Interactive cardiovascular and thoracic surgery
-
Interact Cardiovasc Thorac Surg · Apr 2012
Sternal wire-grip: a new device in the surgical armamentarium.
We describe a new wire-grip that enhances the surgeon's grip on sternal wires and facilitates their tightening with minimal risk of slips. This wire-grip should protect against operating room personnel injury during sternal re-approximation.
-
Interact Cardiovasc Thorac Surg · Apr 2012
Surgical results and long-term follow-up of T(4)-non-small cell lung cancer invading the left atrium or the intrapericardial base of the pulmonary veins.
Patients with locally advanced non-small cell lung cancer infiltrating the left atrium (LA) or the intrapericardial base of the pulmonary veins (PVs) are generally not considered good candidates for surgery because of the poor long-term survival. In the last 10 years, 31 consecutive patients with non-small cell lung cancer directly invading the LA or the intrapericardial base of the PVs underwent surgery. Pneumonectomy was the operation performed most frequently. ⋯ In these patients, surgery could be performed with an acceptable operative mortality and morbidity. Surgery should be considered whenever a complete resection is technically possible. A careful preoperative evaluation is mandatory to select good candidates for surgery.
-
Interact Cardiovasc Thorac Surg · Apr 2012
Case ReportsIt sometimes happens: late tracheal rupture after total thyroidectomy.
Thyroidectomy is a safe procedure often performed either for benign or malignant thyroid diseases. Complication rate is low and tracheal injury associated with thyroidectomy is rarely described. The trachea may be perforated or lacerated intraoperatively; nevertheless, damage is usually recognized and directly repaired with reduced patient morbidity. ⋯ The patient, without delay, underwent an exploration of the neck with a debridement of laceration. In view of the fact that a local infection was present, only a right pre-thyroid muscle flap was stitched on the defect. The patients recovered uneventfully.
-
Interact Cardiovasc Thorac Surg · Apr 2012
Combined elective percutaneous coronary intervention and transapical transcatheter aortic valve implantation.
There is no established strategy of how and when to treat coronary artery disease (CAD) in patients referred for transcatheter aortic valve implantation (TAVI). Simultaneous, single-stage treatment of both pathologies is a possible solution. We report our initial results of simultaneously performed transapical TAVI and elective percutaneous coronary interventions (PCI) in high-risk patients with severe aortic valve stenosis. ⋯ Survival at 12, 24 and 36 months of the PCI and TAVI group 87.1 ± 5.5, 69.7 ± 10.3 and 69.7 ± 10.3%, respectively. The results showed that the single-stage approach with combined elective PCI and TAVI is feasible and safe. It has become our primary choice for treatment of high-risk patients with severe aortic valve stenosis and CAD.