Journal of cardiac surgery
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The most frequent limb complications from peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done. ⋯ Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding.
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Postinfarction ventricular septal defect (VSD) is a life-threatening complication of acute myocardial infarction. Surgical repair of this type of VSD is associated with a high mortality rate. We present a technique of using perventricular closure for a postinfarction apical VSD without cardiopulmonary bypass.
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Comparative Study
Is resternotomy a risk for continuous-flow left ventricular assist device outcomes?
The number of patients undergoing resternotomy continues to rise. Although catastrophic hemorrhage remains a dreaded complication, most published data suggest that sternal reentrance is safe, with negligible postoperative morbidity and mortality. A significant proportion of left ventricular assist device (LVAD) implantations are reoperative cardiac procedures. The aim of our study was to compare outcomes between first time sternotomy and resternotomy patients receiving continuous-flow LVADs, as a bridge to transplantation or destination therapy. ⋯ Survival at 30, 180, and 360 days after LVAD implantation is similar between the resternotomy and primary sternotomy group. No major differences in complications or hemodynamic measurements were observed. Although a limited observational study, our findings agree with previously published resternotomy outcomes.
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Case Reports
Compartment syndrome of the vein donor leg following an uneventful coronary artery bypass surgery.
Compartment syndrome (CS) is a very rare complication of coronary artery bypass surgery (CABG) due to elevated intra-compartmental pressure induced by ischemia-reperfusion injury. We report a patient with CS following an uneventful CABG and discuss its management.
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Congenital anomalies of the mitral valve are rare. A mitral arcade is defined as a fibrous continuity between the papillary muscles and the anterior mitral leaflet creating a hammock like suspension. We present images of a mitral anomaly that consists of a direct attachment of the anterolateral papillary muscle to the anterior mitral leaflet, which we have labeled as a "hemi-arcade." We discuss the surgical findings and review the available literature regarding a mitral "arcade".