The heart surgery forum
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The heart surgery forum · Jun 2013
Experience with a minimally invasive approach to combined valve surgery and coronary artery bypass grafting through bilateral thoracotomies.
Minimally invasive coronary artery bypass grafting (MICS-CABG) and minimally invasive valve surgery (MIVS) have been used independently to manage occlusive coronary artery disease and valvular diseases, respectively. We present 12 patients who underwent combined MICS-CABG and MIVS via bilateral mini-thoracotomies. ⋯ MICS-CABG combined with MIVS via bilateral minithoracotomies yielded short-term results comparable to those for CABG and valve repair via median sternotomy. There were no operative mortalities or reoperations. The possible advantages of the minimally invasive approach included earlier extubation and earlier discharge from the hospital. Combined CABG and valve surgery can be safely performed via bilateral thoracotomies.
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The heart surgery forum · Jun 2013
Case ReportsSimultaneous repair of a sinus of valsalva aneurysm and a bicuspid aortic valve.
Sinus of Valsalva aneurysms (SOVA) are rare cardiac abnormalities that are most commonly congenital in origin and frequently associated with aortic valve pathology. Unruptured SOVA are more frequently identified currently, owing to the increased use and accuracy of diagnostic investigations. Early surgical intervention is recommended to prevent complications. We describe a case of a young patient with an enlarging right SOVA and a regurgitant bicuspid aortic valve who subsequently underwent simultaneous patch repair of the SOVA and primary aortic valve repair.
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The heart surgery forum · Apr 2013
Randomized Controlled Trial Multicenter StudySafety and efficacy of cangrelor, an intravenous, short-acting platelet inhibitor in patients requiring coronary artery bypass surgery.
Oral P2Y₁₂ platelet receptor inhibitors are a cornerstone of reducing complications in patients with acute coronary syndromes or coronary stents. Guidelines advocate discontinuing treatment with P2Y₁₂ platelet receptor inhibitors before surgery. Cangrelor, a short-acting, reversible, intravenously administered P2Y₁₂ platelet inhibitor is effective in achieving appropriate platelet inhibition in patients who are awaiting coronary artery bypass grafting (CABG) and require P2Y₁₂ inhibition. The objective of this study was to assess the effects of preoperative cangrelor on the incidence of perioperative complications, which are currently unknown. ⋯ Compared with placebo, bridging patients with cangrelor prior to CABG effectively maintains platelet inhibition without increasing post-CABG complications, including bleeding and the need for transfusions. These data suggest cangrelor treatment is a potential strategy for bridging patients requiring P2Y₁₂ receptor inhibition while they await surgery.
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The heart surgery forum · Apr 2013
Controlled Clinical TrialEvaluation of positive inotropic drug effects on thyroid hormone levels after open heart surgery.
The aim of this study was to examine the effects of positive inotropic drugs, including adrenaline, dopamine, and dobutamine on thyroid hormone levels following open heart surgery. ⋯ Although thyroid hormone levels were affected by positive inotropic drug usage after open heart surgery, this effect was not significant and thyroid hormone levels remained within normal ranges.
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The heart surgery forum · Apr 2013
Case ReportsSurgery on a patient with iatrogenic aortic valve leaflet perforation after repair of a congenital ventricular septal defect.
Aortic valve regurgitation caused by a leaflet perforation occurs most often with infective endocarditis involving the aortic valve. Although rare, leaflet perforation can be caused by suture-related injury during cardiac operations, such as mitral valve replacement, ventricular septal defect (VSD) repair, and repair of an ostium primum atrial septal defect. Few reports have described this form of iatrogenic aortic valve leaflet perforation. We used a pericardial patch in a successful repair of an iatrogenic perforation in an aortic valve leaflet that occurred after simple VSD repair.