Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Apr 2011
Restoration of the thoracic aorta in Type A dissection with hybrid prosthesis.
Following successful repair of Type A dissection, late morbidity and mortality depend on the progression of residual chronic Type B dissection. To avoid the development of late aneurysms of the descending thoracic aorta, a persistent aortic false lumen around the stent-graft can be prevented by remodeling the thoracic aorta. Ten consecutive patients (mean age: 56 years) with acute Type A dissection underwent a "frozen elephant trunk operation" with the E-vita hybrid prosthesis, under deep hypothermic circulatory arrest, between October 2009 and April 2010. ⋯ Two patients suffered postoperative pulmonary arterial embolism; one underwent embolectomy. Restoration of the thoracic aorta is a safe procedure to close the false lumen during the primary operation for acute Type A dissection. However, the diameter of the stent should reflect the overall aortic size, independent of the diameter of the true lumen.
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Asian Cardiovasc Thorac Ann · Apr 2011
Case ReportsTricuspid valve repair in Ebstein's anomaly by posterior annular plication.
Two girls, aged 14 and 11 years, with Ebstein's anomaly, were treated by simple posterior annular plication of the functional annulus, without plication of the atrialized right ventricle. At follow-up after 15 and 12 months, both patients were in functional class I with no tricuspid regurgitation on echocardiography. This technique looks simple, safe, and effective, particularly for mild forms of Ebstein's anomaly, but the longevity of this repair remains to be determined.
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Asian Cardiovasc Thorac Ann · Feb 2011
Comparative StudyDoes preoperative clopidogrel increase bleeding after coronary bypass surgery?
Antiplatelet therapy has been demonstrated to reduce the risk of cardiac events in patients presenting with acute coronary syndrome, yet all effective therapies also increase the risk of bleeding. This study aimed to test the hypothesis that patients undergoing coronary artery bypass grafting, who received clopidogrel within 5 days before surgery, have worse bleeding outcomes and blood transfusion requirements than those who stopped clopidogrel >5 days earlier. We recruited 342 patients who underwent on-pump elective coronary artery bypass grafting between January 2004 and December 2008. ⋯ There was no significant difference in the amount of blood products used. There was no reexploration in either group. It was concluded that preoperative clopidogrel exposure does not increase the risk of hemostatic reoperation or the requirements for blood and blood product transfusion during and after coronary artery bypass grafting.
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Bronchogenic cysts are most frequently located in the middle mediastinum near the carina. Esophageal bronchogenic cysts are extremely rare. An intramural esophageal bronchogenic cyst was successfully resected from a 51-year-old man.