Sport can enhance locomotor status and tolerance for prolonged physical activities in people with vascular diseases. However, it is necessary in such frail people to assess their ability for practicing before beginning any physical activities. Many sports appear indicated but optimal selection depends on individual adaptation.
Mediastinal infection is a life-threatening complication observed after cardiac surgery or esophageal surgery, most commonly in cardiac surgery with an incidence of 0.15% to 8%. Even today the mortality remains as high as 50% when left diagnosed and treated lately. Septic chock is the most usual clinical presentation. Chest X-ray, thorax CT scanning, eso-gastroduodenal transit are essential investigations for accurate diagnosis. The treatment of mediastinitis ranges from aggressive antibiotic treatment, to local debridement of wound or surgical drainage associated with plastic surgery or to total sternal resection and reconstruction with flaps.
Beside standard anatomic description, this paper underlines details which have a specific clinical application. These clinical applications concern all cardiologic fields. Regarding the coronary artery network, its anatomy remains the support of angina pectoris and myocardial infarction symptomatology. In valvular diseases, the anatomy of the valvular and subvalvular apparatus supports the pathophysiological concept and the technical aspect of left atrioventricuar valvuloplasty. Regarding the modulation of cardiac performances, the responsibility of extrinsic and intrinsic nervous support lies on anatomical considerations. The present paper utilizes the international nomina anatomica which is actually taught to students.
Since the advent of the thrombolytic therapy, the indications for surgical treatment of non complicated myocardial infarction have changed. Previously, early reperfusion of the acute coronary occlusion was a surgical procedure; some studies showed the interest of such early revascularisation surgery, with satisfactory results. Today, other less invasive methods such as thrombolytic therapy or percutaneous angioplasty have supplanted surgery. Nevertheless, surgery remains an additional solution, as a complement of the other techniques. At present, surgery is indicated in acute myocardial infarction only in case of failure or complications of the other methods, and in case of myocardial infarction complicated by a cardiogenic shock or mechanical complications. Advances in operative techniques, myocardial protection and postoperative care allow having satisfactory results despite the poor prognosis of these complications.
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