Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
-
Ann Thorac Cardiovasc Surg · Oct 1999
Case ReportsEvoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal repair: a case report.
An 82-year-old man underwent thoracoabdominal aortic replacement under cardiopulmonary bypass with left femoral artery cannulation. Lumber descending evoked spinal cord potentials and segmental evoked spinal cord potentials were monitored simultaneously for detecting spinal cord damage. ⋯ This monitoring system revealed that peroneal nerve paralysis can occur due to leg ischemia caused by femoral artery cannulation. This is, to our knowledge, the first report that segmental evoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal surgery.
-
Ann Thorac Cardiovasc Surg · Oct 1999
Clinical TrialThe efficacy and mid-term results with use of gelatin resorcin formalin (GRF) glue for aortic surgery.
Twenty-six patients were treated by surgical procedure for aortic diseases with use of Gelatin Resorcin Formalin (GRF) glue. They consisted of 25 cases of emergency surgery for type A acute aortic dissection (AAD) and one elective case of distal arch aneurysm. Fifteen patients had moderate to massive aortic regurgitation (AR). ⋯ The actuarial survival rate at 35 months was 76. 9%. According to these results, we recommend that GRF glue is very effective to reinforce the diseased aortic wall and will improve long-term survival. However, it is considered that the hemostasis effect of GRF glue is not sufficient to be used on anastomosed stitches from the outer side of the aorta.
-
Ann Thorac Cardiovasc Surg · Aug 1999
Case ReportsOpen stent-graft repair for acute type A aortic dissection with an intimal tear in the descending aorta.
A 47-year-old man with acute retrograde aortic dissection (Stanford type A) was treated with total aortic arch replacement and endoluminal stent-grafting for an intimal tear in the descending aorta. A stent-graft was introduced into the descending aorta via the transected arch aorta and the entry of the dissecting aneurysm was closed. Open endovascular stent-grafting via the arch aorta is an alternative for repair of acute type A aortic dissection with an intimal tear in the descending aorta, in cases where direct closure of the intimal tear is difficult.
-
Ann Thorac Cardiovasc Surg · Jun 1999
Case ReportsA single-stage operation for bicuspid aortic valve, annulo-aortic ectasia, hypoplastic aortic arch, and coarctation of the aorta: A case report.
The patient was an 18-year-old man who had been diagnosed as having a bicuspid aortic valve and dilatation of the ascending aorta six years previously. As he grew up, aneurysmal change of the ascending aorta and hypertension in the upper body gradually progressed. Preoperative evaluation showed annulo-aortic ectasia and the following congenital abnormalities: bicuspid aortic valve, hypoplastic aortic arch, and coarctation of the aorta. Composite graft replacement and extended total aortic arch replacement were carried out.
-
Ann Thorac Cardiovasc Surg · Jun 1999
Case ReportsSuccessful surgical treatment of primary aorto-duodenal fistula associated with inflammatory abdominal aortic aneurysm: A case report.
We report a rare case of a 50-year-old woman with intermittent gastrointestinal (GI) bleeding and diagnosed as having primary aortoenteric fistula (PAEF) with inflammatory abdominal aortic aneurysm (IAAA). She was transferred to our institution with suspected PAEF as assessed by duodenoscopy and CT scan. ⋯ The fistula was closed and the aneurysm replaced by a Woven Dacron Graft with an inter-positioning omental flap. A high index of suspicion is the most important diagnostic aid to prevent overlooking this often fatal disease.