Journal of cardiac surgery
-
Despite recent advances in critical care management, the mortality of acute respiratory distress syndrome (ARDS) remains high. The final rescue therapy for patients with severe hypoxia refractory to conventional therapy modalities is the extracorporeal gas exchange. ⋯ Quick encouragement of ECMO for the temporary management of gas exchange may increase survival rates in trauma patients with ARDS.
-
A variety of techniques has been used to repair prolapse of the commissure of the mitral valve. However, the application of these techniques may be technically challenging. ⋯ We use this technique with "spaghetti" for reinforcement, and annuloplasty for repair of the prolapse. We have recognized it to be a simple, durable, and reproducible technique for repair of prolapse of the mitral valve commissure.
-
Case Reports
Repeated paracentesis for treatment renal failure after heart transplantation in patient with ascites.
We report a case of orthotopic heart transplantation in a 42-year-old man who had cardiomyopathy with severe biventricular heart failure, ascites, and large umbilical hernia. He successfully received an orthotopic heart transplantation. After heart transplantation, renal failure was noted. ⋯ His cardiac and abdominal symptoms subsided gradually following transplantation. His umbilical hernia was repaired 55 days after the heart transplantation because of strangulation. In this case study, we report a patient with ascites who was treated for postoperative renal failure with repeated paracentesis.
-
Repair of aortic arch aneurysm is technically demanding, requiring complex circulatory management. Very large atherosclerotic saccular aneurysms of the arch are grave markers of extensive arch and brachiocephalic atheromatous disease and represent high surgical risks for perioperative neurologic complications. Operative morbidity and mortality may be prohibitive with traditional surgical intervention. We described our experience with a hybrid procedure for total arch repair with a brachiocephalic bypass with a trifurcated graft followed by concomitant placement of a stent graft in the arch. ⋯ Saccular arch aneurysms can be technically treated by total arch repair with brachiocephalic bypass and concomitant aortic arch stent graft placement. Hybrid arch repair provides an alternative to patients otherwise considered prohibitively high risk for traditional open arch repair.
-
Levosimendan (LS) is a novel calcium sensitizer drug that enhances cardiac contractility without increasing myocardial oxygen consumption, and induces vasodilatation. Positive inotropic support is routinely used for weaning from cardiopulmonary bypass circulation in patients with reduced left ventricular function. ⋯ There was a dramatic increase in cardiac output 20 minutes after LS infusion, and weaning from cardiopulmonary bypass circulation was achieved. We suggest that LS enhances cardiac performance during and after cardiopulmonary bypass, and can be useful for patients who are unable to be weaned from cardiopulmonary bypass.