European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Paraplegia and paraparesis are major concerns in descending and thoracoabdominal aortic repair. A shorter period of spinal cord ischemia is preferred for protection. ⋯ Blood supply of intercostal arteries including the Adamkiewicz artery is resumed by perfusing the vascular tube in not more than 20 min. This technique has been applied in four patients, and there was neither paraplegia nor paraparesis.
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Eur J Cardiothorac Surg · Feb 2006
Review Case ReportsTracheal replacement with an aortic autograft.
Tracheal replacement after extensive resection remains a challenge for the thoracic surgeon. We propose an innovative solution: the use of an aortic autograft. After an experimental work on animals with aortic autografts and allografts [Martinod E, Seguin A, Pfeuty K, Fornes P, Kambouchner M, Azorin JF, Carpentier AF. ⋯ The stent was removed at three months. The patient died at six months from an acute pulmonary infection without any sign of anastomosis leakage or graft rupture. A new field of clinical study has to be investigated.
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Eur J Cardiothorac Surg · Feb 2006
Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: clinicopathological correlation.
To compare the identifiable pulmonary abnormalities during thoracoscopy with the histological findings in patients requiring surgical intervention for recurrent or persistent primary spontaneous pneumothorax (PSP) and correlate these with the postoperative events. ⋯ Video-assisted thoracoscopic stapling of an identified bleb or apex of the upper lobe and apical pleurectomy represents the standard treatment for the majority of recurrent or persistent PSP. Most patients with surgically treated PSP have subpleural blebs or bullae or isolated emphysema. In type I cases, simple apical excision and apical pleurectomy are not sufficient and perhaps additional talc poudrage might be indicated.
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To assess the results of aortic valve replacement with the pulmonary autograft in patients with rheumatic heart disease. ⋯ The Ross procedure is not suitable for young patients with rheumatic heart disease. However, it provides acceptable mid-term results in carefully selected older (>30 years) patients with isolated rheumatic aortic valve disease.
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Eur J Cardiothorac Surg · Feb 2006
Randomized Controlled TrialResidual air in the venous cannula increases cerebral embolization at the onset of cardiopulmonary bypass.
When the right atrium (RA) cannula is connected to the venous return line of the cardiopulmonary bypass (CPB) circuit, air is often introduced. Air in the venous cannula may increase cerebral air embolization at initiation of CPB despite the arterial line filter. We measured the volume of air present in the venous cannula after cannulation of the RA. Transcranial Doppler quantified emboli as high-intensity transient-signals (HITS) in both middle-cerebral arteries (MCA) at the beginning of CPB. ⋯ Air in the venous cannula can result in HITS in the MCA. Minimizing the volume of air introduced into the venous cannula after cannulation of the RA can decrease cerebral air embolization at the beginning of CPB.