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Heart Surgery Forum

Curt Tribble Md
During my training and my early faculty tenure, there was a picture of a dust-caked, grizzled cowboy that hung between the two primary cardiac operating rooms. Beneath the picture was written, "There are a lot of things about this job they didn't tell me when I signed on." When we moved into our new hospital, the picture did not resurface. However, I never forgot the lesson conveyed by that picture. One of the most important obligations faculty members have is to help their trainees find a job. While their trainees have likely had part-time jobs and, of course, they've held training positions, they usually have not had a 'real' job before...
December 15, 2016: Heart Surgery Forum
Giorgio Maria Aru, Tad Kim, Roberto Giorgio Aru, Mary Carolyn Vinson
A 55-year-old man with autoimmune deficiency syndrome presented with an infected left ventricular pseudoaneurysm and sepsis. The aneurysmectomy consisted of a Dor-style pericardial patch plus debridement of the abscess cavities. The infected pseudoaneurysm recurred, much larger, within five months due to persistent infected abscess cavities. The second repair was done without a Dor-style patch and with an omental flap. No recurrence has occurred one year after the second repair, but the patient has asymptomatic, partial gastric herniation inside the pericardium...
December 1, 2016: Heart Surgery Forum
William Zachary Chancellor, Curt Tribble
Left ventricular assist devices (LVAD) are increasingly used to support patients as they await heart transplantation and as destination therapy for patients with end-stage cardiac failure. While the methods of LVAD implantation have become fairly standardized, early postoperative management of patients receiving these devices remains challenging. One issue that has plagued surgeons, cardiologists, and intensivists caring for patients after LVAD implantation is right heart dysfunction. While many scoring systems have been developed to try to anticipate RV failure, the accuracy of these predictive tools remains low...
October 31, 2016: Heart Surgery Forum
Hasan Baki Altinsoy, Ozkan Alatas, Salih Colak, Hakan Atalay, Omer Faruk Dogan
BACKGROUND: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. METHODS: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period...
October 31, 2016: Heart Surgery Forum
Yasser Yehia Hegazy, Ralf Sodian, Wael Hassanein, Amr Rayan, Juergen Ennker
BACKGROUND: The use of bilateral internal mammary arteries (BIMA) is limited worldwide, especially in patients with chronic obstructive pulmonary disease (COPD). Thus, we assessed the safety of the use of BIMA in COPD patients. METHODS: From cohorts of 8846 patients operated on at our center for primary isolated multi-vessel coronary bypass operations between 2002 and 2012, we studied two propensity-matched groups of patients with COPD who received either single internal mammary artery and saphenous vein grafts (SIMA group: 137 patients) or exclusively BIMA (BIMA group: 137 patients)...
October 31, 2016: Heart Surgery Forum
Mirko Muretti, Mario Manca, Francesco Massi, Michele Portoghese
Spontaneous coronary artery dissection is a rare condition usually encountered in young women without risk factors for atherosclerotic disease but with tortuous coronary artery or contemporary presence of fibromuscular dysplasia. Sometimes spontaneous coronary dissection occurs in patients with atherosclerotic disease, although without significant epicardial coronary artery stenosis. We report a case of a patient who underwent minimally invasive mitral valve repair, whose initially uneventful postoperative course was complicated by spontaneous coronary artery dissection of the left main causing a life threatening condition...
October 31, 2016: Heart Surgery Forum
Curtis G Tribble
In helping to organize many different educational environments in the School of Medicine and the Department of Surgery at the University of Virginia over the last 30 years, my colleagues and I have long recognized that our students and trainees, while uniformly well prepared academically for their respective missions, often take inadequate care of themselves. Everyone who has flown on a plane will recall that the flight attendants always tell passengers that, if oxygen is needed, one must put one's own mask on first, before helping others put their masks on...
October 31, 2016: Heart Surgery Forum
Hakan Atalay, Zeki Temizturk, Hasan Baki Altinsoy, Davut Azboy, Salih Colak, Atakan Atalay, Omer Faruk Dogan
BACKGROUND: The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation. METHODS: We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0...
October 27, 2016: Heart Surgery Forum
Ali Ghodsizad, Michael M Koerner, A El-Banayosy, Mohamed Zeriouh, Arjang Ruhparwar, Matthias Loebe
The SynCardia Total Artificial Heart (TAH) has been used for patients with biventricular failure, who cannot be managed with implantation of a left ventricular (LV) assist device. Following TAH implantation, our patient developed severe hemolysis, which could only be managed successfully by aggressive blood pressure control [Ohashi 2003; Nakata 1998].
October 21, 2016: Heart Surgery Forum
Huifeng Yuan, Xinwei Han, Dechao Jiao, Pengli Zhou
OBJECTIVE: To explore the potential risk factors of abdominal aortic aneurysm (AAA) in the Chinese population. METHODS: A matched case-control study was designed for the study. Patients with AAA administrated in the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2007 were included in the study. Sex and age-matched volunteers were selected for the case-control in the same period. A uniform questionnaire was sent to patients and volunteers to collect demographic data, past medical history, and behavioral factors...
October 21, 2016: Heart Surgery Forum
Serkan Akarsu, İrem İris Kan, Tolunay Sevingil, Mustafa Tok
BACKGROUND: This study aims to investigate the effect of body mass index (BMI) on mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) surgery. METHODS: We retrospectively evaluated the medical records of 403 patients undergoing coronary artery bypass surgery in our center. The patients were divided into 5 groups according to their BMI values. Preoperative demographic characteristics, operative data, and postoperative complications during the six-month follow-up period were compared between the groups...
October 21, 2016: Heart Surgery Forum
Mark M Levinson Md
Twenty years ago, I presented a new vision for medical publishing. The Heart Surgery Forum was inaugurated in August of 1995 as a multimedia scientific publication communicating over the new "Information Highway" known as the graphical Web.  In the early days of HTML and HTTP, new ideas could evolve and disseminate quickly to a community that spanned the globe. The HSF began as a "Labor of Love" for my profession and my colleagues as a dynamic tool for the betterment of themselves and their patients. Included in the original HSF Web site was a novel means to present interesting cases using color photos, movies, text and graphics, which was groundbreaking in 1995...
October 21, 2016: Heart Surgery Forum
Alwin Kumar Rathinam, Raja Amin Raja Mokhtar
Biomodeling the human anatomy in exact structure and size is an exciting field of medical science. Utilizing medical data from various medical imaging topography, the data of an anatomical structure can be extracted and converted into a three-dimensional virtual biomodel; thereafter a physical biomodel can be generated utilizing rapid prototyping machines. Here, we have reviewed the utilization of this technology and have provided some guidelines to develop biomodels of cardiac structures. Cardiac biomodels provide insights for cardiothoracic surgeons, cardiologists, and patients alike...
August 23, 2016: Heart Surgery Forum
Konrad Paczkowski, Ireneusz Haponiuk, Maciej Chojnicki, Radosław Jaworski
We present a case of a 2.5-year-old-girl with complex congenital heart disease: tricuspid atresia (TA), bulboventricular septal defect (VSD), hypoplastic right ventricle, d-transposition of the great arteries (d-TGA) with aortic outflow from redundant RV. Due to II/III degree atrioventricular block induced after diagnostic cardiac catheterization, an epicardial pacemaker was implanted during the Glenn procedure. Because of severe left ventricle outflow tract obstruction, she was finally referred for extracardiac TCPC (extracardiac Fontan type) with recruitment of PV and Damus-Kaye-Stansel anastomosis...
August 23, 2016: Heart Surgery Forum
Konrad Paczkowski, Ireneusz Haponiuk, Maciej Chojnicki, Grażyna Brzezińska-Rajszys
An iatrogenic aneurysm of an innominate artery is an extremely rare complication, especially in children. Nevertheless, this pathology was diagnosed in a child given palliative care with chronic respiratory insufficiency and a history of encephalitis requiring permanent ventilation at home via a tracheal tube.A nine-year-old girl with colitis ulcerosa and a history of hemorrhagic encephalitis, with chronic home ventilation therapy, was admitted in an emergency setting because of massive bleeding from the upper respiratory tract and the area surrounding the tracheotomy...
August 23, 2016: Heart Surgery Forum
Anna Drohomirecka, Paweł Kwinecki, Witold Gwóźdź, Mariusz Mieczyński, Piotr Stępiński, Jarosław Jasiński, Krzysztof Stręk, Romulad Cichoń
BACKGROUND: As arterial myocardial revascularization is proved to provide great results, radial artery use as a graft and its consequences remain an important issue. OBJECTIVES: The aim of the study was to evaluate how patients assess their forearm and hand function after radial artery harvest for coronary artery bypass grafting (CABG). METHODS: 50 patients (mean age 52.2 ± 7.4 years) who underwent CABG at least 6 months (median follow up 11...
August 23, 2016: Heart Surgery Forum
Oiva Arvola, Henri Haapanen, Johanna Herajärvi, Tuomas Anttila, Ulla Puistola, Peeter Karihtala, Vesa Anttila, Tatu Juvonen
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is used to overcome the threat of cerebral ischemia during complex surgical operations of the heart and the aortic arch. Remote ischemic preconditioning (RIPC) has been shown to mitigate neurological damage. METHODS: We analyzed blood samples in a consecutive series of 52 piglets that underwent a 60-min period of DHCA with RIPC (the RIPC group) or without (the control group), to reveal whether the protective effect to oxidative stress could be seen by measuring serum 8-hydroxydeoxyguanosine (8-OHdG)...
August 23, 2016: Heart Surgery Forum
Ugur Gocen, Atakan Atalay, Orhan Kemal Salih
Congenital left ventricular diverticulum is a rare cardiac anomaly. During the newborn period, symptomatic patients are diagnosed with heart failure findings. We present a 23-day-old male newborn with congenital left ventricular diverticulum diagnosed during fetal echocardiographic examination. After the birth, the patient had heart failure symptoms and his echocardiographic examination showed low cardiac ejection fraction. Diverticulum was operated with endoventricular circular patch plasty (DOR) technique, and after, cardiopulmonary bypass venoarterial extracorporeal membrane oxygenation (ECMO) support was performed because of low cardiac output syndrome...
August 23, 2016: Heart Surgery Forum
Dohun Kim, Si-Wook Kim, Hong-Ju Shin, Jong-Myeon Hong, Ji Hyuk Lee, Heon-Seok Han
A 10-day-old boy was transferred to our hospital due to tachypnea. Patent ductus arteriosus (PDA), 4.8 mm in diameter, with small ASD was diagnosed on echocardiography. Surgical ligation of the ductus was performed after failure of three cycles of ibuprofen. However, the ductus remained open on routine postoperative echocardiography on the second postoperative day, and chest CT revealed inadvertent ligation of the left pulmonary artery (LPA) rather than the PDA. Emergent operation successfully reopened the clipped LPA and ligated the ductus on the same (second postoperative) day...
August 23, 2016: Heart Surgery Forum
Adam Golab, Marcin Slojewski, Miroslaw Brykczynski, Magdalena Lukowiak, Marek Boehlke, Daniel Matias, Tomasz Smektala
Three-dimensional (3D) printing involves preparing 3D objects from a digital model. These models can be used to plan and practice surgery. We used 3D printing to plan for a rare complicated surgery involving the removal of a renal tumor and neoplastic mass, which reached the heart atrium. A printed kidney model was an essential element of communication for physicians with different specializations.
August 22, 2016: Heart Surgery Forum
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