Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2011
Case ReportsDistal repair using the frozen elephant trunk technique to treat an extended mycotic aneurysm of the aortic arch.
We reported successful distal repair using the frozen elephant trunk technique to treat a mycotic aneurysm extending from the ascending aorta to the descending aorta. A blood culture sample was positive for Escherichia coli, and total arch replacement with a rifampicin-bonded graft covered the omental pedicle flap.
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Interact Cardiovasc Thorac Surg · Dec 2011
Case ReportsVascular antispastic medication should take priority over other antihypertensives after coronary artery bypass grafting using a radial artery conduit.
Radial artery conduits have recently been used more often in coronary artery bypass grafting because of their potentially better long-term patency than saphenous vein conduits. However, vasospasm of the radial artery conduit due to its nature as a muscular artery has always been of concern and a variety of vasodilators have empirically been used to reduce the risk of spasm. ⋯ We report a case of a patient with a radial artery graft who did not receive vasodilators after surgery due to hypotension. The patient developed vasospasm of the radial artery conduit which did not respond to direct injection of vasodilators into the conduit but recovered after taking oral vasodilators for four weeks.
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Interact Cardiovasc Thorac Surg · Dec 2011
Cardiac displacement during off-pump coronary artery bypass grafting surgery: effect on sublingual microcirculation and cerebral oxygenation.
Cardiac displacement during off-pump coronary artery bypass (OPCAB) surgery causes a fall in cardiac output. Here, we investigate how this drop in systemic perfusion is transferred to the oxygenation of sublingual and cerebral tissue. Sublingual microcirculatory perfusion or microcirculatory hemoglobin oxygen saturation (μHbSO(2)) measurements were performed using sidestream dark-field imaging and reflectance spectrophotometry, respectively (both n = 12). ⋯ After repositioning of the heart, all the values returned to baseline. Our data suggest that systemic hemodynamic alterations during cardiac displacement in OPCAB surgery reduce sublingual and cerebral tissue oxygenation. These findings are particularly important for patients at risk for the consequences of cerebral ischemia.
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Interact Cardiovasc Thorac Surg · Dec 2011
Case ReportsSuccessful conservative management of blunt right ventricular rupture in a patient with prior cardiac surgery.
Blunt cardiac trauma is one of the leading causes of death on site in motor vehicle accidents and frequently requires an emergent surgical intervention if the patient reaches the hospital. We experienced a rare case of blunt right ventricular disruption that was successfully managed by conservative therapy without surgery.