Asian cardiovascular & thoracic annals
-
Asian Cardiovasc Thorac Ann · May 2014
Randomized Controlled TrialIs steel wire closure of sternotomy better than polyester suture closure?
Median sternotomy is the preferred approach for open heart surgeries. The sternotomy incision is predominantly closed with either steel wire or polyester suture. The type of material used is primarily based on the surgeon's choice, and both materials achieve a good result. No prospective clinical study has been undertaken to evaluate differences in the incidence of wound infection and the degree of pain associated with both techniques. ⋯ The use of polyester suture for sternal closure in adult patients results in increased wound infection, wound pain, and late wound complications, but lower mediastinal drain output.
-
Asian Cardiovasc Thorac Ann · May 2014
Left atrial reduction in modified maze procedure with concomitant mitral surgery.
An association between mitral valve disease and atrial fibrillation is common. Modifications of energy sources have simplified surgical ablation. Left atrial size reduction should improve outcomes of the maze operation. ⋯ Radiofrequency ablation is an effective option for treatment of permanent atrial fibrillation concomitant with mitral valve surgery. Atrial reduction to <50 mm improves success. Elimination of atrial fibrillation significantly prolongs patient survival.
-
Asian Cardiovasc Thorac Ann · May 2014
Case ReportsInfected pseudoaneurysm following a modified Blalock-Taussig shunt procedure.
A 3-year-old boy with pulmonary atresia with ventricular septal defect, who had undergone placement of a modified Blalock-Taussig shunt, presented with a 1-week history of high fever. Computed tomography showed a pseudoaneurysm at the anastomosis between the right brachiocephalic artery and the graft. After intravenous antibiotic therapy, the pseudoaneurysm and infected graft were resected through a median sternotomy. This report describes successful management of a potentially fatal complication following placement of a modified Blalock-Taussig shunt.
-
Asian Cardiovasc Thorac Ann · May 2014
Case ReportsAcquired coronary-to-bronchial artery fistula after two valve surgeries.
A 62-year-old woman with Takayasu arteritis and 2 prior aortic valve replacements, was admitted with unstable angina. Computed tomographic angiography showed a newly developed right coronary artery-to-right bronchial artery fistula. Because of dense aortic calcification, catheter embolization was undertaken, which was successful. We believe the acquired coronary artery fistula developed after her uneventful second aortic valve surgery, due to inevitable trauma to the mediastinum and ascending aorta, and partly due to her underlying Takayasu arteritis.
-
Asian Cardiovasc Thorac Ann · May 2014
Observational StudyPatent ductus arteriosus in preterm infants: benefits of early surgical closure.
Patent ductus arteriosus in preterm neonates leads to significant morbidity. Surgery is indicated when pharmacological treatment fails or is contraindicated, but the optimal timing remains unclear. ⋯ Performing early ligation of symptomatic ductus arteriosus after unsuccessful pharmacological therapy in preterm neonates might lower complication rates and improve neurological outcome. Prospective randomized studies are needed to determine the optimal treatment.