Heart, lung & circulation
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Heart, lung & circulation · Feb 2013
Totally thoracoscopic surgical treatment for atrial septal defect: mid-term follow-up results in 45 consecutive patients.
Totally thoracoscopic operation provides minimally invasive alternative for patients with atrial septal defect. In this study, we report the mid-term follow-up results of 45 patients with atrial septal defect who underwent totally thoracoscopic operation and discuss the feasibility and safety of this new technique. ⋯ Totally thoracoscopic repair is feasible and safe for patients with ASD, even with or without tricuspid regurgitation however more clinical data is needed in the future study.
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Heart, lung & circulation · Jan 2013
The role of the preoperative screening of sleep apnoea by Berlin Questionnaire and Epworth Sleepiness Scale for postoperative atrial fibrillation.
Undiagnosed obstructive sleep apnoea (OSA) is a risk factor for postoperative atrial fibrillation (POAF) as well as for heart disease in general. This necessitates screening during preoperative assessment to facilitate the implementation of strategies to minimise the postoperative risk. Overnight polysomnography is the "gold standard" for the diagnosis of OSA but may be impractical during preoperative assessment, and so questionnaires may be useful for screening OSA. The Berlin Questionnaire (BQ) and Epworth Sleepiness Scale (ESS) are two of the widely prescreening tools for persons who may suffer from sleep disorders. Thus, screening for and treating OSA as part of the routine preoperative evaluation of cardiac surgical patients may be a useful strategy for preventing POAF. ⋯ Preoperative questionnaire-based diagnosis of OSA by the simple BQ and ESS may be useful in predicting POAF, and can be easily incorporated into routine screening of surgical patients undergoing CABG operation.
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Heart, lung & circulation · Jan 2013
Review Case ReportsRight-to-left atrial shunting associated with aortic root aneurysm: a case report of a rare cause of platypnea-orthodeoxia syndrome.
Platypnea-orthodeoxia is a rare syndrome characterised by dyspnoea and hypoxaemia worsened on upright posture. We report the case of a 76 year-old man treated for lung adenocarcinoma who had developed severe hypoxaemia due to right-to-left shunt through a patent foramen ovale (PFO). Diagnosis was suspected by systemic uptake of isotope during lung scintigraphy performed to exclude pulmonary embolism. ⋯ Chest computed tomography and echocardiography showed a 59-mm aneurysm of the thoracic aorta. The opening of the PFO seemed to be the result of mechanical deformation of the atrial septum by aortic root dilatation. Transcatheter closure of the atrial defect has provided excellent results, including a rapid increase in systemic saturation and improvement of symptoms without any complications.
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Heart, lung & circulation · Dec 2012
Case ReportsTransjugular and transseptal treatment of a degenerated mitral valve prosthesis with a balloon-expandable biological valve.
In selected high-risk patients, trans-catheter valve implantation is an emerging therapy for a degenerated bioprosthesis in need of repeated valve replacement. During the last two years, valve-in-valve implantations have mainly been performed in the aortic position and only rarely in the mitral position. Here we describe for the first time the case of a 62 year-old female with severe mitral regurgitation of a degenerated Carpentier Edwards bioprosthesis treated by transjugular, transseptal implantation of a SAPIEN-XT valve. In conclusion this case, together with previous reports, show the feasibility and safety of percutaneous valve-in-valve implantations to treat a degenerated bioprosthesis.
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Heart, lung & circulation · Dec 2012
Case ReportsExtracorporeal membrane oxygenation support in a situation of diagnostic dilemma.
Severe acute respiratory distress syndrome (ARDS) in children carries a high morbidity and mortality. High frequency ventilation and extracorporeal membrane oxygenation (ECMO) are used as rescue modes of support in difficult situations. Malignancy may be considered to be a relative contraindication to ECMO support. We report a case where the decision was made to support the patient with ECMO for fulminant Epstein-Barr (EBV) infection while investigations were being done to exclude an underlying malignancy.