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1.
Eur J Cardiothorac Surg ; 53(1): 284-285, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28958060

RESUMO

Penetrating cardiac injuries with extensive intracardiac components and minimal epicardial components are a rare presentation. A 31-year-old male presented with complex mitral valve and ventricular septal injuries with partial atrioventricular disruption but with hardly visible epicardial injuries; the patient's presentation, progression of injuries and successful management are discussed.


Assuntos
Valva Mitral/lesões , Septo Interventricular/lesões , Ferimentos Perfurantes/cirurgia , Adulto , Humanos , Masculino , Valva Mitral/cirurgia , Septo Interventricular/cirurgia , Ferimentos Perfurantes/diagnóstico
2.
Ann Thorac Surg ; 97(5): 1824-6, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24792287

RESUMO

In patients with partial anomalous pulmonary venous return of the right superior pulmonary veins to the superior vena cava, surgical repair generally consists of either intraatrial baffle with or without caval enlargement, or superior caval transection and cavoatrial anastomosis to the right atrial appendage. We discuss here a novel technique of superior caval enlargement without need for patch material or reimplantation.


Assuntos
Apêndice Atrial/cirurgia , Veias Pulmonares/anormalidades , Veias Pulmonares/cirurgia , Síndrome de Cimitarra/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Veia Cava Superior/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ponte Cardiopulmonar/métodos , Feminino , Humanos , Masculino , Segurança do Paciente , Esternotomia/métodos , Resultado do Tratamento , Malformações Vasculares/cirurgia , Veia Cava Superior/anormalidades
4.
Ann Thorac Surg ; 94(3): 1023-5, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22916765

RESUMO

In patients with tetralogy of Fallot (TOF) repair and a borderline pulmonary valve annulus (PVA) size, surgical repair often necessitates a transannular incision and subsequent placement of a patch with or without a monocusp or, alternatively, a right ventricle-to-pulmonary artery conduit. We discuss here a technique in which the pulmonary valve annulus can be safely preserved, with infrequent postoperative issues as well as the potential for less incidence of right ventricular outflow intervention in the long term.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Valva Pulmonar/diagnóstico por imagem , Tetralogia de Fallot/cirurgia , Obstrução do Fluxo Ventricular Externo/prevenção & controle , Anuloplastia da Valva Cardíaca , Ponte Cardiopulmonar/métodos , Seguimentos , Comunicação Interventricular/cirurgia , Humanos , Polietilenotereftalatos/uso terapêutico , Artéria Pulmonar/cirurgia , Valva Pulmonar/patologia , Medição de Risco , Esternotomia/métodos , Tetralogia de Fallot/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia Doppler/métodos
5.
Pediatr Cardiol ; 33(4): 533-8, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22105493

RESUMO

Few data exist regarding the efficacy and safety of the Amplatzer ductal occluder (ADO) type 1 device in the Asian region. This retrospective study, conducted between August 2001 and April 2011, attempted device placement for 231 patients (165 females and 66 males) with a median age of 7.4 years (range, 3 months to 64 years) and an average weight of 19.4 kg (range, 4.1-81.0 kg). Among the patients in this study, 66 (28.6%) had pulmonary hypertension, ten (4.3%) had trisomy 21, and eight (3.5%) had other congenital cardiac anomalies. The mean narrowest patent ductus arteriosus (PDA) diameter was 4.2 mm (range, 1.3-10 mm), and the ampulla size was 9.6 mm (range, 4-20 mm). Successful implantation was achieved for 229 patients (99.1%). Complete angiographic occlusion was achieved for 201 patients (87.8%) at the end the procedure. Follow-up data were available for 129 patients (66%). At the follow-up assessment, complete echocardiographic occlusion was seen in 128 patients (99.2%) after 1 month and in 100% of the patients after 6 months. The significant morbidities involved one device embolization and one dislodgment, for which surgical retrieval was performed. No mortalities occurred during the study period, and no late clinical adverse events occurred during the follow-up period. Occlusion of the PDA using ADO is safe, effective, and applicable for a wide range of PDA sizes including large PDAs in small symptomatic infants and in adults. Good outcomes can be attributed to experience of the operators, proper patient selection, and appropriate device size selection.


Assuntos
Permeabilidade do Canal Arterial/terapia , Embolização Terapêutica/instrumentação , Dispositivo para Oclusão Septal/tendências , Adolescente , Adulto , Criança , Pré-Escolar , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Filipinas , Estudos Retrospectivos , Dispositivo para Oclusão Septal/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
6.
World J Pediatr Congenit Heart Surg ; 3(1): 139-41, 2012 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-23804700

RESUMO

The first successful stage I palliation for hypoplastic left heart syndrome (HLHS) in a four-day-old female in the Philippines is reported, along with a discussion of the particular dynamics and challenges of performing this kind of surgery in a developing nation. Challenges met were not limited to the preoperative and perioperative period but involved the interstage period as well. In the face of such challenges, our experience, reported here, is the cause for cautious optimism.

8.
J Card Surg ; 26(1): 37-9, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20459453

RESUMO

Left main coronary artery aneurysm is a rare condition that presents as a potential surgical challenge due to its location. We present a case of successful repair of a posterior saccular aneurysm of the left main coronary artery by aneurysm exclusion, afferent and efferent ligation with coronary artery bypass grafting.


Assuntos
Aneurisma Coronário/cirurgia , Vasos Coronários/cirurgia , Aneurisma Coronário/diagnóstico por imagem , Angiografia Coronária , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
9.
Ann Thorac Surg ; 89(6): 1756-64; discussion 1764-5, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20494023

RESUMO

BACKGROUND: Few data support current guidelines for donor selection in lung transplantation. We determined degree of compliance with current donor guidelines, effect of these and variances on survival, and other donor factors predicting survival. METHODS: From July 1999 to June 2008, 10,333 primary transplants were performed in the US, with United Network for Organ Sharing data available for age, ABO type, chest radiograph, arterial difference in partial pressure of oxygen (PaO(2)) greater than 300 on 100% fraction of inspired oxygen, smoking, absence of aspiration/sepsis, and purulent secretions. Multivariable survival methods were used to determine relevance of these and new variables, adjusted for recipient risk factors. RESULTS: In 56% of transplants, variance from at least one guideline was observed: chest radiograph, 41%; smoking, 21%; and PaO(2), 18%; but rarely ABO compatibility (0.06%). Practice within guidelines was not associated with increased mortality. Common variances from guidelines; eg, PaO(2)/fraction of inspired oxygen down to 230, were not associated with increased mortality, but smoking (p = 0.02) was. New donor variables associated with increased mortality were diabetes (p = 0.001), presence of cytomegalovirus antibodies (p < 0.0001), recent smoking history (p = 0.02), African-American (p = 0.005), blood type A (p = 0.02), death other than from head trauma (p = 0.02), and gender (p = 0.02), race (p = 0.03), and size (p = 0.002) discordances. CONCLUSIONS: Variance from current donor guidelines for lung transplantation is frequent; analysis suggests that donor PaO(2) ranges can be widened and a suspicious chest radiograph, evidence of sepsis, and purulent bronchial secretions ignored. Older age and smoking history appear to have a minor impact. New and possibly important factors identified suggest the need to better understand the impact of a wider range of donor variables on recipient outcomes.


Assuntos
Seleção do Doador/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Transplante de Pulmão , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Transplante de Pulmão/mortalidade , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida
10.
Ann Thorac Surg ; 89(2): 601-3, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20103352

RESUMO

Early, complete disruption of bronchial closure is a rare complication after pulmonary resection that will result in almost certain death if immediate intervention is not taken. We present a case of a catastrophic bronchopleural fistula that was successfully closed using an Alloderm patch (LifeCell Corp, Branchburg, NJ) in the acute setting.


Assuntos
Fístula Brônquica/cirurgia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Colágeno , Fístula/cirurgia , Neoplasias Pulmonares/cirurgia , Mediastinoscopia , Doenças Pleurais/cirurgia , Complicações Pós-Operatórias/cirurgia , Implantação de Prótese/métodos , Toracotomia , Idoso , Fístula Brônquica/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/patologia , Empiema Pleural/diagnóstico , Empiema Pleural/cirurgia , Fístula/diagnóstico , Humanos , Neoplasias Pulmonares/patologia , Masculino , Doenças Pleurais/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Reoperação , Tomografia Computadorizada por Raios X
11.
Interact Cardiovasc Thorac Surg ; 9(5): 893-5, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19720657

RESUMO

Pseudoaneurysms of the ascending aorta developing after previous aortic or aortic valve surgery pose a high risk of exsanguination upon sternal reentry. In the past, femorofemoral bypass and hypothermic circulatory arrest before sternotomy was the preferred approach. Today, however, availability of the PORT-ACCESS EndoCPB system (Edwards Lifesciences, Irvine, CA, USA) allows for endovascular clamping and cardioplegia before sternotomy, avoiding circulatory arrest.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma Aórtico/cirurgia , Oclusão com Balão/instrumentação , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Parada Cardíaca Induzida/instrumentação , Esternotomia , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/etiologia , Aortografia/métodos , Constrição , Ecocardiografia Transesofagiana , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Reoperação , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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