Journal of cardiac surgery
-
Case Reports
Syncope as an initial manifestation of atypical lipomatous hypertrophy of the interatrial septum.
Lipomatous hypertrophy of the interatrial septum (LHIS) is an incidental echocardiographic abnormality characterized by dumb-bell configuration of the interatrial septum from excess fat deposition. We report a case of syncope in a patient with LHIS obstructing the superior vena cava at the right atrial junction.
-
Acute refractory cardiogenic shock with early multisystem organ failure has a poor outcome without mechanical circulatory support. We review our experience with emergent peripheral cardiopulmonary support as a bridge to decision in these patients. ⋯ Salvage peripheral cardiopulmonary support is a useful tool to rapidly stabilize acute refractory cardiogenic shock permitting an assessment of neurologic and end-organ viability.
-
We report the use of fibrinogen/thrombin-coated equine collagen patch (Tachosil(®) ) as a sealant agent in six patients who underwent heart surgery for congenital heart disease (CHD) and developed an intraoperative lymphatic leakage detected at the time of surgery. The use of fibrinogen/thrombin-coated equine collagen patch proved to be safe and effective in preventing the development of postoperative chylothorax.
-
Anticoagulation with heparin is recommended in patients with an intra-aortic balloon pump (IABP) to prevent thrombosis and embolization. However, anticoagulation increases the risk of bleeding, particularly in the early postoperative period after cardiac surgery. We investigated the safety of heparin-free management after IABP insertion in patients who underwent cardiac surgery. ⋯ In patients undergoing cardiac surgery with IABP support, the rate of thromboembolic complications was relatively low compared to historical controls. Heparin-free management may reduce the risk of hemorrhagic complications, with a low risk of thrombotic complications. Heparin should not be routinely used in patients requiring IABP after cardiac surgery.
-
Apical and midventricular hypertrophic cardiomyopathy (HCM) are rare variants of HCM, in which the hypertrophy is located mainly at the midventricular to apical levels. Heart transplantation was the only possible surgical solution for many of these patients; however, transapical myectomy represents another good alternative. We present our surgical technique of apical ventriculotomy for apical and midventricular myectomy. ⋯ The transapical approach provides excellent exposure of the apex and midventricle, and the technique is useful when myectomy is aimed at eliminating the ventricular obstruction and/or enlarging the left ventricular cavity size in patients with apical hypertrophy.