Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
-
Ann Thorac Cardiovasc Surg · Jan 2013
Case ReportsIpsilateral jugular to distal subclavian vein transposition to relieve central venous hypertension in rescue vascular access surgery: a surgical report of 3 cases.
Central venous thrombosis may often arise following central venous cannulation for temporary haemodialysis access. Venous thrombosis may be clinically asymptomatic due to the presence of collateral circulation. However, if an arteriovenous (AV) fistula is prepared below the obstructed venous segment, then symptoms may occur. ⋯ The AV fistula was used for dialysis treatment starting from the first postoperative day. At follow-up (mean 13 months), there was no recurrence of upper limb venous hypertension. In patients with subclavian occlusion and ipsilateral low flow, patent AV fistula, jugular to distal subclavian vein transposition may prove useful in cases when percutaneous angioplasty is technically not feasible or long term patency is not expected.
-
Ann Thorac Cardiovasc Surg · Jan 2013
Preoperative high N-terminal pro-B-type natriuretic peptide level can predict the incidence of postoperative atrial fibrillation following off-pump coronary artery bypass grafting.
N-terminal pro-B type natriuretic peptide (NT-pro-BNP) is one of the biomarkers, increased by myocardial ischemia or subsequent, burdened wall stress. The aim of this study was to assess if NT-pro-BNP can predict the incidence of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). ⋯ A high preoperative level of NT-pro-BNP could predict the incidence of postoperative AF after OPCAB.
-
Ann Thorac Cardiovasc Surg · Jan 2013
Case ReportsSurgical embolectomy of a floating right heart thrombus and acute massive pulmonary embolism: report of a case.
Right heart thrombus represents a mobilized deep venous thrombosis that is lodged temporarily in the right atrium and ventricle, and is often referred to as "emboli in transit." Floating right heart thrombus is an uncommon but life-threatening condition, and usually coexists with an already massive pulmonary embolism. The presence of floating right heart thrombus appears to substantially increase the risk of mortality compared to the presence of pulmonary embolism alone. Floating right heart thrombus needs emergency treatment, but there is no clear consensus regarding optimal management, e. g.,thrombolytic therapy, anticoagulation therapy, or surgical removal. ⋯ The patient's postoperative course was uneventful, and she remained in good health without recurrence of pulmonary embolism. This success was based on rapid diagnosis by transthoracic echocardiography and computed tomography, prompt decision-making to proceed with surgical intervention and efficient postoperative care. In this case, surgical embolectomy was effective for a floating right heart thrombus with acute massive pulmonary embolism.
-
Ann Thorac Cardiovasc Surg · Jan 2013
Review Case ReportsTracheo-innominate artery fistula: two case reports and a clinical review.
Tracheo-innominate artery fistula (TIF) is a surgical emergency with high mortality rates. Reported incidence is 0.1%-1.0% after tracheostomy with peak incidence 3 days to 6 weeks post procedure. ⋯ For the successful management of TIF, treatment should be initiated immediately with the special considerations kept in mind. We describe two cases of TIF, and its clinical characteristics are reviewed in accordance with relevant literature.
-
Ann Thorac Cardiovasc Surg · Jan 2013
ReviewEvolution in experimental Fontan circulation: a review.
Experimental right heart bypass operations have influenced the evolution of current application of the Fontan procedure. In this review, we summarize the evolution and progress of the experimental Fontan operation (FO) and discuss the questions raised so far. The evolution and progress of the experimental FO is analyzed in this review by collecting data retrieved from English literature research. ⋯ Computational fluid dynamics (CFD) has played a significant role in the investigation of the hemodynamic characteristics of the FO and has been applied to the design and integration of the procedure. CFD was also employed to evaluate the performance of assisted Fontan circulation. Accumulated experience from the experimental studies and clinical practice, in combination with the cooperation of different fields in medicine and positive sciences, are definitely expected to help the evolution furthermore.