The Annals of thoracic surgery
-
Comparative Study
Long-term outcome of direct neopulmonary artery reconstruction during the arterial switch procedure.
Neopulmonary stenosis at anastomosis site is one of the most frequent complications after the arterial switch procedure for transposition of the great arteries. The surgical technique is a crucial factor associated with the frequency of stenotic complications. We present the outcomes of direct neopulmonary anastomosis during the arterial switch procedure in patients with simple transposition. This research was to assess the efficacy of this surgical technique based on the incidence of postprocedural supravalvular neopulmonary stenosis (SVPS). ⋯ Direct neopulmonary artery anastomosis during arterial switch is an interesting alternative to patch reconstructions and ensures a good postoperative result with low rates of complications and SVPS.
-
Comparative Study
Combined proximal endografting with distal bare-metal stenting for management of aortic dissection.
Established endovascular treatments for aortic dissection often result in incomplete aortic repair, potentially leading to late complications involving the distal aorta. To address the problems of incomplete true lumen reconstitution and late aneurysmal change, we report the midterm results of combined proximal endografting with distal true lumen bare-metal stenting (STABLE: Staged Total Aortic and Branch vesseL Endovascular reconstruction) in Stanford type A and B aortic dissection. ⋯ Staged total aortic and branch vessel endovascular reconstruction is a feasible ancillary endovascular technique to address the problems of distal true lumen collapse, incomplete aortic remodelling, and late aneurysm formation in aortic dissection.
-
We report a case of barotraumatic esophageal perforation caused by the explosion of a carbonated beverage containing plastic bottle into the mouth. A 6-year-old girl presented with sudden sharp pain in her mouth and upper abdomen after outburst of the plastic bottle. ⋯ Surgical repair was performed successfully. The patient was discharged on postoperative day 15 after an uneventful postoperative course.
-
Histoplasmosis in the mediastinum is an uncommon diagnosis that presents similarly to other benign and neoplastic conditions encountered in the chest. Here we describe a 36-year-old woman who presented with dyspnea secondary to a large anterior mediastinal mass that was biopsy and culture negative for neoplasm or infection. Video-assisted thoracoscopic surgery biopsy confirmed a large anterior mediastinal mass adherent to the aorta, which contained foci of histoplasmosis species. She is currently undergoing a long postoperative course of itraconozole and an empiric course of oral steroids to prevent development of fibrosing mediastinitis.
-
Traumatic aortic rupture is a significant challenge, further complicated by prior coronary artery bypass graft surgery with a left internal mammary artery anastomosis. We present a patient with prior coronary artery bypass graft and valve replacement who sustained multiple injuries, including an aortic rupture, after a motor vehicle crash. This report describes successful treatment of a patient with a thoracic endograft and carotid subclavian bypass to preserve the left internal mammary artery inflow.