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Thoracic and Cardiovascular Surgeon Reports

Ahmed F Elmahrouk, Tamer Hamouda, Mohamed F Ismail, Ahmed Jamjoom
Background  The coronary artery anatomy in patients with transposition of the great artery (TGA) is a contributing factor for outcome in arterial switch procedure. Case Presentation  A full-term, 7-day-old baby boy diagnosed as dextro-TGA (dTGA) with intact ventricular septum. Intraoperatively, the left coronary sinus had a blind indentation from which a firm cord-like left main coronary artery originates. Procedure completed as usual for a routine arterial switch operation. Conclusion  About 5% of patients with D-TGA have a single coronary artery...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Ahmed F Elmahrouk, Mohamed F Ismail, Abdulbadee Bugis, Nashwa Badawy, Hesham Mohamed Aboelghar, Tamer Hamouda, Ahmed Jamjoom
Background  Factor X deficiency (also known as Stuart-Prower factor deficiency) is an autosomal recessive extremely rare hereditary hematologic disorder, affecting around 1:1,000,000 of the general population. Case Presentation  This case report describes a patient with hypoplastic left heart syndrome and severe factor X deficiency, who underwent staged surgical palliation. From stage 1 Norwood palliation, through superior cavopulmonary anastomosis and ending with total cavopulmonary connection with satisfactory hemostasis and no significant perioperative bleeding complication...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Nawras Diab, Clarence Pingpoh, Matthias Siepe, Friedhelm Beyersdorf, Ahmed Kharabish, Martin Czerny
A 63-year-old female with a history of kidney transplantation was admitted for emergency repair of a perforated mycotic aneurysm of the right subclavian artery (RSA) in combination with a paravertebral and posterior mediastinal abscess. After resection of the aneurysm and after radical local debridement, orthotopic repair was performed with a self-made pericardial tube graft from the brachiocephalic bifurcation to the thoracic outlet. The paravertebral and posterior mediastinal abscess was drained. The postoperative course was uneventful...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Torulv Holst, Thorsten Großwendt, Majd Makarious Laham, Mehdy Roosta-Azad, Afsaneh Zandi, Markus Kamler
Endovascular stent placement for chronic postthrombotic iliofemoral venous obstructive lesions is an effective therapeutic option and might be complicated by stent migration. We report a case of a venous stent that was lost from the iliac vein into the right ventricle rescued by emergent open-heart surgery.
January 2018: Thoracic and Cardiovascular Surgeon Reports
Georg Schlachtenberger, Stephen Gerfer, Axel Kröner, Thorsten Wahlers
Background  Primary cardiac tumors are rare, and many diagnosed tumors are benign with an incidence of 0.001% to 0.03%. The primary angiosarcoma is one of the malignant entities. Discussion  We discuss a case report of a 76-year-old male who underwent a preoperative diagnosis for an upcoming shoulder operation when his cardiologist diagnosed a large cardiac tumor. The patient was referred to our department where he received further diagnostics. The transesophageal echocardiography and the cardiac-magnetic resonance imaging showed a massive tumor with a dimension of 8...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Michael John Paisley, Zachary Deboard, Donald Thomas
Background  The rare complication of mitral valve rupture from blunt trauma is certainly not at the top of the differential of shock. Case Description  We report the case of a 56-year-old woman who sustained numerous injuries after a 30-m fall with cardiogenic shock secondary to mitral valve rupture causing severe mitral valve regurgitation. Management included successful primary leaflet repair, annuloplasty, and single vessel coronary artery bypass. Conclusion  Valvular repair in the setting of polytrauma is a complex decision that requires careful balance of risks and benefits relative to patient stability...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Najah Khan, Vid Fikfak, Edward Y Chan, Min P Kim
Background  Technology has evolved to facilitate pulmonary resection. The latest technological advances in computer-aided surgery (Da Vinci Xi) allow for more control during pulmonary resection. Case Description  A 59-year-old woman presented with two primary tumors of the left upper and lower lung. After induction chemotherapy, patient had a "five on a dice" port placement and technique was used to perform successful robot-assisted pneumonectomy. The patient was discharged home on postoperative day 3 without any complications...
January 2017: Thoracic and Cardiovascular Surgeon Reports
H Edward Garrett
Background  The Cor-Knot device is a titanium fastener which is widely used in cardiac valve procedures. Adverse events associated with use of the device have been rare. Case Description  A patient underwent robotic mitral valve repair using the Cor-Knot fastener. Five years later, he suffered a cerebral vascular accident secondary to embolization of a metallic foreign body. He had had no other medical procedures which could account for a source of metallic embolization. Conclusion  Long-term surveillance after use of the Cor-Knot fastener is limited...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Marco Gennari, Piero Trabattoni, Antonio L Bartorelli, Marco Agrifoglio
No consensus exists on the timing, safety, and efficacy of treating severe symptomatic aortic and carotid stenosis. In the older population and in the presence of multiple comorbidities that arise during the surgery, a less invasive transcatheter treatment may be the only reasonable option. We discuss this topic by analyzing a case of an 84-year-old man who underwent a combined single-stage transcatheter procedure.
January 2017: Thoracic and Cardiovascular Surgeon Reports
Stanislav Tsvelodub, Léon M Putman, Andrea Gieselmann, Hans-Hinrich Sievers
Background  Nutcracker phenomenon (NCP) can occur due to various anatomical anomalies. Anterior and posterior NCP are defined in the literature. Posterior NCP combined with left atrial isomerism is a rare condition. Case description  We present a rare case of an asymptomatic posterior NCP involving the azygos vein in a patient with a complex cardiovascular pathology with left atrial isomerism, left ventricular outflow tract obstruction, interrupted inferior vena cava, and azygos continuation. Conclusion  Detection of the NCP especially involving such a rare anatomical anomaly as an azygos continuation has a crucial importance for diagnostic and surgical procedures...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Sebastian Paul Pleger, Nadine Nink, Andreas Böning, Ahmed Koshty
Background  Endograft infections (EIs) are rare complications after endovascular procedures in the thoracic and abdominal aortas. The challenging treatment encloses antibiotic and surgical therapies. Case Description  A 74-year-old male patient developed an EI after an endovascular procedure (thoracic endovascular aortic repair [TEVAR]). Despite a long-term oral antibiotic therapy, the clinical symptoms showed no falling trend. Because of the expanded infection from above the celiac trunk up to the aortic arch, we decided to remove the infected endograft and to implant an extra-anatomic ascendobifemoral bypass...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Daniel Reichart, Niklas Schofer, Florian Deuschl, Andreas Schaefer, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
Background  Transcatheter heart valve (THV) therapies have shown to be an alternative to surgical valve replacement, especially in high-risk patients requiring redo surgery. However, reports of transcatheter-based interventions in tricuspid valve position are scarce. Case Description  Here, we report a case of successful concomitant transcatheter aortic valve-in-valve (ViV) and tricuspid valve-in-ring (ViR) procedures using a 23-mm CoreValve Evolut R THV (Medtronic, Inc., Minneapolis, Minnesota, United States) in aortic position and a 29-mm SAPIEN3 (Edwards Lifesciences, Inc...
January 2017: Thoracic and Cardiovascular Surgeon Reports
German Alberto Fortunato, Guillermo Stöger, Ricardo Gustavo Marenchino, Vadim Kotowicz
Background  The authors present two cases with type B aortic dissection initially treated by endovascular stent graft who developed aortic complications posttreatment and required surgical treatment. Case Description  A 50-year-old woman and a 65-year-old man underwent endovascular treatment for thoracic aortic aneurysm associated with type B dissection and -both of them evolved with endoleak type 1. The first case was related to aortobronchial fistula, and the second one was associated with ascending aortic aneurysm...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Abdulwahab Al Khalifa, William Gourdin McMaster, Colin Schieman, Richard Whitlock, Christopher Ricci, Matthew Danter
Colonic interposition grafts are commonly used as an esophageal conduit following esophageal resection. Significant morbidity is associated with this reconstruction due to the nature of the operation. Many of the complications associated with this procedure have clear management strategies; however, there is a paucity of data when it comes to managing rare complications. In this report, we discuss the presentation, operative intervention, and postoperative care of a patient who presented with a left ventricle to esophageal colonic interposition graft fistula...
January 2017: Thoracic and Cardiovascular Surgeon Reports
George Awad, Patrick Zardo, Hassina Baraki, Ingo Kutschka
Management of aortic dissection with a novel endovascular technique known as thoracic endovascular aortic repair (TEVAR) paired with surgical debranching as a less invasive alternative to conventional repair has gained widespread acceptance. However, experience for complicated, Stanford type B dissection involving the aortic arch is still limited.
January 2017: Thoracic and Cardiovascular Surgeon Reports
Mina Rouman, Alexander Petrovitch, Eva-Maria Gey, Thomas Kuntze
Background  An aberrant right subclavian artery (RSA) or arteria lusoria is the most common congenital abnormality of the aortic arch with an incidence of 0.3 to 3.0%. Case Description  We report a case of a perforated aneurysmal aberrant RSA, managed using a hybrid approach. Conclusion  In emergency cases with acute bleeding, we recommend an endovascular approach to avoid the lethal sequel of arterial leakage. Whenever possible, the pulsatile blood flow to the right arm should be restored. Management should be tailored to the nature of the aneurysmal aberrant RSA, patient's comorbidities, and concomitant lesions...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Fayza Haider, Khulood Al Saad, Fatima Al-Hashimi, Hakima Al-Hashimi
Pleuropulmonary blastoma (PPB) is a rare aggressive malignant tumor of infancy and early childhood. The tumor arises in the lung and pleura and is regarded as a pulmonary dysontogenetic or embryonic neoplasm. Four types are defined in literature. Type I PPB is a rare, cystic lung neoplasm in infants characterized by subtle malignant changes and a good prognosis. Recurrences after type I PPB are usually advanced with a poor prognosis. We report this case to increase awareness about this entity so that the pediatricians, pediatric surgeons, radiologist, and pathologist recognize it early...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Philippe Grieshaber, Holger Nef, Andreas Böning, Bernd Niemann
Background Bleeding from bypass anastomosis leakage occurs early after coronary artery bypass grafting. Later, once the anastomosis is covered by intima, spontaneous bleeding is unlikely. Case Description A 63-year-old male patient developed a pseudoaneurysm-like, subepicardial late-term bleeding resulting in a hematoma that compromised coronary artery flow by increasing extracoronary pressure. This resulted in severe angina pectoris (Canadian Cardiovascular Society IV) and myocardial ischemia within the affected area...
January 2017: Thoracic and Cardiovascular Surgeon Reports
Katharina Huenges, Bernd Panholzer, Jochen Cremer, Assad Haneya
Organ shortage unavoidably leads to shifting strategies in modern transplantation medicine. Experiences with specific comorbidities in terms of organ transplantation therefore have to be made. We report a case of a 51-year-old male patient with successful orthotopic heart transplantation from a donor with granulomatosis with polyangiitis. After a good recovery, the patient was discharged to rehabilitation 2 months after transplantation.
January 2017: Thoracic and Cardiovascular Surgeon Reports
Julia Hillebrand, Sven Martens, Andreas Hoffmeier
Primary tumors of the heart are rare. The majority of them are benign, the left atrial myxoma being the most frequent one. Clinical appearance varies from unapparent to life-threatening complications such as stroke, acute heart failure, or even sudden death. Diagnosis and consecutive surgical treatment strongly depend on the clinical symptoms, but their extent does not correlate with the risk for serious complications. Therefore, patients with variable clinical presentation can be especially endangered. Consequent diagnostic and immediate operative therapy is essential...
January 2017: Thoracic and Cardiovascular Surgeon Reports
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