The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Aug 2011
Case ReportsPrimary resection of Kommerell's diverticulum in a 37-year-old patient.
A previously non-operated 37-year-old patient presented with esophageal dysphagia for solid food and stridorous breathing. Computed tomography and magnetic resonance showed a 33-mm wide Kommerell's diverticulum. ⋯ The left subclavian artery, which originated from the diverticulum, was reimplanted into the descending aorta. In addition to dissecting any tissue which is making vascular ring-like structures around the trachea and the esophagus, it is important to resect the diverticulum itself and reimplant the left subclavian artery arising from it, in this way leaving the aortic arch free from any additional dislocating forces.
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Thorac Cardiovasc Surg · Aug 2011
Management of chylothorax with octreotide after congenital heart surgery.
Chylothorax is a rare complication of congenital cardiac surgery that can seriously impair the postoperative course unless treated properly. We present our treatment protocol and results with octreotide, a somatostatin analogue, in cases of chylothorax following congenital heart surgery. ⋯ Octreotide, a long-acting somatostatin analog, is an effective and safe agent for the treatment of postoperative chylothorax and warrants further investigation in a larger series with a greater number of patients.
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Thorac Cardiovasc Surg · Jun 2011
Preoperative NT-proBNP levels: a reliable parameter to estimate postoperative atrial fibrillation in coronary artery bypass patients.
Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass grafting (CABG). This study was designed to evaluate whether the levels of preoperative and postoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) are predictors of postoperative paroxysmal atrial fibrillation in patients who undergo coronary artery bypass surgery. ⋯ The main finding of the current study is a positive correlation between high levels of preoperative NT-proBNP and the risk of new-onset AF after CABG surgery.