Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Nov 2015
Surgical outcome of hypoplastic left heart syndrome with intact atrial septum.
The surgical outcomes of hypoplastic left heart syndrome with intact atrial septum remains very poor in spite of the introduction of prenatal diagnosis before the Norwood operation. The hybrid operation consisting of bilateral pulmonary artery banding and balloon atrioseptectomy is one of the treatment strategies to potentially improve this patient population, however, the long-term outcomes are unknown. ⋯ The hybrid operation for hypoplastic left heart syndrome with intact atrial septum may have improved the neonatal outcome and Fontan completion rate in this extremely high-risk group of patients, but the long-term outcome remains dismal. Considering the late mortality related to pulmonary complications, aggressive fetal intervention to create a nonrestrictive atrial septal communication to promote normal development of the pulmonary vessels may be the last resort to improve the long-term outcome.
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Asian Cardiovasc Thorac Ann · Nov 2015
Case ReportsBioprosthetic aortic valve replacement on a mechanical valve ring.
Mechanical valve failure is a known but rare occurrence in cardiac surgery. A 71-year-old lady underwent surgery for failure of her mechanical aortic valve. It was replaced with another mechanical valve. ⋯ Under these circumstances, a novel approach was adopted and a bioprosthetic valve was implanted on the mechanical valve sewing ring as a final resort. The intervention was successful. This illustrates a case of the need for innovative approaches in cardiac surgery.
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Asian Cardiovasc Thorac Ann · Nov 2015
Case ReportsSurgery for false aneurysm developing after type A acute aortic dissection.
Aortic false aneurysm is life-threatening with high morbidity and mortality rates. Surgical treatment varies according to the pathologic process, infection status, and site of origin of the aneurysm. We presented a case of false aneurysm of the ascending aorta, developing after type A acute aortic dissection repair. The operation was performed with the use of deep hypothermia and circulatory arrest to avoid massive uncontrollable hemorrhage.
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Asian Cardiovasc Thorac Ann · Nov 2015
Observational StudyHyperbilirubinemia after cardiac surgery: An observational study.
We aimed to assess the incidence and perioperative risk factors for hyperbilirubinemia after cardiac surgery, and determine its influence on early operative outcome. ⋯ Postoperative hyperbilirubinemia is common in patients undergoing cardiopulmonary bypass and is associated with high hospital mortality. The factors associated with its occurrence are increased preoperative bilirubin level, preoperative prothrombin time, cardiopulmonary bypass time, aortic crossclamp time, and blood transfusion units. Persistent hyperbilirubinemia is associated with a worse outcome than early transient hyperbilirubinemia.
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We present an unusual case of bronchial foreign body in an adult who presented with bronchiectasis more than two decades later. The patient was unaware of his accidental aspiration of the foreign body, and the final diagnosis was made intraoperatively.