Interactive cardiovascular and thoracic surgery
-
Interact Cardiovasc Thorac Surg · Aug 2013
Simple adaptations of surgical technique to critically reduce the risk of postoperative sternal complications in patients receiving bilateral internal thoracic arteries.
Limited blood supply to the thoracic chest wall is a known risk factor for sternal wound complications after CABG. Therefore, bilateral internal thoracic arteries are still rarely utilized despite their proven superior graft patency. The aim of our study was to analyse whether modification of the surgical technique is able to limit the risk of sternal wound complications in patients receiving bilateral internal thoracic artery grafting. ⋯ Adjusted for common risk factors, skeletonization of BITA grafts together with augmented sternal wires is effective in preventing sternal complications. The use of PRF sealant, however, increased the risk for superficial wound complications.
-
Interact Cardiovasc Thorac Surg · Aug 2013
Case ReportsPost-infarction biventricular free wall rupture with extracardiac shunt presenting as ventricular septal rupture.
Ventricular free wall rupture is a rare, usually fatal complication of acute myocardial infarction. Subacute free wall rupture with pseudoaneurysm formation is even rarer, but may be associated with a chance of survival if surgery is performed expeditiously. ⋯ We report an unusual case of post-infarct biventricular rupture masquerading as a ventricular septal defect, due to an extracardiac shunt within the pseudoaneurysm. Our patient underwent urgent surgery, made an excellent recovery and was discharged home in a fully functional condition within a week post-surgery.