiac surgery in Germany during 2004: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery.
All cardiac surgical procedures performed in 79 German cardiac surgical units in the year 2004 are presented in this report, which is based on a voluntary registry organized by the German Society for Thoracic and Cardiovascular Surgery. A total of 100 830 cardiac surgical procedures (ICD and pacemaker procedures excluded) were reported to the registry for the year 2004, an increase by 1.1 % compared to the year 2003. ⋯ Hospital mortality in 58 144 isolated CABG procedures (7.1 % off pump) was 2.8 %, and 4.5 % in 18 617 isolated valve procedures. This registry is an important tool of the German Society for Thoracic and Cardiovascular Surgery to allow a continuous and voluntary monitoring of quality and to illustrate the development of cardiac surgery in Germany.