Journal of cardiac surgery
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Case Reports
Intraoperative transeophageal echocardiography to diagnose an anomalous circumflex artery.
We describe a 43-year-old male presenting for hemiarch replacement and possible aortic valve replacement. Intraoperative transesophageal echocardiography (TEE) demonstrated an atypical coronary vessel, enabling proper diagnosis of an anomalous circumflex artery and appropriate operative planning.
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Case Reports
Transcatheter aortic valve insertion catastrophe in inoperable patients: should aortic valve replacement be denied?
This paper reports the outcomes of patients initially deemed inoperable for standard aortic valve replacement who received transcatheter aortic valve insertion. Each patient experienced a transcatheter valve insertion complication and was then subsequently reconsidered for urgent standard valve replacement. We review the outcomes of these inoperable patients and discuss recommendations for managing this complication.
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Even mild paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) is associated with increased late mortality. Electrocardiogram-gated multi-slice computed tomography (MSCT) enables detailed aortic annulus assessment. We describe the impact of MSCT for PVL following TAVR. ⋯ The OSACA ratio has a significantly higher discriminatory performance for PVL ≤ trace than the OSACA (TEE) ratio, and aortic annular measurement from MSCT is more accurate than that from TEE.
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This report describes an effective cerebral perfusion method using an additional 4th side limb graft sewn to a trifurcated graft in patients undergoing redo aortic root reconstruction combined with total aortic arch replacement. This method is useful in cases where the origin of the innominate artery is unsuitable for clamping or when axillary perfusion is not employed, and assures continuous brain protection and minimizes circulatory arrest time.
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Randomized Controlled Trial Comparative Study
Effects of epidural anesthesia on acute and chronic pain after coronary artery bypass grafting.
To evaluate the effects of thoracic epidural anesthesia (TEA) as an adjunct to general anesthesia (GA) on postoperative pain after coronary artery bypass grafting (CABG). ⋯ TEA significantly reduced the intensity of postoperative pain and analgesic consumption in the early postoperative period following CABG. The delivery of effective analgesia along with conventional medications may prevent chronic pain after surgery.