The Annals of thoracic surgery
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Bronchogastric conduit fistula is a rare and potentially fatal complication after esophagectomy for esophageal cancer. We report a case of a patient transferred to our institution with a complex bronchogastric conduit fistula after a thoracoscopic three-hole esophagectomy for midesophageal squamous cell carcinoma. ⋯ This was successfully reconstructed with a single-stage repair by use of an Alloderm patch reinforced with an intercostal muscle flap. At postoperative follow-up the patient is doing well and tolerating a regular diet without dysphagia.
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Case Reports
Endovascular repair of ruptured aberrant left subclavian artery with right aortic arch.
Association of a right-sided aortic arch with an aberrant left subclavian artery is rare. We present a case of successful endovascular repair of a ruptured Kommerell diverticulum associated with a right-sided aortic arch and aberrant left subclavian artery. ⋯ We managed the rather hostile neck with an extra-large Palmaz stent. A left carotid-to-subclavian bypass with an 8-mm Dacron graft was also performed to restore left arm perfusion and prevent vertebrobasilar insufficiency.
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Acute kidney injury in patients undergoing cardiac surgery and coronary angiography on the same day.
Contrast media used for coronary angiography may result in a contrast-induced nephropathy. Acute kidney injury (AKI) is a common complication of cardiac surgery. It has been hypothesized that cardiac surgery in close succession to coronary angiography may increase the risk of postoperative AKI. However, data from the existing literature are conflicting. The aim of this study is to investigate the risk of AKI in patients undergoing angiography and cardiac surgery on the same day, and to assess the efficacy of a policy limiting this practice. ⋯ Acute kidney injury after cardiac surgery is a multifactorial event; surgery on the same day of angiography significantly increases the risk of AKI, and limiting this practice results in a containment of the postoperative AKI incidence.