Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsTotal cavopulmonary connection for functionally single ventricle with pulmonary atresia and abnormal arborization of pulmonary arteries--exclusion of overwhelmed area by collateral arteries from Fontan circulation.
Functionally single ventricle with major aortopulmonary collateral arteries and pulmonary atresia is very rare. Surgical indication for this combination of abnormalities is still unclear and Fontan procedure is still a crucial challenge for the patient who has this anomaly. We report a case with asplenia, functionally single ventricle, pulmonary artesian and pulmonary abnormal arborization who successfully underwent staged Fontan operation. In this case, the left upper lobe area, where the flow from a Glenn shunt was overwhelmed by the collateral arterial blood flow, was excluded from the Fontan circulation by the ligation of the left upper pulmonary arterial branch at its most proximal side at the time of fenestrated extracardiac total cavopulmonary connection.
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Interact Cardiovasc Thorac Surg · Dec 2008
Recent results regarding the clinical impact of smoking history on postoperative complications in lung cancer patients.
Cigarette smoking is a well-known risk factor for perioperative surgery-related complications; however, steady progress in perioperative management has been made year by year. This study investigated the influence of cigarette smoking on postoperative complications in patients with lung cancer over the last three years in our institution. Clinical records of 194 patients who had undergone a pulmonary resection for lung cancer were retrospectively reviewed. ⋯ In a subgroup of smokers subclassified by their smoking status or smoking index, there were no significant differences in postoperative complications. Over the recent three years of this study, smoking history was not a significant risk factor in postoperative complications. Especially in smokers, smoking status or smoking index was not a significant risk factor in postoperative complications, too.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsGiant left coronary ostial aneurysm after modified Bentall procedure in a Marfan patient.
We performed surgical repair of a giant left coronary ostial aneurysm after aortic root replacement using composite valve graft (modified Bentall procedure) in a patient with Marfan syndrome. Aneurysmal formation in the left main stem itself is very rare. ⋯ In aortic root surgeries in Marfan patients, the size of the side hole on the composite graft should be kept relatively small to fit the diameter of the native coronary arteries for prevention of coronary buttons from forming aneurysms at the level of the coronary button anastomosis. In addition, close observation to the coronary button anastomosis is indispensable in postoperative check-up.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsUpper limb ischemia in a patient with Wegener's granulomatosis.
We report a clinical case of a small-vessel vasculitis with ischemia of the left upper limb. ⋯ Classic Wegener's granulomatosis is a form of vasculitis that primarily involves the upper and/or lower respiratory tract and kidney. The amount of clinical symptoms is enormous and the diagnosis, arduous. In the literature there are only a few clinical cases referring to limb ischemia in a setting of Wegener's granulomatosis. This is a unique case report of upper limb ischemia due to involvement of a medium-large size artery in a patient with Wegener's granulomatosis.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsSurgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique.
A 50-year-old man was diagnosed with Stanford type A acute aortic dissection with cerebral malperfusion and unconsciousness. This clinical presentation was investigated by computed tomography which revealed a severe type A dissection involving all limb arteries. Successful operative treatment based on the direct arterial cannulation of the real lumen of dissected aorta at the level of Botallo's ligament by Seldinger technique achieves an appropriate perfusion and rapid cooling of the instable patient. To our knowledge this is the first reported case in the literature.