Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Mar 2013
Comparative StudyThe effect of lung-size mismatch on mechanical ventilation tidal volumes after bilateral lung transplantation.
Mechanical ventilation tidal volumes are usually set according to an estimate of patient size in millilitres (ml) per kilogram (kg) body weight. We describe the relationship between donor-recipient lung-size mismatch and postoperative mechanical ventilation tidal volumes according to recipient- and donor-predicted body weights in a cohort of bilateral lung transplant patients. ⋯ During mechanical ventilation after bilateral lung transplantation, undersized allografts received relatively higher tidal volumes compared with oversized allografts when the tidal volumes were related to donor-predicted body weights.
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Interact Cardiovasc Thorac Surg · Mar 2013
A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method.
While performing thoracoscopic wedge resection of the lung, the location of the lesion is generally identified by visual inspection or palpation. When difficulty in identification of the lesion by thoracoscopy is anticipated, preoperative marking is performed. However, complications and technical difficulties plague current marking techniques. To overcome this problem, we designed a new, safe and easy marking technique that avoids pleural puncture, called the intrathoracic stamping method.
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Interact Cardiovasc Thorac Surg · Mar 2013
Aortic arch reconstruction in newborns with an autologous pericardial patch: contemporary results.
The incidence of recurrent aortic arch obstruction after Norwood procedure and other types of aortic arch reconstruction in newborns remains high. Biological and synthetic materials are used to enlarge the aorta. We report our experience using autologous pericardium to reconstruct the aortic arch in patients with hypoplastic left heart syndrome, aortic arch interruption and hypoplastic aortic arch. ⋯ The use of autologous pericardium in aortic arch reconstruction procedure is effective and associated with an acceptable incidence of recurrent arch obstruction. Its availability and characteristics make it an attractive alternative to other materials.
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Interact Cardiovasc Thorac Surg · Mar 2013
Comparative Study Controlled Clinical TrialContinuous renal replacement therapy versus furosemide for management of kidney impairment in heart transplant recipients with volume overload.
It is unknown whether continuous renal replacement therapy or furosemide therapy is superior in heart transplant recipients who are in postoperative kidney insufficiency and volume overload. This prospective non-randomized, controlled trial investigated the efficacy of the two methods after transplantation. ⋯ In this study, continuous renal replacement therapy in heart transplant recipients with reduced kidney function was associated with an improvement in estimated glomerular filtration rate status in comparison with furosemide.
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Interact Cardiovasc Thorac Surg · Mar 2013
Case ReportsLate ventriculo-atrial shunt migration leading to pericardial cerebrospinal fluid effusion and cardiac tamponade.
We present the case of a patient with cardiac tamponade secondary to late intrapericardial migration of a disrupted ventriculo-atrial shunt (VAS). A 48-year old woman was referred for cardiac tamponade. She had a history of congenital hydrocephalus with implantation of a VAS (Codman(®)) in 1994. ⋯ Surprisingly, cardiac tamponade was not related to bleeding but to the accumulation of translucid liquid whose gross aspect and biochemistry were very suggestive of cerebrospinal fluid (CSF). We hypothesize that a fibrin sheath had developed around the VAS at the time of its disconnection and acted as a fibrous tunnel allowing continued CSF drainage through its distal part. Surgical strategies to prevent late VAS disconnection should be considered at the time of implantation.