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Heart Surgery Forum

Ali Ghodsizad, Kai Singbartl, Matthias Loebe, Mohamed Zeriouh, Arjang Ruhparwar, April Grant, Ali El-Banayosy, M M Koerner
Mechanical circulatory support can prevent multi-organ failure and death in patients with advanced cardiogenic shock. Here we describe our experience using extracorporeal membrane oxygenation (ECMO) for treatment of advanced cardiogenic shock which has been used by our team for daily routine care in more than 200 patients during the last five years at the Penn State Medical Center. Venoarterial (VA) ECMO has been used as a viable therapeutic option for advanced cardiogenic shock as a bridge to recovery (BTR) or bridge to next decision (BTD)...
December 22, 2017: Heart Surgery Forum
Curt Tribble Md
I was in Chicago in 1987 when Dr. Shumway delivered his American Association for Thoracic Surgery (AATS) presidential address, and, like most in the audience, I knew he was correct. Having had the privilege of getting to do a lot of thoracic and cardiovascular surgery in my surgical training, I was preparing myself to make my own move to the left side of the operating table. In fact, I had already resolved that I would make my own "shift to the left" very soon after that meeting in 1987, hoping to become, like Dr...
December 22, 2017: Heart Surgery Forum
Semiha Terlemez, Onur Işık, Suzan Şahin, Abdullah Barış Akcan, Münevver Kaynak Türkmen
The inadvertent ligation of the left pulmonary artery (LPA) is a rarely seen surgical complication that has been presented in the literature in a limited number of cases after patent ductus arteriosus (PDA) ligation surgery. Case Report: A PDA closure operation was performed on our patient, a 28-week-old preterm. In the postoperative follow-up, we identified on echocardiography taken on the same postoperative day that the ductus space was still present. On CT angiography, we determined that not only was the ductus space still continuing, but, in addition, ligation of the LPA had been performed inadvertently...
December 22, 2017: Heart Surgery Forum
Hiroshi Kodama, Shinya Takahashi, Keijiro Katayama, Taijiro Sueda
A 74-year-old man hospitalized due to acute myocardial infarction (AMI) of the first diagonal branch developed cardiogenic shock. Ultrasonography showed anterolateral papillary muscle rupture (PMR) which caused anterior mitral leaflet prolapse and severe mitral valve regurgitation, and he successfully underwent mitral valve replacement. Anterolateral PMR causing anterior mitral leaflet prolapse due to obstruction of the first diagonal branch is rare and should be considered in such an AMI case.
December 21, 2017: Heart Surgery Forum
Chunxiao Zhang, Yaguang Zheng, Xinbin Liu, Yutong Cheng, Yang Liu, Yan Yao, Xinguo Wang, Jianping Xu
BACKGROUND: With the follow-up extending to 5 years, the outcomes of SYNTAX (Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) trial were comparable between coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in left-main (LM) patients with intermediate SYNTAX scores of 23-32. A subdivision depending on SYNTAX score will help to identify unsuitable LM patients with intermediate SYNTAX scores to receive PCI treatment. METHODS: Between January 2011 and June 2013, 104 patients with LM Coronary Artery Disease (CAD) undergoing PCI were selected retrospectively...
December 21, 2017: Heart Surgery Forum
Heidi B Schubmehl, Muhamed Saric, Alan F Vainrib, Mathew Williams, Leora B Balsam
The technique of mechanical circulatory support or the site of cannulation may affect transvalvular flow. We describe early failure of a mitral bioprosthesis in a patient with temporary left ventricular assist device support, likely from thrombosis. Salvage with transcatheter mitral valve replacement was attempted. Temporary mechanical circulatory support strategies that maximize flow across a new bioprosthesis should be sought to avoid early valvular thrombosis.
December 12, 2017: Heart Surgery Forum
Liqian Xu, Ji Yang, Yunmei Yang
Noncompaction of the ventricular myocardium (NVM) is a rare congenital cardiomyopathy that is characterized by multiple prominent trabeculations and deep intertrabecular recesses, and occurs due to arrest of normal embryogenesis of the endocardium and myocardium. It is also referred to as isolated left ventricular noncompaction (LVNC), because lesions are mainly in the left ventricle. The main clinical manifestations are heart failure, arrhythmia, systemic embolism, and sudden death. Systemic embolism is related to the occurrence of atrial arrhythmias or thrombus formation in the left ventricle...
December 7, 2017: Heart Surgery Forum
Emrulah Hayta, Özge Korkmaz
BACKGROUND: Few data are available on the capacity for functional exercise after cardiac rehabilitation in patients who have undergone coronary artery bypass graft (CABG) surgery. The aim of this study was to determine the clinical and biochemical factors that affect the 6-minute walk test (6MWT) results in patients who have undergone CABG. METHODS: Data were prospectively collected from 56 patients consecutively admitted at our hospital between January 2013 and May 2015 for a 3-month cardiac rehabilitation program...
December 7, 2017: Heart Surgery Forum
Mehmet Kaplan, Tolga Can, Anil Karaagac, Murat Acarel, Adlan Olsun, M Inanc Yesilkaya, Hakki Aydogan
BACKGROUND: Blood transfusions are the most common type of tissue and organ transplantation. Perioperative and postoperative transfusions may cause morbidity and mortality and transfusion should based on only hematocrit values but also on hemodynamic and clinical parameters of the patient, which cannot be ignored. METHODS: A prospective study was conducted between January 2015 and October 2016 with adult patients undergoing elective open heart surgery. In these patients, a protocol was established, and patients were divided into two groups as transfusion (-) and transfusion (+)...
December 1, 2017: Heart Surgery Forum
Alexander T Booth, Patrick D Melmer, Benjamin Tribble, J Hunter Mehaffey, Curt Tribble
Vasoplegic syndrome is a form of vasodilatory shock that occurs frequently in patients who undergo cardiac surgery requiring cardiopulmonary bypass (CBP). Treatment often demands high doses of vasopressors over sustained periods for hypotension that can be refractory to standard vasoactive medications. Furthermore, the development of vasoplegia greatly contributes to morbidity and mortality following cardiac surgery. Methylene blue (MB) has become a popular therapy for cardiac vasoplegia despite a paucity of prospective data to direct its use...
October 31, 2017: Heart Surgery Forum
Shuyang Lu, Lai Wei, Jiayu Zheng, Chunsheng Wang
In this case report, we present the delayed diagnosis of an atypical partial anomalous pulmonary venous connection, which was initially misdiagnosed as primary pulmonary arterial hypertension. It was difficult to make a conclusive diagnosis using transthoracic echocardiography (TTE), because the two high right superior pulmonary veins drained into the superior vena cava and limited the shunt of patent foramen ovale. Preoperative TTE only showed right heart volume overload, pulmonary arterial hypertension, and severe tricuspid valve insufficiency...
October 31, 2017: Heart Surgery Forum
Franjo Rudman, Davor Baric, Danijel Unić, Igor Rudež
We read with great interest the report by Dr. Colak and coworkers about utilization of omentoplasty in poststernotomy mediastinitis treatment [Colak 2016]. In our opinion, several points need to be addressed.
October 31, 2017: Heart Surgery Forum
Cenk Conkbayir, Rezan Fahrioglu Yamaci, Pinar Gencer, Burc Barin, Genco Yucel, Cenk Eray Yildiz, Murat Ugurlucan, A Nazli Basak
BACKGROUND: The distribution of gene variants in the Turkish Cypriot population with coronary artery disease has not been investigated. In this study, we sought to research different genetic variants in the susceptibility to coronary artery disease and to identify possible associations between various clinical parameters and the genes involved in blood coagulation as well as glucose and lipid metabolism among the Turkish Cypriots and compared the results with the respective Turkish patients from Turkey...
October 30, 2017: Heart Surgery Forum
Curtis G Tribble
We came to The University of Virginia (UVA) within a year of each other nearly four decades ago: one (DN) to join the UVA basketball team during four of the best years of UVA basketball, and to earn 2 degrees, first in English and then in Sports Psychology; and the other (CT) to begin 7 years of training in general, vascular, thoracic, and cardiac surgery, which culminated with a faculty appointment in the UVA Department of Surgery, with part of the charge being to organize most of the Department's educational programs...
October 30, 2017: Heart Surgery Forum
Miha Antonic
BACKGROUND: Even minor postoperative reductions in renal function influence the outcome of cardiac surgery. The mechanisms of postoperative renal injury in cardiac surgery are multifactorial and include ischemia-reperfusion injury. The study investigates the effect of the antioxidant ascorbic acid on the postoperative acute kidney injury after elective CABG surgery. METHODS: A prospective randomized single-center trial was conducted in on-pump coronary artery bypass patients...
October 24, 2017: Heart Surgery Forum
Igor Rudez
October 24, 2017: Heart Surgery Forum
Ali Baran Budak, Kevin McCusker, Serdar Gunaydin
BACKGROUND: Despite the recent introduction of a number of technical and pharmacologic blood conservation measures, bleeding and allogeneic transfusion remain persistent problems in open-heart surgical procedures. Efforts should be made to decrease or completely avoid transfusions to avoid these negative reactions. METHODS: Our coronary artery bypass grafting database was reviewed retrospectively and a total of 243 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) were studied in a 12-month period (January-December 2016) after the implementation of the new program, and compared with 275 patients of the previous 12-month period...
October 24, 2017: Heart Surgery Forum
Hae Won Jung, Sung Yun Lee, Yoon Cheol Shin, Woo-Ik Chang, Jun Hyun Kim, Hye Ryeong Jo
A 50-year-old woman was referred to our hospital with a chief complaint of chest pain. Coronary angiography revealed a fistula between the left anterior descending artery and pulmonary artery with giant aneurysms. Although coronary angiography is considered the standard tool to confirm a coronary artery fistula, the patient in this case underwent successful surgical repair with the aid of multi-modality imaging.
October 24, 2017: Heart Surgery Forum
Tamer Ghazy, Utz Kappert, Ralf-Thorsten Hoffmann, Helena Hegelmann, Zuzana Fajfrova, Mohamed Eraqi, Klaus Matschke, Norbert Weiss, Adrian Mahlmann
BACKGROUND: Legitimacy of entry-oriented therapy for DeBakey I aortic dissection is of eminent importance in the era of emerging ascending aorta endovascular therapy. This study aims to evaluate early, midterm, and reintervention results of entry-oriented operative strategy compared to more aggressive strategies for treatment of DeBakey type I aortic dissection with an isolated intimal tear in the ascending aorta. METHODS: This study prospectively followed 98 consecutive patients who received an operation for DeBakey type I aortic dissection with the intimal tear in the ascending aorta between 2007 and 2013 for up to 6 years...
October 24, 2017: Heart Surgery Forum
Curtis G Tribble
There is a considerable amount of data that using more than one arterial graft provides a survival advantage for patients undergoing coronary bypass operations. The Society of Thoracic Surgeons has a set of official guidelines for the use of arterial grafts which include the following recommendations:Internal mammary arteries (IMA's) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated.As an adjunct to left internal mammary artery (LIMA), a second arterial graft (right IMA or radial artery [RA]) should be considered in appropriate patients...
August 28, 2017: Heart Surgery Forum
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