The heart surgery forum
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The heart surgery forum · Jan 2007
Randomized Controlled Trial Comparative StudyIntraoperative and histochemical comparison of the skeletonized and pedicled internal thoracic artery.
Skeletonization of the internal thoracic artery (ITA) has advantages, but the variation of ITA preparation may be traumatic for the arterial wall. We sought to compare intraoperative results and endothelial nitric oxide synthase (e-NOS) expression on the vessel wall after left ITA harvesting with skeletonization and the conventional technique. ⋯ Although skeletonization of the ITA is a more technically demanding procedure, it provides some advantages such as increased available graft length and reduced sternal devascularization. This technique did not have any detrimental effects on the endothelial cell lining and e-NOS expressions on the endothelial layer. To reach a definitive judgment for using skeletonized ITA, we need information about the long-term angiographic patency rates.
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The heart surgery forum · Jan 2007
Randomized Controlled Trial Comparative StudyEffects of pretreatment with different topical vasodilators on blood flow in the internal mammary artery: a prospective randomized study.
This study was conducted to investigate how brief pretreatments with 4 different vasodilators applied topically at normal body temperature affect blood flow in the internal mammary artery. ⋯ Brief treatment of the internal mammary artery with topical vasodilators at normal body temperature significantly increases blood flow in this vessel. The data from this study are particularly valuable in relation to off-pump surgery, in which this vessel is usually anastomosed soon after it is harvested.
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The heart surgery forum · Jan 2007
Case ReportsGiant right atrial myxoma mimicking hepatic cirrhosis: a case report.
Cardiac myxomas are rare benign tumors of the heart. The growth rate of these tumors remains unknown. Right atrial myxoma can simulate nonspecific constitutional symptoms, such as remittent or lasting fever, weight loss, and chronic anemia, and may escape timely diagnosis until the development of severe complications such as pulmonary hypertension due to embolism from fragments originating from the tumor mass or blockage of the right atrioventricular ostium or Budd-Chiari syndrome with acute abdominal pain. We present a case of a giant right atrial myxoma mimicking hepatic cirrhosis in a 52-year-old man.
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The heart surgery forum · Jan 2007
Case ReportsAorto-innominate fistula by gun-shot injury: a case report.
We report an aorto-innominate fistula caused by gun-shot injury. The fistula was diagnosed by aortography and repaired under hypothermic circulatory arrest.
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The heart surgery forum · Jan 2007
Randomized Controlled TrialNormothermia is the key for the treatment of internal thoracic artery spasm.
Free flow of the internal thoracic artery decreases commonly after harvesting because of spasm. Tissue heat loss is inevitable during surgery. The aim of this study was to compare the internal thoracic artery pedicle rewarming method with topical papaverine applications in different thermal conditions. ⋯ Topical application of heated papaverine itself does not warm pedicle tissue, but papaverine efficiency increases when the pedicle is stored in normothermic conditions. Preserving internal thoracic artery pedicles in normothermic conditions can be the preferred treatment for spasms.