ABSTRACT
Presented herein is a clinical case report concerning successful simultaneous surgical treatment of a female patient with a complication after transcatheter treatment for chronic dissection of the descending portion of the thoracic aorta. The woman was subjected to elective transcatheter isolation of chronic dissection of the descending thoracic aorta using a stent graft with complete coverage of the zone of the origin of the left subclavian artery. Repeat control imaging studies several months after the intervention revealed residual blood flow through the false channel, directed retrogradely from the distal edge of the stent graft to the left subclavian artery. Besides, the patient was also found to have local dissection of the distal part of the ascending aorta (zone 0). An operative intervention was performed: sternotomy, prosthetic repair of the ascending portion of the aorta and part of the aortic arch, as well as transposition of the left subclavian artery to the left common carotid artery. The control imaging studies confirmed radical removal of the false aneurysm of the ascending aorta and the presence of total thrombosis of the false channel at the level of the stent graft.
Subject(s)
Aortic Aneurysm, Thoracic , Aortic Dissection , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Aortic Dissection/diagnosis , Aortic Dissection/etiology , Aortic Dissection/surgery , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/diagnosis , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Female , Humans , Stents , Treatment OutcomeABSTRACT
An analysis of treatment results was made in 216 patients with intussusception of bowels at the period from 2000 to 2015. The authors showed that it would be reasonable to carry out a conservative therapy in the cases of recurrent intussusception in absence of peritonitis symptoms.
Subject(s)
Conservative Treatment , Digestive System Surgical Procedures , Intussusception , Peritonitis , Adolescent , Biomedical Engineering , Child , Child, Preschool , Conservative Treatment/adverse effects , Conservative Treatment/methods , Conservative Treatment/statistics & numerical data , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Digestive System Surgical Procedures/statistics & numerical data , Female , Humans , Infant , Intussusception/complications , Intussusception/diagnosis , Intussusception/physiopathology , Intussusception/therapy , Male , Outcome and Process Assessment, Health Care , Patient Selection , Peritonitis/diagnosis , Peritonitis/etiology , Recurrence , Reoperation/methods , Reoperation/statistics & numerical dataABSTRACT
The article presents the experience of treatment of newborn children and infants with congenital malformations of the lung and mediastinum, which required a surgery. Children (138 cases) were treated during recent 18 years. There was a prevalence of full-term infants (73%). Fetal malformations were diagnosed in prenatal period in majority of cases. Computed tomography was the main method of diagnostics after delivery. Children (110 cases) were operated out of 138. Children with extrapulmonary sequestration didn't undergo surgery in case of absence of clinical manifestations. The authors made a conclusion that malformations of the lung and mediastinum should be included in number of differentiated diseases in case of respiratory distress syndrome in newborn children. The indications to early surgery should be the danger of contamination and malignant transformation, presence of intrathoracic tension syndrome in neonatal period.
Subject(s)
Lung , Mediastinum , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory System Abnormalities/complications , Child, Preschool , Diagnosis, Differential , Early Medical Intervention , Female , Humans , Infant , Infant, Newborn , Lung/abnormalities , Lung/pathology , Lung/surgery , Male , Mediastinum/abnormalities , Mediastinum/pathology , Mediastinum/surgery , Outcome Assessment, Health Care , Prenatal Diagnosis/methods , Respiratory Distress Syndrome, Newborn/etiology , Thoracic Surgical Procedures/methods , Thoracic Surgical Procedures/mortality , Tomography, X-Ray Computed/methodsABSTRACT
The authors share the observations from their cardiosurgical practice showing that one of the causes of sudden death or of rapid worsening of the state of patients with implanted bicuspid artificial valves might be their dysfunction resulting both from breakage of the hinged mechanisms of the valve with its dislocation and migration and from the disturbed mobility of the valve cusp due to a thrombus formed in the atrium. The observations show that the "ideal" construction of the valve is to be created.
Subject(s)
Heart Valve Prosthesis , Prosthesis Failure , Adult , Aortic Valve , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/pathology , Fatal Outcome , Female , Humans , Male , Middle Aged , Mitral ValveABSTRACT
Fifty-nine newborn infants with Hirschsprung's disease were treated at the Saint-Petersburg Center of Surgery of Developmental Anomalies from 1978 to 1991. The typical rectosigmoid form was found in 47.5% and a long zone of agangliosis in 35.6% of children. Mortality rate--16.7%. According to the development of enterocolitis, three variants of the course of the disease in the newborns were distinguished. It is shown that the informativeness of the diagnostic methods increases with the growth of the infants, and the final diagnosis of Hirschsprung's disease is best established at the age of over two weeks on the basis of repeated or initially postponed contrast study of the large intestine. Inefficacy of nonoperative treatment conducted for 2-3 days and recurrence of symptoms of intestinal obstruction are indications for operative decompression of the intestine. The performance of one-stage radical operation at the age of about one month is advisable in an uncomplicated course of the disease.
