Cardiovascular surgery (London, England)
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Congenital bicuspid aortic valve is a relatively rare malformation. It is reported that the presence of this anomaly predisposes the patient to development of true aortic aneurysms or dissecting aortic aneurysms. Between 1981 and August 1997, 25 patients with an aneurysm of the thoracic aorta associated with congenital bicuspid aortic valve underwent surgical treatment at the authors' institution. ⋯ No hospital deaths occurred in the authors' patients. Pathological examination of surgical specimens of the aortic wall showed cystic medial necrosis in 11 patients and mucoid degeneration in nine. In patients with congenital bicuspid aortic valve, attention should be paid to aneurysmal dilatation and aortic dissection as complications in addition to valve dysfunction.
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Review Case Reports
Treatment of May-Thurner syndrome with catheter-directed thrombolysis and stent placement, complicated by heparin-induced thrombocytopenia.
May-Thurner syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis and severe leg edema. We report the case of a 41-year-old female who presented with severe left leg edema present for 1 day. One week earlier she had experienced acute shortness of breath and pleuritic chest pain. ⋯ The endovascular reconstruction remains patent 4 months later. Heparin-induced thrombocytopenia complicating endovascular reconstruction of the iliofemoral venous system in a patient with May-Thurner Syndrome is an uncommon occurrence. This case and a review of the literature are discussed.
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Current studies indicate that portable ultrasound used by trained trauma surgeons in the emergency room can be performed using the focused abdominal sonogram for trauma technique in approximately 2 minutes to evaluate patients with blunt torso trauma. It has been shown to be as accurate as DPL and computed tomography (CT) in the detection of hemoperitoneum following abdominal trauma. It is also very accurate in detecting pericardial fluid and may have a role in the evaluation of penetrating injuries of the thorax, either from stab or gunshot wounds. ⋯ With the use of this new technology, the potential for early diagnosis of victims of trauma and prompt treatment is at hand. One of the greatest challenges remaining is that of training surgeons in the use of ultrasound. The author's experience in conducting ultrasound courses for surgeons at the Uniformed Services University of the Health Sciences is described.