ABSTRACT
Chronic mesenteric ischemia has traditionally been treated with either open surgical revascularization or endovascular therapy. Endovascular surgery has typically been preferred due to the lower rates of peri-procedural and post-procedural morbidity, yet this comes at the expense of long-term durability. Intravascular shockwave lithotripsy is a technique utilized to modify intimal and medial calcified plaque in order to improve vessel expansion and patency. Intravascular lithotripsy has been investigated as both primary and adjunctive treatment for peripheral arterial and coronary arterial lesions, however, its use in the treatment of chronic mesenteric ischemia requires further investigation. We present a case of a 75-year-old woman with symptomatic mesenteric ischemia who underwent intravascular shockwave lithotripsy of a 99% stenosis superior mesenteric artery with an excellent outcome.
Subject(s)
Lithotripsy , Mesenteric Ischemia , Vascular Calcification , Aged , Female , Humans , Ischemia/therapy , Mesenteric Ischemia/diagnostic imaging , Mesenteric Ischemia/surgery , Stents , Treatment Outcome , Vascular Calcification/therapy , Vascular Surgical ProceduresABSTRACT
Aortic valve replacement has long been the standard of care for many aortic valve diseases. Neo sinus reconstruction and aortic valve reconstruction with native pericardium, known as the Ozaki procedure, is a relatively new technique with early studies showing good mid-term durability and hemodynamics without the need for life-long anticoagulation. We present the case of a 56-year-old male presenting with aortic valve endocarditis and severe aortic insufficiency who underwent successful aortic valve reconstruction via the Ozaki procedure complicated by postpericardiotomy syndrome and cardiac tamponade. Although the Ozaki procedure is a promising alternative to conventional aortic valve replacement, further study is needed to determine long-term re-operation rates, stability and mortality.
Subject(s)
Aortic Valve Insufficiency , Cardiac Tamponade , Aortic Valve/surgery , Aortic Valve Insufficiency/etiology , Aortic Valve Insufficiency/surgery , Cardiac Tamponade/diagnosis , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Humans , Male , Middle Aged , Pericardium/transplantation , Postpericardiotomy Syndrome/diagnosis , Postpericardiotomy Syndrome/etiology , Postpericardiotomy Syndrome/surgery , Treatment OutcomeABSTRACT
CASE: Comminuted fractures of the capitate, in the absence of associated carpal injuries, are exceedingly rare. Treatment of this complex injury is not well-documented in the literature. We describe the case of a comminuted capitate fracture that was successfully managed with Kirschner wire fixation. CONCLUSION: Based on this case and a review of the literature, management of a comminuted capitate fracture with Kirschner wire fixation can lead to successful treatment and positive patient outcomes.
