J Cardiovasc Surg
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Comparative Study
The significance of creatine kinase in cardiac patients with acute limb ischaemia.
The value of creatine kinase (CK) and aspartate transaminase (AST) has not been previously evaluated following cardiac surgery in the diagnosis of acute limb ischaemia. Our objective was to assess the value of CK and AST with reference to the diagnosis of limb ischaemia, effect on renal function and prognosis following cardiac surgery. ⋯ PATIENTs who develop limb ischaemia following cardiac surgery have a high morbidity and mortality. A CK of 17,000 U/L (5667-46539) is indicative of serious limb ischaemia. Renal failure is likely to develop in patients with CK>15,000 U/L. AST may become a useful additional marker of limb ischaemia.
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The aim of this study was to report the case of a patient with chronic dissecting infrarenal abdominal aortic aneurysm (AAA) and to review the literature for this rare vascular disorder. The preoperative assessment, surgical treatment, and postoperative course of a patient with a dissecting AAA and associated left iliac artery dissection were analyzed. The literature is reviewed with respect to etiology and pathogenesis as well as diagnostic and therapeutic management of infrarenal dissecting AAA. ⋯ A review of the literature demonstrates the rarity of dissecting aneurysm exclusively involving the infrarenal aortic segment. Primary dissecting aneurysm of the infrarenal abdominal aorta is a rare morphologic finding. Principles of diagnostic and therapeutic management of common atherosclerotic AAA also apply to dissecting AAA.
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Intraoperative right ventricular infarction immediately after coronary artery bypass grafting is a rare and potentially serious complication. We report a case in which an additional coronary artery bypass graft to a right ventricular branch with 99% stenosis brought about recovery from profound acute right ventricular failure. This case shows that complete revascularization to all graftable vessels, including even the right ventricular branch, is mandatory for successful coronary artery bypass grafting.