RÉSUMÉ
We report a case of a postinfarction ventricular septal defect caused by an acute recurrent occlusion after the implantation of a covered stent, which was performed as a rescue procedure for the ruptured left anterior descending artery during a percutaneous coronary intervention. Although the emergent implantation of a covered stent for the ruptured coronary arteries such as the left main coronary artery or the origins of the left anterior descending artery can be performed during a percutaneous coronary intervention, and a coronary bypass surgery should be considered in order to decrease the risk of complete occlusion, thus providing a superior long term patency.
Sujet(s)
Artères , Maladie des artères coronaires , Vaisseaux coronaires , Communications interventriculaires , Intervention coronarienne percutanée , EndoprothèsesRÉSUMÉ
BACKGROUND: The indications and the optimal time of surgery of infective endocarditis are controversial. We report the surgical results of our hospital during the last 10 years with literature review. MATERIAL AND METHOD: Between January 2000 and December 2009, we enrolled 23 infective endocarditis patients who underwent surgery, and analyzed retrospectively. In the preoperative blood culture, 8 cases (34.8%) were positive. The average preoperative antibiotics treatment period was 20.78+/-16.00 days. There were 12 (52.2%) urgent operations. The average follow up period was 49.26+/-33.21 months. RESULT: 20 mechanical valve replacements were performed, 9 in aortic position, 8 in mitral position and 3 in the both positions. The other procedures were one mitral valvuloplasty, one infected myxoma extirpation, and one infected pacemaker lead removal with debridement. The average period of postoperative intravenous antibiotic treatment was 24.39+/-15.98 days. There were 5 complications, including 2 cases of postoperative bleeding, one postcardiotomy syndrome, one cerebral ischemia, and a low cardiac output syndrome. There were statistically significant postoperative improvement in NYHA class, left ventricle end diastolic/end systolic volume, and left atrium size (p-value<0.05). CONCLUSION: We could obtain the satisfactory results without any mortalities by using sufficient preoperative antibiotics in hemodynamically stable patients, and by prompt surgery in unstable patients.
Sujet(s)
Humains , Antibactériens , Encéphalopathie ischémique , Bas débit cardiaque , Débridement , Endocardite , Études de suivi , Atrium du coeur , Valvulopathies , Ventricules cardiaques , Hémorragie , Myxome , Études rétrospectivesRÉSUMÉ
Bronchogenic cysts are usually located in the pulmonary parenchyma or in the mediastinum. When bronchogenic cysts are located in the mediastinum, they are usually near the bronchus or esophagus, and rarely located in the retroperitoneal space. It is difficult to differentiate between bronchogenic cysts and benign cysts prior to surgert. We report here on a patient for who had a mass in the retroperitoneum, with the preoperative diagnosis being a benign neurogenic tumor. Via left open thoracotomy, pathologic reports revealed that the mass was a bronchogenic cyst. We report here on the case of a bronchogenic cyst that was located in the retroperitoneal space of the diaphragm.