Surgical repair of delayed chronic type A dissection after previous coronary artery bypass grafting

We report of a 57 years-old woman who had undergone coronary artery bypass three years previously. Computed tomography [CT] revealed that the ascending aorta was dilated to about 7cm in diameter, with type A dissection. Angiography revealed that left internal thoracic artery [LITA] graft to left anterior descending artery [LAD] and saphenous vein grafts to posterior descending artery [PDA] branch of the right coronary artery [RCA] and second obtuse marginal [OM] branch of the circumflex artery [CX] correspondingly were patent. Though the risk of surgical, treatment via repeat median sternotomy is usually very high in these cases, we successfully performed the reoperation using profound hypothermic circulatory arrest. We dissected the mediastinum by using a sternum retractor for ITA and saphenous vein grafts dissection. We didn't use cardioplegia during profound hypothermic circulation

comparison between minilaparotomy and conventional approach for the surgical therapy of aortailiac occlusive disease

To search for less traumatizing measures for Aortic Occlusive Disease [AOD] surgeries to improve the recovery from surgery. Another objective was comparison of retroperitoneal minilaparotomy [RML] with conventional transperitoneal classic median laparotomy [TCML] with respect to per-operative and post-operative outcome and complications. It was a retrospective comparative study. All patients undergoing AOD surgery were enrolled. Our comparative data of 20 patients who had AOD surgery by TCML [TCML group] performed from January 2003 to December 2006 and 20 cases of patients who had AOD surgery by RML [RLM group] performed from January 2006 to December 2009 is presented. Chi-square and Fischer test with significance of p value being taken at 0.05 were used for categorical data, while student's t test was used for continuous data. Mean age, gender, the operation and aortic occlusion time was similar between the TCML and RLM groups. The length of stay in the intensive care unit [ICU] and total hospital stay in the RLM group was statistically shorter compared to the TCML group[p<0.05]. Major complications were rare in both the groups. During AOD surgery, RLM appears to be an attractive alternative to traditional TCLM with fewer complications