Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Aug 2005
Case ReportsSurgical treatment of pulmonary embolism with recent intracranial hemorrhage.
Massive pulmonary embolism (PE) with concomitant intracranial hemorrhage (ICH) has a high mortality rate. Although thrombolytic therapy is generally accepted as emergent treatment for massive PE, the risk of bleeding complications are significant. ⋯ Thrombolysis was deferred, and emergent surgical embolectomy with cardiopulmonary bypass (CPB) was elected. Patient outcome was favorable without recurrence of ICH.
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Ann Thorac Cardiovasc Surg · Aug 2005
Case ReportsPosterior mitral annuloplasty through the aortic root.
A case of mitral regurgitation associated with aortic root aneurysm treated with posterior mitral annuloplasty is presented. The annuloplasty was performed through the aortic annulus using valve-preserving aortic root reconstruction. Postoperatively, mitral regurgitation resolved, and the degree of aortic regurgitation decreased from severe to mild. Thus, we conclude that the transaortic approach is useful for simple mitral valve repair with concomitant aortic root surgery.
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Ann Thorac Cardiovasc Surg · Aug 2005
Randomized Controlled Trial Comparative Study Clinical TrialSystemic inflammatory response syndrome (SIRS) in serious chest injuries: is a pharmacological blockade effective?
There has been an ongoing increase in the frequency and severity of blunt chest injuries. Their rather high lethality is caused by the injury alone as well as by the following systemic inflammatory response. The aim of the study is to verify the efficacy of the pharmacological blockade of the systemic inflammatory response syndrome (SIRS) in serious blunt chest injuries, and to identify whether the administration of indomethacin as a cyclooxygenase inhibitor could prevent a multiorgan dysfunction (MODS) and a multiorgan failure (MOF). ⋯ The results obtained during the first 20 months of the study imply that a certain number of patients with serious blunt chest trauma could benefit from indomethacin administration.
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Ann Thorac Cardiovasc Surg · Aug 2005
Case ReportsEndarterectomy and graft replacement of severely calcified (porcelain) ascending aorta with coronary ostial involvement in a patient requiring aortic valve replacement.
We report a successful aortic valve replacement within an extensively calcified (porcelain) aorta, involving the left coronary artery ostium. Clamping such an aorta can result in embolization, dissection, and mural laceration. A 72-year-old female presented with a severely calcified and stenotic aortic valve with a peak pressure gradient of 101 mmHg. ⋯ Under deep hypothermic circulatory arrest, the aorta was transected at the proximal arch and distal graft anastomosis was performed. This was followed by endarterectomy of the porcelain ascending aorta and the left coronary ostium. Aortic valve replacement, proximal aortic graft anastomosis, and a coronary artery bypass grafting (CABG) with the left internal thoracic artery (LITA) anastomosed to the left anterior descending artery (LAD) were then performed in a sequential manner.
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Ann Thorac Cardiovasc Surg · Aug 2005
Case ReportsTetraplegia after coronary artery bypass, a rare complication.
Paraplegia after coronary artery bypass is rare. We present here a rare case of acute paraplegia after coronary artery bypass due to cervical disc herniation. This patient further developed respiratory failure due to denervation of respiratory muscles, resulting in tetraplegia. Prompt diagnosis with MRI and surgical decompression should be performed, otherwise permanent neurological impairment may occur.