Journal of cardiac surgery
-
Comparative Study
Comparison of three different surgical methods in aortic root aneurysms: long-term results.
Degenerative ascending aortic aneurysms frequently present with aortic valve pathology. If only the noncoronary sinus of Valsalva is dilated, replacement of the noncoronary sinus by tailoring the supracoronary graft with or without aortic valve replacement (AVR) can be a simple operation strategy. We sought to describe our experiences in this kind of operation, and compare them with a relatively homogeneous group of patients who underwent the classical Bentall operation. ⋯ Noncoronary cusp replacement for aortic root remodeling in patients with ascending aortic aneurysm is a technically simple and durable operation. Short- and mid-term results of this method were favorable compared to the Bentall procedure.
-
Case Reports
Giant left ventricular aneurysm complicating silent inferoposterior myocardial infarction.
True ventricular aneurysm in the inferior location is rare. A 54-year-old male was evaluated for recurrent heart failure. ⋯ The patient underwent aneurysm repair and coronary artery bypass grafting to RCA.
-
Early tracheostomy may increase the risk of mediastinitis after median sternotomy. Patients who had postoperative tracheostomy after cardiac surgery in the period 2000-2005 were retrospectively analyzed (total: 5095 patients) to evaluate the incidence of mediastinitis and sternal wound infections. Fifty-seven cases (1.1% of all operated patients) had postoperative tracheostomy at an average 5.6 +/- 0.7 days postoperatively. ⋯ The bacterial strains isolated from subcutaneous infection were qualitatively and quantitatively different from those isolated from bronchial secretions. We conclude that in this study there is no demonstrable link between early tracheostomy after sternotomy and mediastinitis. Early tracheostomy should not be denied due to concerns of increasing the risk of mediastinitis.
-
Renal cell carcinoma (RCC) is a commonly encountered malignancy in urology. Extensive RCC may frequently invade the renal vein and the inferior vena cava (IVC). ⋯ Current techniques for resection of supradiaphragmatic RCC tumor thrombus in the IVC incorporate cardiopulmonary bypass (CBP) with deep hypothermic circulatory arrest, especially in cases where the thrombus reaches the right atrium. We report a safe technique using a transabdominal approach to such lesions that allows exposure to the level of the intrapericardial IVC and right atrium permitting safe resection of the tumor thrombus without median sternotomy, CBP, or deep hypothermic circulatory arrest.
-
Case Reports
Endovascular stent: grafting in penetrating atherosclerotic ulcer of the thoracic aorta.
The aim of our study is the presentation of some interesting images of a case with symptomatic penetrating atherosclerotic ulcer (PAU) of the thoracic aorta and its endovascular treatment. Penetrating atherosclerotic ulcer is an ulcerating atherosclerotic lesion that penetrates the elastic lamina and is correlated with intramural hematoma (IMH) formation into the media layer of the aortic wall. ⋯ Surgical treatment may become necessary in cases involving the ascending aorta or in cases of intramural haematoma formation. In the era of minimally invasive surgery stent-grafting is indicated mainly in the elderly patients in presence of serious co-morbidities.