Texas Heart Institute journal
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A few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic; alternatively, they may manifest themselves in the form of chest pain, dysphonia, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. ⋯ The affected segment of the thoracic aorta was replaced with a Dacron graft and a left superior lobectomy was performed. Nevertheless, the patient died during the postoperative period due to adult respiratory distress syndrome. Pathogenesis, diagnosis, and management of aortobronchial fistulae are discussed.
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Randomized Controlled Trial Clinical Trial
Blood flow in the internal mammary artery after the administration of papaverine during coronary artery bypass grafting.
Between January 1993 and February 1994, 106 patients whose internal mammary arteries were to be used for revascularization to treat coronary artery disease were examined for a prospective study of papaverine administration. The mean blood flow in the internal mammary artery was 59.9 mL/min +/- 7.3 mL/min before papaverine administration. ⋯ The highest increases in blood flow were observed in Group I (105.3%) and in Group III (112.6%). On the basis of our results, we recommend that papaverine be injected perivascularly into the pedicle of the internal mammary artery, since retrograde injection can cause dissection.
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Case Reports
Aneurysm of the innominate artery with aberrant origin of the left carotid artery. Case report.
Aneurysms of the supra-aortic vessels represent an unusual form of aneurysmal disease. Usually detected as asymptomatic masses, such aneurysms may cause life-threatening complications. We describe our surgical treatment for an aneurysm of the innominate artery that gave anomalous origin to the left carotid artery; the literature regarding such lesions is also reviewed.