The Annals of thoracic surgery
-
The aim of the present study was to evaluate the current outcome and reoperation rate after applying a one-stage correction strategy for interrupted aortic arch (IAA) with ventricular septal defect (VSD) and also for aortic coarctation and hypoplastic aortic arch (CoA-HyAA) with VSD beginning September 1999. ⋯ One-stage complete correction is feasible in newborns with aortic arch obstruction with VSD. Complex cardiac anatomy presents no additional risk for the procedure. The early one-stage correction yields excellent surgical results and good functional outcome.
-
Comparative Study
Long-term outcome of type B aortic intramural hematoma: comparison with classic aortic dissection treated by the same therapeutic strategy.
The long-term clinical course and therapeutic strategy of patients with type B aortic intramural hematoma (IMH) are not completely known. The purpose of this study was to clarify long-term prognosis of patients with type B IMH by comparison with type B classic aortic dissection (AD). ⋯ Patients with type B IMH have similar long-term prognosis to patients with type B AD. Medical therapy with frequent follow-up imaging studies and timed surgical repair in cases with progression can be a rational therapeutic strategy in patients with type B IMH.
-
A 68-year-old woman with concentric left ventricular hypertrophy, prosthetic valve endocarditis with aortic root abscess, and sepsis had aortic root replacement with an aortic allograft. On weaning from cardiopulmonary bypass, she had hemodynamic instability caused by systolic anterior motion of the mitral valve, which resulted in a left ventricular outflow tract obstruction; the peak pressure gradient across the left ventricular outflow tract was 130 mm Hg, and there was moderately severe (3+) mitral regurgitation. After reinstitution of cardiopulmonary bypass, a central Alfieri edge-to-edge stitch was placed between the anterior and posterior leaflets of the mitral valve. This reduced the gradient across the left ventricular outflow tract to 10 mm Hg and eliminated the mitral regurgitation, which enabled successful separation from cardiopulmonary bypass.
-
Comparative Study
Flow in coronary bypass conduits on-pump and off-pump.
The purpose of the study was to measure the blood flow in coronary artery bypass grafting conduits on-pump and off-pump and to estimate the total conduit flow. ⋯ There were no major differences in conduit flow on-pump versus off-pump. Conventional coronary artery bypass grafting on-pump may restore up to approximately half of the normal resting coronary artery blood flow (250 mL/min).
-
Case Reports
Metachronous and synchronous lung tumors: five malignant lung pathologies in 1 patient during 7 years.
We present the case of a 70-year-old man who previously had a left upper lobectomy for nonsmall cell lung carcinoma that subsequently developed into small cell carcinoma, which was successfully treated, and finally he had a right upper lobectomy that revealed three synchronous lung malignancies. We were unable to find a previous case report with a total of five separate lung malignancies with a combination of metachronous and synchronous tumors. This case demonstrates the importance of screening after the diagnosis and treatment of lung carcinoma.