The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 2013
Case ReportsAortic mispuncture during routine catheterization requires emergency cardiac operation.
Transseptal puncture for left heart catheter or left atrial appendage occlusion is a highly standardized routine intervention in interventional cardiology. However, mispuncture is rare but can be life threatening at worst. Here, we report the case of a combined mispuncture of the right atrium and the ascending aorta resulting in a pericardial effusion with a hemodynamic effective tamponade requiring urgent cardiac operation for successful life saving.
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Thorac Cardiovasc Surg · Oct 2013
Can EuroSCORE II predict the mortality and length of intensive care unit stay after total aortic arch replacement with stented elephant trunk implantation for DeBakey type I aortic dissection?
EuroSCORE is a widely used objective risk scoring model. ⋯ Although EuroSCORE II is the newest risk model for cardiac surgery, it is not accurate when it is applied for thoracic aortic surgery. A new risk evaluating system specially designed for aortic surgery should be developed in the future.
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Thorac Cardiovasc Surg · Oct 2013
Multicenter StudyEvaluation of the thoracic aortic dissection treated by endografts covering a longer distance of aorta according to the location of the Adamkiewicz artery.
Presurgical locating the Adamkiewicz artery (AKA) will be very helpful for thoracic aortic endovascular repair. This study aimed to evaluate the effects of using longer endografts according to location of AKA on outcomes of endovascular treatment for thoracic aortic dissection. ⋯ Accurate preoperative knowledge of AKA is extremely useful for selecting a longer device to provide a better structural stability of affected aorta and promote false lumen thrombosis during a midterm follow-up phase.
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Thorac Cardiovasc Surg · Oct 2013
Case ReportsSuccessful management of a mycotic pseudoaneurysm involving an arch branch using an endovascular stent graft.
Mycotic aneurysms in the aortic arch are extremely rare and represent a challenging surgical problem. Although surgery is the standard treatment, application of endovascular repair has been extended, but this technique carries a concern regarding the interposition of an artificial graft in the infected lesion. We present the case of an infected pseudoaneurysm in the thoracic aorta which was successfully excluded by treatment with a stent graft.
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Necrotizing pneumonia, pulmonary abscess, and lung gangrene are rare complications of severe pulmonary infection with devitalization and sloughing of lung tissue. Pulmonary necrosis is often associated with alcoholism and other chronic disorders with known immunodeficiency. Mortality is significant and both treatment strategies as well as the role of surgery are controversially debated. ⋯ Necrotizing pulmonary infections are infrequent but are life-threatening disease entities. Patients often present with severe comorbidity and chronic disorders causing immunodeficiency. If initial medical therapy fails surgery offers a reasonable therapeutic approach. Aim of surgical therapy is resection of all gangrenous lung parenchyma and effective drainage of pleural empyema. Then recovery is feasible in up to 80%.