The Korean journal of thoracic and cardiovascular surgery
-
Korean J Thorac Cardiovasc Surg · Aug 2015
Right Heart Failure during Veno-Venous Extracorporeal Membrane Oxygenation for H1N1 Induced Acute Respiratory Distress Syndrome: Case Report and Literature Review.
A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. ⋯ Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.
-
Korean J Thorac Cardiovasc Surg · Aug 2015
Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back.
We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. ⋯ Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.
-
Korean J Thorac Cardiovasc Surg · Jun 2015
Venovenous Extracorporeal Membrane Oxygenation for Postoperative Acute Respiratory Distress Syndrome.
Extracorporeal membrane oxygenation (ECMO) has recently attracted interest as a treatment for severe acute respiratory distress syndrome (ARDS). However, the outcomes of this procedure in post-surgical settings have not yet been characterized. In this study, we evaluated the outcomes of ECMO in patients with severe postoperative ARDS. ⋯ Although the overall survival rate of patients treated with ECMO for postoperative ARDS was unfavorable, ECMO offered an invaluable opportunity for survival to patients who would not have been expected to survive using conventional therapy. CVVHD may be beneficial in improving the outcomes of such patients, whereas a prolonged duration of pre-ECMO ventilator support was associated with poor survival.
-
Korean J Thorac Cardiovasc Surg · Jun 2015
Successful Left-Heart Decompression during Extracorporeal Membrane Oxygenation in an Adult Patient by Percutaneous Transaortic Catheter Venting.
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in patients with cardiogenic shock. Insufficient decompression of the left ventricle (LV) is considered a major factor preventing adequate LV recovery. A 40-year-old male was diagnosed with acute myocardial infarction, and revascularization was performed using percutaneous stenting. ⋯ Severe LV failure developed, and percutaneous transaortic catheter venting (TACV) was incorporated into the venous circuit of VA ECMO under transthoracic echocardiography guidance. The patient was successfully weaned from VA ECMO. Percutaneous TACV is an effective, relatively noninvasive, and rapid method of LV decompression in patients undergoing VA ECMO.
-
Korean J Thorac Cardiovasc Surg · Apr 2015
Robot-assisted cardiac surgery using the da vinci surgical system: a single center experience.
We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. ⋯ Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.