J Cardiovasc Surg
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Blunt innominate artery injury is a rare but often lethal complication of severe deceleration trauma. We report the case of a 38-year-old man with such an injury who was successfully operated on an emergency basis. In cases of brachiocephalic vessel trauma, a high index of suspicion in chest deceleration injuries may lead to a proper investigative process and an accurate diagnosis. ⋯ A chest CT scan may contribute to the diagnosis and can rule out major trauma of the aorta, but the procedure of choice for the definite diagnosis is usually the angiography. Subsequent early repair is favorable to avoid complications and fatal events. Cardiopulmonary bypass use in selected cases favors the outcome.
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Case Reports
Stent-graft replacement of chronic traumatic aneurysm of the thoracic aorta after blunt chest trauma.
Chronic traumatic aneurysm of the thoracic aorta is an unusual occurrence. Open-chest surgery for repair of chronic traumatic aneurysms results in mortality rate of 5-18%, and a morbidity rate of 11-50% also. ⋯ Stent-grafting procedure is described. Stent-grafting in chronic traumatic aneurysm of the thoracic aorta seems to be a viable minimal invasive therapeutic option for traumatic rupture of the aortic isthmus.
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Review Case Reports
False aneurysm of perforating branch of the profunda femoris artery after external fixation for a complicated femur fracture.
False aneurysm of the profunda femoris artery rarely occurs and is a serious complication following femur fracture. A 39-year-old man who developed a false aneurysm arising from the perforating branch of the profunda femoris artery following an external fixation for a complicated femur fracture was presented. Clinical diagnosis was confirmed by selective arterial angiography after occurrence of significant hemorrhage and swelling of the injured thigh. ⋯ The patient was discharged on the 10th postoperative day with external fixation. False aneurysm in a branch of the profunda femoris artery is a very rare status following application of the external fixator due to complicated femur fracture. Related literatures and interventions were reviewed on the basis of this case.
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Severe pulmonary oxygenation impairment occurred in some patients with pleurotomy during the harvest of the internal mammary artery graft followed by coronary artery bypass grafting (CABG). Peripheral pulmonary atelectasis in the postoperative chest X-ray was detected in these patients. We studied the efficacy of intraoperative positive end-expiratory airway pressure (PEEP) therapy for the prevention of postoperative pulmonary oxygenation impairment. ⋯ In conclusion, PEEP therapy may prevent pulmonary atelectasis and oxygen impairment after CABG.
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Aim of this study was to evaluate the factors influencing immediate and long-term results in patients undergoing aortic root replacement with a composite graft. ⋯ The Bentall procedure for aortic root replacement is safe and durable; in hospital mortality in elective status it was 1.28%; early and long-term mortality higher in patients with acute dissection. Six late deaths were procedures related. Sixty-six patients (76.4%) were in NYHA I class at follow-up. The incidence of late outcomes, thromboembolism (1.03%), graft infection (2.06%), pseudoaneurysm (0%), reoperation in ascending aorta or aortic valve (3.1%), operations on the remaining aorta (6.7%), and hemorrhage due to anticoagulant therapy (1.03%), are very low.