Journal of cardiac surgery
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Concerns of increased surgical risks with ascending aortic replacement have led surgeons to manage post-stenotic aortic dilatation more conservatively during aortic valve replacement (AVR). The present study aimed to assess the prognostic implications and surgical risks of replacing the dilated aorta during AVR. ⋯ Concomitant replacement of the dilated ascending aorta during AVR did not increase the immediate postoperative morbidity or mortality risks and tended to exert a long-term beneficial effect on the risk of late mortality.
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Near-infrared spectroscopy (NIRS) is a noninvasive continuous monitoring method for measuring the oxyhemoglobin saturation of the brain tissue. NIRS monitoring can suggest neuronal hypoxia in the frontal-brain before irreversible impairment of cellular metabolism. We report two cases of Type B aortic dissection surgery in which spinal regional perfusion monitoring was performed by placing two NIRS sensors on the back-skin through T6-T8 and T9-T11 vertebraes.
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Review Meta Analysis
Dual anti-platelet therapy after coronary artery bypass grafting: is there any benefit? A systematic review and meta-analysis.
Anti-platelet therapy is an important component of medical therapy post coronary artery bypass grafting (CABG). While aspirin administration is a Class I indication after CABG, the benefit of concomitant clopidogrel is a controversial issue. ⋯ Dual anti-platelet therapy after CABG improved early saphenous vein graft patency, but may increase the risk of bleeding. The use of dual anti-platelet therapy appears to be most beneficial in patients undergoing off-pump CABG. Prospective randomized studies are necessary to determine whether this beneficial effect of dual therapy is also achieved in patients undergoing on pump CABG.
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Review Case Reports
Combined thoracic endovascular aortic repair and neurosurgical intervention for injury due to posterior spine surgery.
Aortic injuries represent a rare but life-threatening complication of spinal surgery. Perforation of the aorta due to pedicle screw penetration or misplacement can lead to immediate bleeding with hemodynamic instability or to pseudoaneurysm development with delayed risk of rupture, which can occur weeks to months later. Recently, thoracic endovascular aortic repair (TEVAR) in aortic trauma has contributed to a reduction of both mortality and morbidity. The literature on this subject is reviewed.
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Simultaneous mycotic aortic aneurysms are a rare but life-threatening complication. We describe the technique of one stage hybrid open debranching and endovascular repair using three thoracic stent-graft devices deployed to cover the whole aorta to exclude multiple mycotic aneurysms.