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Heart Surgery Forum

H Tarık Kızıltan
Patients who have aortoiliac aneurysms with arteriovenous fistulas are difficult to treat. The traditional mode of surgical repair based on aneurysmal excision, fistula closure and graft inclusion has been associated with high perioperative mortality. As an alternative the exclusion technique has also been utilized. Over the years the popularity and success rate of endovascular techniques have increased in the treatment of these patients, yet a technical failure during an endovascular repair always makes surgical repair inevitable...
July 26, 2018: Heart Surgery Forum
Yongxin Wang, Zhiqiang Yang, Yonggang Yuan, Zesheng Xu
BACKGROUND: Unprotected left main coronary artery (ULMCA) disease is associated with high mortality and morbidity. The aim of this study is to investigate the efficacy of percutaneous coronary intervention (PCI) on gender-specific patients with ULMCA in the Chinese population and provide a basis for further treatment of PCI in ULMCA disease. METHODS: 173 patients (female, N = 52; male, N = 121; mean age = 61.02 ± 7.95) with ULMCA disease, who underwent PCI between January 2010 and December 2014, were investigated in our study...
July 26, 2018: Heart Surgery Forum
Saygin Turkyilmaz, Ali Aycan Kavala
PURPOSE: To compare the operative and post-operative outcomes of mitral valve surgery (MVS) with a superior transseptal (STS) approach and a left atriotomy (LA) approach. METHODS: In a tertiary academic center, the charts of patients who underwent MVS between 2012 and 2016 were analyzed retrospectively. A total of 135 patients underwent MVS. Forty patients who underwent MVS with the STS approach were enrolled in the study as the STS group. In the same period, we selected 40 patients who underwent MVS with the LA approach to serve as the control group (LA group)...
July 26, 2018: Heart Surgery Forum
Stephen Derryberry, Curt Tribble
Antegrade cardioplegia delivery is the most commonly used delivery route. It is given into the aortic root or directly into the coronary ostia. However, there are many reasons to consider using the retrograde delivery of cardioplegia. This treatise will review the background and techniques for delivering retrograde cardioplegia.
July 26, 2018: Heart Surgery Forum
Peter Michael Rodgers-Fischl, Daniel Davenport, Sibu Saha, Maya Guglin
Introduction: The Framingham Studies revealed that diabetes mellitus (DM) predisposed subjects to a two- to eight-fold increase in the risk of developing heart failure (HF). However, there is much less information available about the reverse issue; namely, whether there is an increased risk of developing DM in patients with HF. We sought to determine if reversal or partial reversal of HF through aortic valve replacement (AVR) would improve glycemic control in patients with DM at our institution...
July 12, 2018: Heart Surgery Forum
Mehmet Akif Onalan, Omer Ali Sayin, Emin Tireli
Aortic aneurysms are a rare condition in children. Wiskott-Aldrich syndrome is a primary immunodeficiency characterized by infections, thrombocytopenia, and eczema. Aortitis and aneurysm formation seem to be progressive in patients with Wiskott-Aldrich syndrome. The risk of death from aneurysmal rupture in patients with Wiskott-Aldrich syndrome is high and surgery is required for resection of aneurysms. We report a case where a successful resection of a descending thoracic aneurysm. We present a-12 year-old child with this syndrome who underwent a one-stage descending aortic aneurysm repair under continuous visceral perfusion...
July 2, 2018: Heart Surgery Forum
Tamer Ghazy, Claudia Dittfeld, Anett Jannasch, Michael Haase, Roberta Galli, Katrin Plötze, Thomas Waldow, Klaus Matschke
OBJECTIVE: Despite various improvements in valve prosthetics, early valve deterioration still occurs, leading to prosthetic failure. Studying the early phase of this deterioration is quite difficult, as the prosthesis to be examined is almost always explanted only after extensive deterioration. The objective of this research is to study the pathology of early valve deterioration in an early stage in order to reveal the possible trigger of the process. METHODS: Three cusps of the same type of bovine pericardium valve prosthesis underwent comparative examination...
July 2, 2018: Heart Surgery Forum
Yasser Hegazy, Mohamed Samy Nassar, Wael Hassanein, Moustafa Elhammami, Juergen Ennker
BACKGROUND: Unexpected intra-operative technical difficulties are not uncommon in cardiac surgery. Our objective is to study the incidence, predictors, and consequences of unexpected difficulties in adult cardiac operations. METHODS: A total of 500 consecutive elective operations were included in the study. Before every operation, the surgeon and the assistant were asked to study the case and give a score (one to ten) for the expected technical difficulty of the operation...
June 26, 2018: Heart Surgery Forum
Giuseppe Filiberto Serraino, Federica Jiritano, Michele Rossi, Pasquale Mastroroberto
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) support has emerged as a valuable rescue therapy in patients with severe acute lung failure. A new bicaval dual-lumen percutaneous cannula can be instituted with a single puncture of the right internal jugular vein under image guidance (fluoroscopy and/or trans-esophageal echocardiography) to support VV-ECMO. However, malpositioning of the dual-lumen catheter can jeopardize the efficacy of the ECMO therapy. CASE REPORT: We report an emergency VV-ECMO instituted at a patient's bedside in the intensive care unit...
June 26, 2018: Heart Surgery Forum
Lefeng Zhang, Yongqiang Jin, Fuqiang Zhang, Hongyin Li, Qingyu Wu
BACKGROUND: Acute kidney injury (AKI) is one of the common complications in infants and children after complex congenital heart surgery. Peritoneal dialysis (PD) is usually applied for renal replacement therapy (RRT), especially in infants. We investigated the efficacy and safety of modified PD for the treatment of acute renal failure and congestive heart failure after cardiac surgery for congenital heart disease in infants. METHODS: We retrospectively analyzed five consecutive patients from October 2015 to February 2017...
June 25, 2018: Heart Surgery Forum
Chong Wang, Lei Jin, Fan Qiao, Qing Xue, Xin Guan Zhang, Lin Han
BACKGROUND: To evaluate the performance of Society of Thoracic Surgeons (STS) 2008 cardiac surgery risk scores for postoperative complications in Chinese patients undergoing single valve surgery at multicenter institutions. METHODS: From January 2009 through December 2012, 4493 consecutive patients older than 16 years who underwent single valve surgery at 4 cardiac surgical centers were collected and scored according to the STS 2008 risk scores. The final research population included the following isolated heart valve surgery types: aortic valve replacement, mitral valve replacement, and mitral valve repair...
June 19, 2018: Heart Surgery Forum
Krishaporn Kradangnga, Eric Monnet
BACKGROUND: Surgical method of choice for functional mitral regurgitation (FMR) is debatable, since recurrence of FMR post-annuloplasty has been reported in a significant number of cases. Developing a pulsatile FMR heart model by left ventricular dilatation can be a favorable option for usage in the primary stages of developing new surgical techniques that adjunctively targets the posterior papillary muscle (PPM) geometry. METHODS: PPM of ex vivo ovine hearts (N = 22) was displaced by three different sizes of patches to induce left ventricular dilatation and FMR...
June 18, 2018: Heart Surgery Forum
Selcuk Anli, Afsaneh Karimian-Tabrizi, Anton Moritz, Nadejda Monsefi
BACKGROUND: The lower patency rate of vein grafts (VG) in comparison to arterial grafts may be related to vein valves, which favor turbulences and thrombosis that lead to graft failure. The aim of this study was to determine the outcome of patients with valvulotomized VG after coronary artery bypass grafting (CABG) procedure. METHODS: From 2007 to 2014, 233 patients with a mean age of 67 ± 9 years had CABG or combined CABG and valve procedures. Valvulotomized saphenous VG and arterial grafts were used...
June 18, 2018: Heart Surgery Forum
Hunbo Shim, Chang Seok Jeon, Pyo Won Park, Wook Sung Kim, Young Tak Lee, Dong Seop Jeong, Yang-Hyun Cho, Kiick Sung
BACKGROUND: Repeated thoracic aorta repair is increasingly common. With the increase in hybrid procedures, determination of the best treatment strategy requires evaluation of the clinical outcomes of classic open surgery. METHODS: We retrospectively reviewed 119 patients (84 men and 35 women, aged 51.0 ± 16.7 years) with a history of open repair involving the thoracic aorta above the diaphragm. The patients underwent an average of 1.3 ± 0.8 surgeries (range: 1-8) on the thoracic aorta before the final operation...
June 18, 2018: Heart Surgery Forum
Piergiorgio Tozzi, Anna Nowacka, Roger Hullin, Patrick Yerly, Matthias Kirsch
BACKGROUND: Outcomes after VAD implantation may be dependent on institutional procedural volume. Specifically, it is claimed that high volumes are associated to better clinical results. This study aims to determine if this procedure is safe even in low-volume center. METHODS: Single center, retrospective cohort study, including Heart Failure consecutive patients who received long-term VAD from 2007 to 2017. Primary outcome was survival to transplant or ongoing MCS at 1-year...
June 15, 2018: Heart Surgery Forum
Amy G Fiedler, Puja Banka, Katherine Zaleski, Michael C Fahey, Roger E Breitbart, Francis Fynn-Thompson
Traumatic pericardial rupture is a rare event with high mortality. We present the case of a 15-year-old boy who sustained thoracic and abdominal trauma secondary to motor vehicle collision, with a delayed diagnosis of traumatic pericardial rupture with cardiac herniation. Out of concern for torsion and hemodynamic collapse, surgical repair was advised. We have developed a novel surgical approach to this rare condition, utilizing a combination of thoracoscopic and open surgical techniques. The guiding principles of our repair include the utilization of fenestrated pieces of bovine pericardium to create a tension free repair, minimizing the likelihood of pericardial effusion, and returning the cardiac mass to normal anatomic position...
June 14, 2018: Heart Surgery Forum
Ahmet Arnaz, Dilek Altun
BACKGROUND: Left atrial pressure (LAP) monitoring provides a valuable option for management of hemodynamic status in pediatric congenital heart surgery during the postoperative period. METHODS: We used a Perifix Soft Tip 701 filter set catheter (B. Braun Melsungen AG 34209 Melsungen, Germany), which is commonly used for continuous epidural anesthesia. The catheter was placed into the left atrium to provide LAP monitoring. The study included 33 children, who needed LAP monitoring during and post-surgery between January 2016 and September 2017...
June 14, 2018: Heart Surgery Forum
Keito Suzuki, Naoyuki Kimura, Akira Sezai, Satoshi Unosawa, Makoto Taoka, Shunji Osaka, Masashi Tanaka
Giant coronary artery aneurysm (GCAA) combined with coronary artery fistula to the pulmonary artery (PA) is rare. A 79-year-old man was accidentally discovered with GCAA. He was operated on by use of aneurysmorrhaphy, and closure of the fistulae was performed. Because ischemic changes appeared, coronary artery bypass grafting was done. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. We report here a case of GCAA with a size of 66 × 52 mm in diameter associated with a fistula formation into the PA...
June 14, 2018: Heart Surgery Forum
Ze-Wei Lin, Qiang Chen, Hua Cao, Gui-Can Zhang, Liang-Wan Chen, Qi-Liang Zhang, Zhi-Nuan Hong
BACKGROUND: The purpose of this study was to assess the short- and mid-term follow-up results of transthoracic device closure of perimembranous ventricular septal defect (pmVSD) in adults. METHODS: Sixty-one adults underwent transthoracic device closure of pmVSD at our institution from Jan. 2012 to Jan. 2016. All relevant clinical data were recorded and analyzed. All patients were invited to undergo contrast transthoracic echocardiography (TTE) for 12 months to 60 months after VSD closure...
June 14, 2018: Heart Surgery Forum
Amit Pawale, Mitsuko Takahashi, Karthik Seetharam, Ramachandra C Reddy
Anomalous left coronary artery from the right coronary sinus (ALCA) is a known cause of sudden death. Surgical correction is recommended for all patients with interarterial course. We describe two patients who underwent surgical correction through an off pump- minimally invasive direct coronary artery bypass (MIDCAB) approach with good short- and mid-term results.
June 14, 2018: Heart Surgery Forum
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