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extremity bypass

Renwei Chen, Xicheng Deng, Jinwen Luo, Peng Huang
INTRODUCTION: Cardiac myxomas are the most frequent primary cardiac tumor in adults. The incidence in pediatric patients is extremely low. Heavy calcification of an atrial myxoma is uncommon in children. CASE PRESENTATION: An 18-month-old boy was admitted for a significant precordial systolic murmur. Transthoracic echocardiography revealed a cardiac mass extending from the inferior vena cava across the right atrium and tricuspid valve into the right ventricle with severe tricuspid regurgitation...
June 2018: Medicine (Baltimore)
Kathryn L Howe, John Harlock, Dominic Parry
Introduction: Type A aortic dissection can present with malperfusion syndrome. Lower limb ischaemia may resolve with repair of the dissection; however, the long duration of repair and/or persistent ischaemia may leave tissue at risk of necrosis with potential for substantial morbidity. Report: Here, the case of a 67 year old man who presented with a Type A aortic dissection with malperfusion of the lower extremities is described. The Vascular Surgery and Cardiac Surgery divisions were consulted simultaneously...
2018: EJVES Short Reports
Michael Sobel, Shinsuke Kikuchi, Lihua Chen, Gale L Tang, Tom N Wight, Richard D Kenagy
OBJECTIVE: When an autogenous vein is harvested and used for arterial bypass, it suffers physical and biologic injuries that may set in motion the cellular processes that lead to wall thickening, fibrosis, stenosis, and ultimately graft failure. Whereas the injurious effects of surgical preparation of the vein conduit have been extensively studied, little is known about the influence of the clinical environment of the donor leg from which the vein is obtained. METHODS: We studied the cellular responses of fresh saphenous vein samples obtained before implantation in 46 patients undergoing elective lower extremity bypass surgery...
June 15, 2018: Journal of Vascular Surgery
Pengxiong Zhu, Xiaofeng Ye, Qiang Zhao
Descending aorta interruption is an extremely rare congenital defect. Conventional repair with end-to-end anastomoses is often a surgical challenge in view of the extensive collateral vessels that develop on the chest wall and inside the chest cavity. Extra-anatomic bypass is the preferred technique for the surgical repair of this entity, which avoids the network of collateral vessels, enables simultaneous treatment of associated lesions, and in all likelihood reduces morbidity and mortality. Here we describe an extra-anatomic bypass from the ascending aorta to the bilateral iliac arteries in a 24-year-old woman using vascular grafts (MAQUET Holding B...
May 16, 2018: Heart Surgery Forum
Yalcin Guzelhan, Cenk Conkbayir, Murat Ugurlucan, Cenk Eray Yildiz, Ufuk Alpagut, Nilgun Bozbuga
The present study was designed to evaluate the relationship between gender and coexisting anxiety in patients undergoing coronary artery surgery. Materials and Methods: A total of 137 patients (41 women and 96 men with a mean age 66.1 ± 6.0 years) patients underwent state and trait anxiety evaluation at baseline (preoperatively) and at six months after (postoperatively) coronary artery bypass graft (CABG). Anxiety symptoms were assessed at enrollment using the Spielberger State-Trait Anxiety Inventory (STAI)...
May 11, 2018: Heart Surgery Forum
K Hua, T S Liu, Y Li, Y Zhao, J B Zheng, N Zhou, S Y Zhou, R Dong
Objective: To evaluated early clinical outcomes of saphenous vein grafts harvested with a No-touch technique in off-pump coronary artery bypass graft (OPCABG) surgery. Methods: A total of 124 patients with three-vessel disease undergoing OPCABG by No-touch technique between June and November 2017 in Beijing An Zhen Hospital were respectively reviewed. Results: The average age of patients was (60.7±10.3) years, and 80 cases (64.5%) were male, with the average body mass index (BMI)of (25.4±2.5) kg/m(2,) the mean preoperative left ventricular ejection fraction (LVEF) of (58...
May 29, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Roberto Gabrielli, Franco Ciocca, Angelica Dante, Aldo Musilli, Maurizio Maiorano, Marco Ventura
BACKGROUND: Redo area region operation is associated with a significant morbidity such as neurovascular injury, infection and lymphorrhea. The traditional management of occluded femoro-popliteal grafts often includes redissection of a scarred groin to obtain adequate inflow via the common femoral artery. These procedures are more technically demanding and require more expertise and judgment than the primary operation. We describe a case of using the ipsilateral iliac branch prosthesis of aorto-bifemoral as inflow for iliac-peroneal bypass, avoiding the previous groin incisions, to minimize the local complications related to a redo groin dissection and to decrease the operative time required to obtain an adequate inflow source...
June 7, 2018: Annals of Vascular Surgery
Tara Talaie, Natasha Hansraj, Christopher Werter, K Nagarsheth, Thomas S Monahan, Shahab Toursavadkohi
Venous ulcers can be a chronic debilitating condition with a high rate of recurrence. Herein we describe a case of a patient who successfully underwent an arterial bypass for rest pain but returned with lower extremity swelling and venous ulcers. Venography demonstrated a focal common femoral vein stenosis due to scarring from the surgical exposure. This was treated with endovenous stenting and resulted in resolution of the swelling and ulceration.
June 7, 2018: Annals of Vascular Surgery
Amit Lehavi, Avraham Yitzhak, Refael Jarassy, Rami Heizler, Yeshayahu Shai Katz, Aeyal Raz
OBJECTIVES: Warming intravenous fluids is essential to prevent hypothermia in patients with trauma, especially when large volumes are administered. Prehospital and transport settings require fluid warmers to be small, energy efficient and independent of external power supply. We compared the warming properties and resistance to flow of currently available battery-operated fluid warmers. METHODS: Fluid warming was evaluated at 50, 100 and 200 mL/min at a constant input temperature of 20°C and 10°C using a cardiopulmonary bypass roller pump and cooler...
June 7, 2018: Emergency Medicine Journal: EMJ
Sebastien Michiels, Caroline Delier, Patrick Philippart
INTRODUCTION: Small bowel intussusception is a rare complication after Roux-en-Y gastric bypass (RYGB) whose incidence tends to increase. This rising could be explained by an increasing bariatric surgery over the last two decades and by a better recognition of this potential complication. PATIENT AND METHODS: We report a case of jejunojejunal intussusception in 33-year-old woman 2 years following a laparoscopic RYGB. She was taken to the operating room for exploratory laparotomy...
June 7, 2018: Acta Chirurgica Belgica
Elise Lupon, Anais Lemaire, Christophe Cron, Bertrand Marcheix
It is well known that a heavily calcified mitral valve significantly increases the perioperative and postoperative risks of mitral valve surgery. A 71-year-old woman was referred to our department with severe mitral valve disease. Cardiac imaging revealed extremely severe calcification of the entire left heart. Surgery was performed through a median sternotomy with standard cardiopulmonary bypass. After dilating the mitral orifice with a balloon, we replaced the valve with a transcatheter Edwards Sapiens 3 aortic valve under direct vision...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Jaspreet Sandhu, Charles La Punzina, Ravi Kothuru
This is a case report describing the delayed presentation of injury to all three lower extremity infrapopliteal arteries after a 34 year old male sustained multiple gunshot wounds, including one to his left lower extremity. As part of his initial assessment, ankle brachial index was performed and was found to be abnormal. Further work up for this was delayed due to need for emergent trauma laparotomy. After this procedure, more detailed evaluation with CT angiography of the extremity injury was performed...
June 2018: Trauma Case Reports
Zhi-Yuan Wu, Lin-Qian Weng, Zuo-Guan Chen, Yue-Xin Chen, Yong-Jun Li
Aortic sarcoma is a rare entity. In this study, we report a case of a 56-year-old man with complaints of pain and numbness of bilateral lower extremities. An endovascular aortic repair was finally adopted to prevent recurrent embolic events. An endo-biopsy was performed and showed aortic sarcoma. Axillary bifemoral and femoro-femoral cross-over bypass surgeries were taken to supply blood to the lower extremities in the 6th month after the first operation. He finally passed away in the 37th month. Aortic sarcoma should be taken into consideration as one of the possible etiologies for massive thrombus in aorta...
April 2018: Journal of Thoracic Disease
Paul D Wiemers, Lucy Marney, Nicole White, Georgina Bough, Alistair Hustig, Wei Tan, Ching-Siang Cheng, Dong Kang, Sumit Yadav, Robert Tam, John F Fraser
BACKGROUND: There is a paucity of data in regards to longer term morbidity outcomes in Indigenous Australian patients undergoing coronary artery bypass grafting (CABG). No comparative data on re-infarction, stroke or reintervention rates exist. Outcome data following percutaneous coronary intervention (PCI) is also extremely limited. Addressing this gap in knowledge forms the major aim of our study. METHODS: This was a single centre cohort study conducted at the Townsville Hospital, Australia which provides tertiary adult cardiac surgical services to the northern parts of the state of Queensland...
April 24, 2018: Heart, Lung & Circulation
Ashlei C Beiswenger, Alice Jo, Karem Harth, Norman H Kumins, Mehdi H Shishehbor, Vikram S Kashyap
BACKGROUND: Dual antiplatelet therapy (DAPT) usually refers to the administration of aspirin plus a platelet P2Y12 receptor blocker. This combination is commonly prescribed after revascularization procedures in patients with peripheral arterial disease (PAD) to prevent failure of the intervention. However, there is not a consensus among peripheral vascular specialists regarding whether the optimal treatment regimen for their patients is mono antiplatelet therapy (MAPT) or DAPT. Furthermore, there is no consensus regarding the optimal duration of DAPT...
June 2018: Journal of Vascular Surgery
B S Sukovatykh, L N Belikov, A O Rodionov, M B Sukovatykh, A Yu Grigorian
AIM: To compare synthetic and biological prostheses for femoral bypass surgery. MATERIAL AND METHODS: There were 40 patients with critical ischemia of lower extremities due to atherosclerotic lesion of aorto-iliac segment and severe comorbidities. They were divided into 2 groups by 20 patients. C-shaped femoro-femoral bypass with synthetic polytetrafluoroethylene and lavsan prostheses was performed in the first group and S-shaped bypass procedure with biological prosthesis from the internal thoracic arteries of the bull - in the second group...
2018: Khirurgiia
Qiang Liu, Xiujie Yin, Mingzhu Li, Li Wan, Liqiao Liu, Xiang Zhong, Zhuoqi Liu, Qun Wang
Occlusive artery disease (CAD) is the leading cause of death worldwide. Bypass graft surgery remains the most prevalently performed treatment for occlusive arterial disease, and veins are the most frequently used conduits for surgical revascularization. However, the clinical efficacy of bypass graft surgery is highly affected by the long-term potency rates of vein grafts, and no optimal treatments are available for the prevention of vein graft restenosis (VGR) at present. Hence, there is an urgent need to improve our understanding of the molecular mechanisms involved in mediating VGR...
2018: PeerJ
Hasan Baki Altinsoy, Ozkan Alatas, Emjed Khalil, Kenan Abdurrahman Kara, Candan Cudi Okten, Omer Faruk Dogan
Background: Popliteal artery entrapment syndrome (PAES) is a very rare pathology that can cause lower extremity ischemia in healthy young people. Anomalous anatomic relationships between the popliteal artery (PA) and the surrounding musculo-tendinous structures cause PAES. We present 31 patients with PAES in 35 limbs that were treated surgically in our clinic within a 12-year period. Patients and Methods: From 2001 to 2015, 31 patients (mean age: 32 ± 7.4 years) underwent surgery for PAES...
2018: Open Cardiovascular Medicine Journal
Camila Delgado, Laura Florez, Ivonne Lollett, Christine Lopez, Shiva Kangeyan, Hansi Kumari, Marios Stylianou, Robert J Smiddy, Lisa Schneper, Robert T Sautter, George Szatmari, Kalai Mathee
The progression of cystic fibrosis (CF) from an acute to a chronic disease is often associated with the conversion of the opportunistic pathogen Pseudomonas aeruginosa from a nonmucoid form to a mucoid form in the lung. This conversion involves the overproduction of the exopolysaccharide alginate, whose production is under control of the AlgT/U sigma factor. This factor is regulated posttranslationally by an extremely unstable process and has been commonly attributed to mutations in the algT/U gene. By exploiting this unstable phenotype, we isolated 34 spontaneous nonmucoid variants arising from the mucoid strain PDO300, a PAO1 derivative containing the mucA22 allele commonly found in mucoid CF isolates...
May 21, 2018: Journal of Bacteriology
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
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