J Cardiovasc Surg
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Case Reports
Ductus diverticulum aneurysm associated with bicuspid aortic valve and dilatation of ascending aorta.
Saccular aortic aneurysm arising in the ductal region, known as ductus diverticulum aneurysm, is a rare anomaly. Due to potentially malignant evolution, recognition of radiological signs associated with this anomaly during the asymptomatic phase may be important in order to plan surgical intervention in time. We report an unusual case of ductus diverticulum aneurysm combined with bicuspid aortic valve, dilatation of ascending aorta, and coronary artery disease.
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During the last ten years, 84 patients treated for ruptured infrarenal aortic aneurysm have been reviewed to evaluate complications and mortality rates, to determine which factors influenced these rates and to identify the means to improve these results. ⋯ These factors cannot be controlled by the surgeon and it should be noted that a significant reduction of the mortality rate may be very difficult or even impossible to achieve. These findings support the concept of aggressive elective resection of abdominal aortic aneurysms.
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Eight children with traumatic asphyxia were evaluated retrospectively. There were five boys and three girls. The mechanism of injuries was motor vehicle accidents in six children. ⋯ Associated injuries were noted in all patients often involving thorax and head. Cerebral seizures complicated head injury in one patient. No mortality was recorded.
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Randomized Controlled Trial Clinical Trial
The use of exogenous creatine phosphate for myocardial protection in patients undergoing coronary artery bypass surgery.
A key component in the development of ischemic functional and structural myocardial injury during cardiosurgical procedures is an inadequate cellular energy supply which occurs as a consequence of the cessation of oxidative metabolism. In such conditions high energy phosphates are rapidly depleted. As they play a critical role in the maintenance of cell viability and postischemic recovery of contractile function, their conservation is therefore a primary objective in any procedure designed to reduce ischemic injury. ⋯ Concluding, the authors wish to state that: Exogenous phosphocreatine (Neoton) perioperative administration in coronary artery bypass patients reduced the need for inotropic drugs, which is clinically manifested in lower frequency of low cardiac output syndrome. Perioperative administration of exogenous CP improves electrophysiological stability of the myocardium. Advantageous clinical and electrophysiological effect of exogenous CP may result from its properties to protect sarcolemma of the cardiomyocytes.
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Case Reports
Membranous obstruction of the inferior vena cava and Budd-Chiari syndrome. Report of a case.
Membranous obstruction of the inferior vena cava (MOIVC) is a rare, congenital or acquired, cause of Budd-Chiari syndrome leading to hepatocellular carcinoma in 20 to 40% of the patients. It has a very poor prognosis when treated medically and balloon angioplasty (PTA) represents, nowadays, the treatment of choice, having no mortality or significant morbidity with follow-up as long as 5 years; transatrial membranotomy, direct reconstruction of IVC and bypass surgery are alternative techniques when PTA is not feasible. ⋯ A successful inferior vena cava-right atrium PTFE bypass, with a 3.5-year follow-up, was performed. This surgical approach is a valuable alternative to transatrial membranotomy and direct reconstruction of the IVC.