European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 1997
Surgical management of atrio ventricular septal defects with normal caryotype.
Atrio ventricular septal defects (AVSD) with normal caryotype represent in average 25% of AVSD. They constitute a more complex group of patients characterized by frequent left sided heart obstructive lesions, raising the problem of the appropriate indications between biventricular and univentricular procedures. ⋯ Biventricular repair should be precluded in patients presenting with subaortic stenosis. Severe mitral valve anomalies lead to elevated mortality and morbidity with frequent reoperations. Univentricular repair might have larger indications and cardiac transplantation might be considered in patients with truly hypoplastic LV presenting with severe pre-operative AV valve regurgitation.
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Penetrating cardiothoracic war wounds are very common among war casualties. Those injuries require prompt and specific treatment in an aim to decrease mortality and late morbidity. There are a few controversies about the best modality of treatment for such injuries, and there are not many large series of such patients in recent literature. ⋯ Penetrating cardiothoracic wounds are among the most serious injuries in war, either in combat or among civilians. In spite of their nature, they can be treated successfully with relatively low mortality and morbidity.
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Eur J Cardiothorac Surg · Mar 1997
Reoperations for bleeding after coronary artery bypass procedures during 25 years.
To study the incidence, causes and risk factors of reoperation for bleeding, 8563 coronary artery bypass procedures performed during 1970-1994 were reviewed. ⋯ Special precautions seem indicated to reduce the risk of reoperation for bleeding in particularly elderly patients undergoing combined coronary surgery and other intracardiac repair.
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Operative control via a thoracic approach of chylothorax can be difficult to achieve, particularly if the chyle leak is secondary to previous thoracic surgery. This report describes the ligation of the thoracic duct at the level of the diaphragmatic hiatus, via an abdominal approach. This technique was the definitive management in four of the last 5 patients presenting with chylothorax in our unit. Typically the leak ceased within 24 h with early discharge of the patient from hospital.