Asian cardiovascular & thoracic annals
-
Asian Cardiovasc Thorac Ann · Dec 2006
Valved patch for ventricular septal defect with pulmonary arterial hypertension.
From March 1998 to December 2004, 16 acyanotic patients aged 2 to 22 years (mean, 7 +/- 5.7 years) with a large ventricular septal defect and elevated pulmonary vascular resistance (9.6 +/- 3.8 Wood units) underwent surgery. A Gore-Tex patch with a 5-8 mm longitudinal slit in the center was used. A piece of pericardium was sewn around the slit on one side of the patch, except for the upper quarter. ⋯ Two patients (12.5%) died in the early postoperative period due to frequent episodes of pulmonary hypertensive crisis and persistent severe pulmonary hypertension. In 3 years of follow-up, pulmonary vascular resistance gradually decreased in all but one patient in whom it increased with a right-to-left shunt and cyanosis. Insertion of a valved patch seems to be a promising technique to decrease morbidity and mortality in severe pulmonary arterial hypertension.
-
Asian Cardiovasc Thorac Ann · Oct 2006
Case ReportsMultinodular goiter compressing the trachea following open heart surgery.
Acute hemorrhage into an adenomatous goiter following cardiac surgery is a rare cause of acute upper airway obstruction. We report an unusual presentation of respiratory distress in a patient with goiter recovering from open heart surgery, which was successfully treated by left hemithyroidectomy. A mandatory evaluation of the upper trachea in patients with long-standing benign goiter is recommended prior to cardiac surgery.
-
Four patients with displaced sternal fractures complained of intractable pain following road traffic accidents. They all had bone deformities, but only one had associated traumatic injuries. All patients underwent operative reduction and fixation of the fractured sternum using a T-shaped compression-tension stainless steel plate and screws. ⋯ Two plates have subsequently been removed. On follow-up, all patients had excellent results. Sternal plating, which is based on the tension-band principle, is an effective treatment for displaced sternal fractures.
-
Asian Cardiovasc Thorac Ann · Aug 2006
ReviewImpact of modified ultrafiltration on morbidity after pediatric cardiac surgery.
Cardiopulmonary bypass is a double-edged sword. Without it, corrective cardiac surgery would not be possible in the majority of children with congenital heart disease. However, much of the perioperative morbidity that occurs after cardiac surgery can be attributed to a large extent to pathophysiologic processes engendered by extracorporeal circulation. ⋯ Over the past several years, a modified technique of ultrafiltration, commonly known as modified ultrafiltration, has been used with increasing enthusiasm. Multiple studies have been undertaken to assess the effects of modified ultrafiltration on organ function and postoperative morbidity following repair of congenital heart defects. This review attempts to evaluate current available scientific evidence on the impact of modified ultrafiltration on organ function and morbidity after pediatric cardiac surgery.