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Thoracic and Cardiovascular Surgeon Reports

Andreas Böning, Christof Schmid
No abstract text is available yet for this article.
December 2015: Thoracic and Cardiovascular Surgeon Reports
Andreas Schaefer, Hendrik Treede, Hermann Reichenspurner, Lenard Conradi
Background In rare cases of pulmonary embolism, large thrombemboli have been found entrapped in a patent foramen ovale (PFO). Case Description A patient was referred to our center with leg swelling and dyspnea. Electrocardiogram showed sinus tachycardia and right axis deviation. Echocardiography revealed a highly mobile biatrial thrombus entrapped in a PFO extending to both tricuspid and mitral valves and prolapsing into the left ventricle. Urgent surgery for cardiac thrombectomy and PFO closure was performed...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Fatos Ballazhi, Michael Weyand, Werner Lang, Christoph Schoerner, Timo Seitz
Aspergillus fumigatus as a clinical entity is difficult to diagnose. We present a case, which could facilitate diagnosis and management of the aforementioned disease. A 60-year-old man with stent graft implantation in the descending aorta (6 years ago) presented with fever, night sweats, and weight loss over 5 months. Leukocytosis and elevated C-reactive protein were constantly spiking. Blood cultures were negative. Notably, the serum immunoglobulin E (IgE) level was strongly elevated (> 1,000 U/mL). Anamnestically, the patient suffered from a mild form of atopic dermatitis and bronchial asthma...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Daniel S Dohle, Konstantinos Tsagakis, Saifeldin Ibrahim, Björn Plicht, Heinz Jakob
The factor time plays an important role in diagnosis and treatment of acute aortic syndromes, not only as a short interval between diagnosis and surgical therapy, but also as a delay of definitive therapy in the selected cases. Severe organ damage caused by malperfusion or other mechanisms can be overcome by a surgical delay, improving prognosis. We report a successful attempt of a controlled delayed surgical treatment in a patient with an acute aortic syndrome complicated from multiorgan failure.
December 2015: Thoracic and Cardiovascular Surgeon Reports
Thomas Schroeter, Philipp Kiefer, Matthias Sauer, Friedrich Wilhelm Mohr
We describe a case of a male patient who presented with a chronic ulcer below the left clavicle. Six years before the present admission a permanent pacemaker, including leads, was explanted related to endocarditis. The initial working hypothesis suspected an infected sebaceous gland as the cause of ulceration. After two periods of unsuccessful surgical treatment of the gland, further examination identified a small pacemaker lead fragment underneath the articulation between sternum and clavicle as a possible reason...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Andreas Borowski, Sebastian Heikaus, Muhammed Kurt
Deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the articular structures affects predominantly temporomandibular, knee, hip, spine, and wrist joints, and is a rare condition, often mimicking malignancy. Sternoclavicular joint is extremely rarely involved. We present a patient with swelling of the right upper extremity, in whom on computed tomography a mass posterior to the sternoclavicular joint causing compression of the brachiocephalic vein was detected. A modified resection arthroplasty was performed, and the histopathological findings revealed massive deposits of CPPD in the articular cartilage...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Minna Voigtlaender, Lenard Conradi, Andrea Hinsch, Florian Langer
Background Antiphospholipid syndrome (APS) is an acquired thrombophilia that can be associated with decreased platelet counts. Case A 67-year-old woman presented with thrombocytopenia and a symptomatic right atrial mass suspicious of cardiac myxoma. Prolongation of the activated partial thromboplastin time (aPTT) was caused by a strong lupus anticoagulant, and bone marrow cytology was consistent with accelerated platelet clearance. The patient underwent uneventful resection of the atrial tumor, which turned out to be a calcified fibrin-rich thrombus...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Federica Jiritano, Lucia Cristodoro, Egidio Bevacqua, Emanuele Malta, Pasquale Mastroroberto
Cardiac surgery in patients with preexisting bleeding disorders can be a challenge. Cardiopulmonary bypass can lead to bleeding disorders, above all in patients with coagulopathy. We report the case of a 42-year-old woman, with type I von Willebrand disease, who underwent off-pump coronary artery bypass grafting. Beating heart surgery associated with an adequate replacement of von Willebrand factor and factor VIII levels were chosen to prevent bleeding disorders. Her postoperative course was uneventful and she was discharged home after 5 postoperative days...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Vijay Joshi, Kaye Laurie, Julian Skoyles, David Richens
We describe a case of a 66-year-old woman with severe mitral regurgitation secondary to posterior leaflet atresia of the mitral valve. Perioperative transesophageal echocardiography suggested the possibility of an absent posterior leaflet with complete prolapse of the anterior leaflet. We questioned the functional outcome if repair was attempted; therefore, mitral valve replacement was performed. We present a case outlining the successful management of this rare condition in an adult as well as a review of current literature...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Elmar W Kuhn, Gerardus Bennink, Thorsten Wahlers, Jens Wippermann
Background Double-chambered right ventricle is a partial separation of the right ventricle by pathological tissue. This anomaly is described in infants and children but can also be diagnosed in young adults. Case Description A 47-year-old patient presented with chest pain and exercise intolerance. Further evaluation revealed a double-chambered right ventricle. During the surgical procedure, fibrotic tissue was transected, and a pulmonary valve replacement including enlargement of the main pulmonary artery was performed...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Saleem Jahangeer, Rebecca Emily Gardiner, Patrick Forde, John Hinchion
Purulent pericarditis is a rare entity in the postantibiotic era. It usually occurs in patients who have underlying chronic and immunosuppressing conditions and its presentation in the healthy adult population is quite rare. Infection of the pericardial space can occur via direct extension from infectious endocarditis, pneumonia, or empyema, or from a more distant source such as meningitis. Purulent pericarditis carries a very high mortality because of delay in the diagnosis and early occurrence of fatal complications...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Javier Gualis, Mario Castaño, Miguel Angel Rodríguez, Cristina García
Advanced age and female sex are known risk factors for ventricular wall rupture during open-heart procedures. We present the case of an 83-year-old female patient with an intraoperative traumatic right ventricular free wall rupture during an aortic valve replacement procedure. Pledgetted interrupted sutures reinforced with large pieces of mediastinal fat were used for rupture repair. After 6 months, the patient was readmitted with the diagnosis of a retrosternal mediastinal mass and clinical signs of cardiac tamponade that required reoperation...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Sonia Erika Frick, Christoph Flothmann, Benjamin Preiswerk, Renate Behr, Michele Genoni
Background The aim of this study is to present the success of a multidisciplinary approach in a patient with a rare triad of disease. Case Description A 33-year-old patient with newly diagnosed human immunodeficiency virus infection presented with miliary tuberculosis, consecutive adult respiratory distress syndrome, and multiple-organ failure. An interdisciplinary, time-limited approach combining extracorporeal membrane oxygenation, intensive care therapy, hemodiafiltration, tuberculostatic therapy, steroids, and antiretroviral therapy led to survival despite a low probability at presentation...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Andreas Kirschbaum, Alexander Damanakis, Caroline Rolfes, Detlef Bartsch
Background Matthys catheters (Matthys drainage A Set, Bösch Feinmechanik und Medizintechnik GmbH, Gottenheim, Germany) are thin catheters with an external diameter of 2.7 mm, which are often used in internal medicine to drain pleural effusions. After puncturing the pleural cavity with a hollow needle the Matthys catheter is advanced through it without resistance. Once the three-way tap on the catheter has been opened, the pleural effusion should flow out. Case Description In our case, the positioning of the Matthys catheter was thought to be completely straightforward but an X-ray check nonetheless revealed malposition...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Murat Akkuş, Ayfer Utkusavaş, Murat Hanözü, Mehmet Kaya, Ihsan Bakir
We report a 55-year-old male patient with a massive flail chest that required chest stabilization by minimally invasive repair of pectus excavatum (MIRPE) employing a Nuss bar. Surgical stabilization of severe flail chest and fractured sternum with Nuss bar by MIRPE is a safe and useful treatment modality in properly selected patients.
December 2015: Thoracic and Cardiovascular Surgeon Reports
Serdar Evman, Ilker Kolbas, Talha Dogruyol, Cagatay Tezel
Background Flail chest is the most serious complication that may occur after thoracic trauma. In this article, we present a case of flail chest caused by blunt chest trauma, which presented dramatic clinical improvement following rib fixation and chest wall reconstruction. Case Description A 53-year-old male patient with flail chest because of the trauma who had been followed in intensive care unit for mechanical ventilatory support underwent chest wall stabilization with titanium reconstruction plate and screws...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Ina Müller, Mario Tönnies, Joachim Pfannschmidt, Dirk Kaiser
Pneumocephalus can be seen after head injury with fracture of the skull-base or in cerebral neoplasm, infection, or after intracranial or spinal surgery. We report on a 69-year-old male patient with pneumocephalus after right-sided lobectomy and en bloc resection of the chest wall for non-small-cell lung cancer. Postoperatively, the patient showed a reduced vigilance level with no response to pain stimuli and anisocoria. The CCT scan revealed an extensive pneumocephalus; following which, the patient underwent neurosurgery with laminectomy and ligature of the transected nerve roots...
December 2015: Thoracic and Cardiovascular Surgeon Reports
Shijie Xing, Jianjun Wang, Wei Zhai, Tian Xia, Chuanxiao Wang
A patient with enormous recurrent dermatofibrosarcoma protuberans underwent modified three-dimensional histology surgery. Frozen-section examination was used to identify the margins. The patient had a normal postoperative course.
December 2015: Thoracic and Cardiovascular Surgeon Reports
Andreas Böning
No abstract text is available yet for this article.
December 2015: Thoracic and Cardiovascular Surgeon Reports
Katsuhiko Matsuyama, Masahiko Kuinose, Nobusato Koizumi, Toru Iwahashi, Kayo Toguchi, Hitoshi Ogino
A 54-year-old man underwent aortic repair for the infected thoracoabdominal aneurysm with a woven Dacron graft (Vascutek, Renfrewshire, Scotland) treated with gentian violet. Four months later, he complained of sudden back pain, resulting in preshock status. Computed tomographic scans showed massive hematoma around the Dacron graft, suggesting graft rupture. Initially, emergency thoracic endovascular aortic repair was performed, which was subsequently followed by open repair. The Dacron graft had a small hole, which was completely compatible with the site contacting with the rib...
December 2014: Thoracic and Cardiovascular Surgeon Reports
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