Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jul 2013
Case ReportsRecurrent upper limb ischaemia due to a crutch-induced brachial artery aneurysm.
An 83-year old man who had used bilateral axillary crutches for 67 years was referred to our hospital for acute left upper limb ischaemia. He underwent successful recanalization through emergent catheter thromboembolectomy. ⋯ Therefore, we performed aneurysm exclusion and subsequent saphenous vein bypass grafting. When a crutch user presents with upper limb ischaemia, a high index of suspicion and early identification of the crutch induced vascular injury are mandatory for appropriate treatment.
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Interact Cardiovasc Thorac Surg · Jul 2013
Case ReportsManaging major vessel injuries with a Fogarty catheter during chest re-opening in children.
Injury of structures, leading to a major bleeding during chest opening, is a severe and potentially life-threatening complication, especially in redo cardiac surgery, both in adults and children. In three paediatric redo operations performed via midline sternotomy, we managed this complication successfully and uneventfully by using an inflated Fogarty catheter to plug the blood leak from the injured vessel before repairing the lesion under direct vision in a bloodless surgical field. Herein we report in detail the technique used and a comment on our experience.
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Interact Cardiovasc Thorac Surg · Jul 2013
Case ReportsTherapeutic hypothermia for severe cerebral air embolism complicating pleural lavage for empyema.
Cerebral air embolism during pleural lavage is a rare, but potentially fatal complication. We present a case of severe cerebral air embolism that developed during pleural lavage for empyema and was successfully treated by therapeutic hypothermia. ⋯ Cranial computed tomography and cranial magnetic resonance imaging showed many small bubbles and widespread infarction in the territory of the right middle cerebral artery. The patient received therapeutic hypothermia maintained at 33°C for 24 h and could leave the hospital without delayed sequelae.
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Interact Cardiovasc Thorac Surg · Jul 2013
Self-expandable transcatheter aortic valve implantation for aortic stenosis after mitral valve surgery.
Transcatheter aortic valve implantation has emerged as a valuable option to treat patients with symptomatic severe aortic stenosis, who are not being considered for surgery because of significant comorbidities. Concerns exist over treating patients who have previously undergone mitral valve surgery for possible interference between the percutaneous aortic valve and the mitral prosthesis or ring. ⋯ Our experience confirms the feasibility of CoreValve implantation in patients with mechanical mitral valves or mitral annuloplasty ring.
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Interact Cardiovasc Thorac Surg · Jun 2013
Case ReportsSuccessful simultaneous repair of traumatic aortic and right atrium ruptures.
A 63-year old woman was transferred to our hospital due to a motor vehicle accident. Enhanced computed tomography showed aortic arch intramural haematoma and pericardial effusion. The patient lost consciousness, and we thought that the cardiac tamponade was indeed due to intrapericardial rupture of the aorta. ⋯ Next, total arch replacement with a four-branched knitted prosthetic graft was performed. Over two-thirds of the intima was circumferentially ruptured at the level of the aortic isthmus. Postoperative neurological complications did not arise.