J Cardiothorac Surg
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J Cardiothorac Surg · May 2017
Combined pulmonary and left ventricular support with veno-pulmonary ECMO and impella 5.0 for cardiogenic shock after coronary surgery.
Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery. ⋯ The combined use of VP ECMO and Impella 5.0 is effective in the management of postcardiotomy biventricular failure as a bridge for further mechanical support or heart transplantation.
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J Cardiothorac Surg · May 2017
Case ReportsPapillary fibroelastoma, unusual cause of stroke in a young man: a case report.
Papillary fibroelastoma is the third most common primary benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors. ⋯ Differential diagnosis of cardiac masses requires clinical informations, laboratory tests, blood cultures and appropriate use of imaging modalities. Papillary fibroelastoma is a potential cause of embolic stroke in the young. The prompt surgical excision of papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent.
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J Cardiothorac Surg · May 2017
Role of mitral valve repair in active infective endocarditis: long term results.
Although mitral valve repair is at present the technique of choice in mitral regurgitation (MR) due to degenerative valve disease, long term results in patients with active mitral infective endocarditis (IE) are still under evaluation. ⋯ Present investigation suggest that in patients with active mitral valve endocarditis MV repair, when technically feasible, is associated with a favorable clinical long term outcome. None of the patients alive at the end of follow-up developed severe mitral regurgitation. Moreover mortality and reinfection rate are uncommon and functional improvement.
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J Cardiothorac Surg · May 2017
Randomized Controlled TrialA randomized comparison of flow characteristics of semiskeletonized and pedicled internal thoracic artery preparations in coronary artery bypass.
Harvesting the internal thoracic artery (ITA) with semiskeletonization is an alternative technique between conventional wide pedicle and skeletonization. It is almost as simple as pedicle harvesting; however, it is supposed to provide the advantage of graft flow and length. Since the heart is unique being the only organ which is perfused during diastole, for comparing the intraoperative graft flow characteristics of semiskeletonization and pedicle technique, we used diastolic filling (DF) using transit-time flow measurement as a primary result. The objective of this study is to compare if semiskeletonized ITA has a greater effect on the intraoperative DF of graft flow versus conventional pedicled ITA in coronary artery bypass. ⋯ Semiskeletonized ITA resulted in superior DF of left anterior descending bypass graft flow as compared with pedicled ITA. It is also provide a greater free flow and length of the graft without the long-delayed operative time.