Pub Date : 2019-09-29DOI: 10.4236/wjcs.2019.910015
S. Laohathai, P. Samankatiwat
Purpose: This study is to identify the prevalence of preoperative hypercoagulability in Thailand high-risk population assessed by Rotational thromboelastography (ROTEM) and test hypothesis that the pre-surgical ROTEM statuses are related to MACCE at 1, 12, 60 months after coronary bypass graft surgery (CABG). Method: This is a prospective cohort in consecutive patients who underwent on-pump CABG between 2013-2015. Blood samplings were collected and analyzed using ROTEM preoperatively. Hypercoagulable state was defined as any clotting time (CT) or clot formation time (CFT) below the lower normal limit or amplitude 10 min after CT (A10), Maximum clot firmness (MCF) in ROTEM measurement is above the upper normal limit of EXTEM, INTEM and FIBTEM. Results: 43% of CABG patients who were diagnosed as hypercoagulability state assessed by ROTEM. Mortality rate was slightly higher in hypercoagulable patients without statistical significance (9% vs 5.1%; P = 0.461). However, overall combined uneventful rate was significantly increased in hypercoagulable patients in 5 years follow-up (27.2% vs 8.6%; P = 0.012). In univariate analysis, ROTEM hypercoagulability is associated major adverse cardiovascular and cerebral event (MACCE) in 5-years follow up [OR (95% CI) = 3.975 (1.28 - 12.32); P = 0.017]. Conclusion: Hypercoagulable patients were identified 43 percent of patients associated with combine uneventful in 5 years follow-up. ROTEM could be applied as a useful tool in the prediction of outcome after CABG surgery.
目的:本研究旨在通过旋转血栓弹性成像(ROTEM)评估泰国高危人群术前高凝性的患病率，并验证冠状动脉搭桥手术(CABG)后1、12、60个月术前ROTEM状态与MACCE相关的假设。方法:这是一项前瞻性队列研究，研究对象为2013-2015年间连续接受无泵搭桥手术的患者。术前采集血样，采用ROTEM进行分析。高凝状态定义为在CT (A10)后10分钟凝血时间(CT)或凝块形成时间(CFT)低于正常下限或振幅，ROTEM测量中的最大凝块硬度(MCF)高于EXTEM、interm和fitem的正常上限。结果:43%的CABG患者经ROTEM评估为高凝状态。高凝患者的死亡率略高，但无统计学意义(9% vs 5.1%;P = 0.461)。然而，在5年的随访中，高凝患者的总体联合平安无事率显著增加(27.2% vs 8.6%;P = 0.012)。在单因素分析中，ROTEM高凝与5年随访的主要心血管和大脑不良事件(MACCE)相关[OR (95% CI) = 3.975 (1.28 - 12.32);P = 0.017]。结论:在5年的随访中，高凝患者中有43%与联合用药相关。ROTEM可作为预测冠脉搭桥术后预后的有效工具。
{"title":"Mortality and Thromboembolic Events in Hypercoagulable States from Rotational Thromboelastography (ROTEM) in Patients Who Undergo Coronary Bypass Surgery","authors":"S. Laohathai, P. Samankatiwat","doi":"10.4236/wjcs.2019.910015","DOIUrl":"https://doi.org/10.4236/wjcs.2019.910015","url":null,"abstract":"Purpose: This study is to identify the prevalence of preoperative hypercoagulability \u0000in Thailand high-risk population assessed by Rotational thromboelastography (ROTEM) and \u0000test hypothesis that the pre-surgical ROTEM statuses are related to MACCE \u0000at 1, 12, 60 months after coronary bypass graft surgery (CABG). Method: This is a prospective \u0000cohort in consecutive patients who underwent on-pump CABG between 2013-2015. \u0000Blood samplings were collected and analyzed using ROTEM preoperatively. Hypercoagulable \u0000state was defined as any clotting time (CT) or clot formation time (CFT) \u0000below the lower normal limit or amplitude 10 min after CT (A10), Maximum clot \u0000firmness (MCF) in ROTEM measurement is above the upper normal limit of EXTEM, INTEM and \u0000FIBTEM. Results: 43% of CABG patients who \u0000were diagnosed as hypercoagulability state assessed by ROTEM. Mortality rate was \u0000slightly higher in hypercoagulable patients without statistical significance \u0000(9% vs 5.1%; P = 0.461). However, overall combined uneventful rate was significantly increased in \u0000hypercoagulable patients in 5 years follow-up (27.2% vs 8.6%; P = 0.012). In \u0000univariate analysis, ROTEM hypercoagulability is associated major adverse \u0000cardiovascular and cerebral event (MACCE) in 5-years follow up [OR (95% CI) = \u00003.975 (1.28 - 12.32); P = 0.017]. Conclusion: Hypercoagulable patients \u0000were identified 43 percent of patients associated with combine uneventful in 5 \u0000years follow-up. ROTEM could be applied as a useful tool in the prediction of outcome \u0000after CABG surgery.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77065194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Togo, Ouattara Ma, A. A. Maïga, M. Bazongo, I. Maiga, Cheik Amed Sekou Touré, I. Coulibaly, S. Diop, A. Ombotimbé, S. Illiassou, S. Coulibaly, M. Koita, Koumba Nelly Dora Ignanga, S. D. Koné, Moussa Oscar Kamano, F. Konaté, A. Koné, A. Sidibé, A. Dramé, Nouhoum Oueloguem, B. Kané, B. Dramé, S. Koumare, Z. Sanogo, S. Yena
Introduction: There has been limited experience with Open Heart Surgeries (OHS) in Sub-Saharan Africa. In west Africa especially in Mali, most fledgling centers are unable to overcome the myriad of challenges encountered in establishing OHS though there is a high prevalence of surgically correctable heart diseases. The aim of this paper is to review our initial experience of our first cases in developing OHS program and discuss the challenges and prospects that need to be overcome to further develop it. Methods: A total of 6 patients who underwent OHS during the first “cardiac mission” in July 2016 were included in this retrospective study. The medical records of the patients were examined and data on age, sex, diagnosis, EuroSCORE, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted. Results: Six patients with a male to female ratio of 1, ages ranging between 12 and 35 years (mean of 22.5 ± 12 years) were studied. The mean of EuroSCORE was 6 ± 41. Pericardial patch closure of isolated atrial septal defect was performed in one patient. One patient had mitral valve repair for rheumatic mitral regurgitation consisting of chordal shortening with a tricuspid valvuloplasty. Three patients had mitral valve replacement with tricuspid valvuloplasty. Four patients had mitral valve replacement. Sixty-day mortality was 0%. Conclusion: Safe conduct of open heart surgery in Mali Hospital setting is feasible. Grant financial aid is required for rapid growth of Open-Heart Surgery in this part of Sub-Saharan Africa.
{"title":"Initial Experience with Open Heart Surgery in Sub-Saharan Africa: Challenges in Mali with Minimum Standards for Practice","authors":"S. Togo, Ouattara Ma, A. A. Maïga, M. Bazongo, I. Maiga, Cheik Amed Sekou Touré, I. Coulibaly, S. Diop, A. Ombotimbé, S. Illiassou, S. Coulibaly, M. Koita, Koumba Nelly Dora Ignanga, S. D. Koné, Moussa Oscar Kamano, F. Konaté, A. Koné, A. Sidibé, A. Dramé, Nouhoum Oueloguem, B. Kané, B. Dramé, S. Koumare, Z. Sanogo, S. Yena","doi":"10.4236/wjcs.2019.99013","DOIUrl":"https://doi.org/10.4236/wjcs.2019.99013","url":null,"abstract":"Introduction: There has been limited experience with Open Heart Surgeries (OHS) in Sub-Saharan Africa. In west Africa especially in Mali, most fledgling centers are unable to overcome the myriad of challenges encountered in establishing OHS though there is a high prevalence of surgically correctable heart diseases. The aim of this paper is to review our initial experience of our first cases in developing OHS program and discuss the challenges and prospects that need to be overcome to further develop it. Methods: A total of 6 patients who underwent OHS during the first “cardiac mission” in July 2016 were included in this retrospective study. The medical records of the patients were examined and data on age, sex, diagnosis, EuroSCORE, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted. Results: Six patients with a male to female ratio of 1, ages ranging between 12 and 35 years (mean of 22.5 ± 12 years) were studied. The mean of EuroSCORE was 6 ± 41. Pericardial patch closure of isolated atrial septal defect was performed in one patient. One patient had mitral valve repair for rheumatic mitral regurgitation consisting of chordal shortening with a tricuspid valvuloplasty. Three patients had mitral valve replacement with tricuspid valvuloplasty. Four patients had mitral valve replacement. Sixty-day mortality was 0%. Conclusion: Safe conduct of open heart surgery in Mali Hospital setting is feasible. Grant financial aid is required for rapid growth of Open-Heart Surgery in this part of Sub-Saharan Africa.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82540579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Impalement injuries are rare and among the most spectacular and dramatic traumatic injuries especially of the chest. The survival of a patient with a thoracic impalement injury can be extremely rare. Herein we present and discuss our successes of the management of 7 rare cases of thoracic impalement injuries over a 5-year period from January 2014 to June 2019 at the Komfo Anokye Teaching Hospital, Kumasi in Ghana. We discuss the presentation, diagnosis, treatment and outcomes of the seven cases encountered.
{"title":"Management of Thoracic Impalement Injury in Ghana: A Five-Year Experience at the Komfo Anokye Teaching Hospital","authors":"I. Okyere, S. G. Brenu, P. Okyere","doi":"10.4236/wjcs.2019.99014","DOIUrl":"https://doi.org/10.4236/wjcs.2019.99014","url":null,"abstract":"Impalement injuries are rare and among the most spectacular and dramatic traumatic injuries especially of the chest. The survival of a patient with a thoracic impalement injury can be extremely rare. Herein we present and discuss our successes of the management of 7 rare cases of thoracic impalement injuries over a 5-year period from January 2014 to June 2019 at the Komfo Anokye Teaching Hospital, Kumasi in Ghana. We discuss the presentation, diagnosis, treatment and outcomes of the seven cases encountered.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75009591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Furukawa, K. Mori, Yukie Shirasaki, H. Ishii, Kunihide Nakamura
Objectives: To investigate the influence of cold renal perfusion on renal function and clinical outcomes in cases where the renal ischemia time exceeded 30 min during pararenal and juxtarenal abdominal aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four patients who underwent open repair for P/JAAAs were retrospectively analyzed. Thirty-nine patients received renal perfusion with cold Ringer’s solution (perfusion group) and 15 patients did not receive renal perfusion (non-perfusion group). There were no significant differences in preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71 mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs. 2/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping (49 ± 21 vs. 47 ± 11 min; p = 0.8) between the groups. Postoperative Cr was significantly lower in the perfusion group than in the non-perfusion group (1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p 2 mg/dL was also significantly lower in the perfusion group than in the non-perfusion group [5 (13%) vs. 7 (47%), p Conclusion: Renal artery perfusion with cold Ringer’s solution clearly reduced the deterioration of postoperative renal function compared to non-renal perfusion.
{"title":"Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery","authors":"K. Furukawa, K. Mori, Yukie Shirasaki, H. Ishii, Kunihide Nakamura","doi":"10.4236/wjcs.2019.99012","DOIUrl":"https://doi.org/10.4236/wjcs.2019.99012","url":null,"abstract":"Objectives: To investigate the influence of cold renal \u0000perfusion on renal function and clinical outcomes in cases where the renal \u0000ischemia time exceeded 30 min during pararenal and juxtarenal abdominal \u0000aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four \u0000patients who underwent open repair for P/JAAAs were retrospectively analyzed. \u0000Thirty-nine patients received renal perfusion \u0000with cold Ringer’s solution (perfusion group) and 15 patients did not receive \u0000renal perfusion (non-perfusion group). There were no significant differences in \u0000preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71 \u0000mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs. \u00002/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping \u0000(49 ± 21 vs. 47 ± 11 min; p = 0.8) between the groups. Postoperative Cr was \u0000significantly lower in the perfusion group than in the non-perfusion group \u0000(1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p 2 mg/dL was also \u0000significantly lower in the perfusion group than in the non-perfusion group [5 \u0000(13%) vs. 7 (47%), p Conclusion: Renal artery perfusion with cold \u0000Ringer’s solution clearly reduced the deterioration \u0000of postoperative renal function compared to non-renal perfusion.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81046312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Miah, M. Uddin, J. B. Saeid, S. A. Nahian, A. Karim, A. Ashoub
Penetrating injuries to anterior chest may result in life-threatening complications such as massive haemothorax, as a result of injury to the internal mammary artery. Isolated internal mammary injury is a very rare cause of massive haemothorax and associated with high mortality. We are presenting this 32-year-old gentleman who sustained a thoracic stab wound and had an emergency right anterior mini-thoracotomy by extending the stab wound rather than standard thoracotomy or sternotomy. This case of isolated penetrating IMA injury managed with mini-thoracotomy is the only documented case so far. We are publishing this case report with patient’s both written and informed consent and institutional approval. This potentially life-threating injury can be managed by mini-thoracotomy with enhanced recovery; however, it is case specific and needs proper judgement.
{"title":"Literature Review for the Management of Isolated Internal Mammary Artery Injury and a Case Managed by Mini-Thoracotomy","authors":"Mohammad Miah, M. Uddin, J. B. Saeid, S. A. Nahian, A. Karim, A. Ashoub","doi":"10.4236/WJCS.2019.98010","DOIUrl":"https://doi.org/10.4236/WJCS.2019.98010","url":null,"abstract":"Penetrating injuries to anterior chest may result in life-threatening complications such as massive haemothorax, as a result of injury to the internal mammary artery. Isolated internal mammary injury is a very rare cause of massive haemothorax and associated with high mortality. We are presenting this 32-year-old gentleman who sustained a thoracic stab wound and had an emergency right anterior mini-thoracotomy by extending the stab wound rather than standard thoracotomy or sternotomy. This case of isolated penetrating IMA injury managed with mini-thoracotomy is the only documented case so far. We are publishing this case report with patient’s both written and informed consent and institutional approval. This potentially life-threating injury can be managed by mini-thoracotomy with enhanced recovery; however, it is case specific and needs proper judgement.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74858308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Sahu, H. Niraghatam, N. Bansal, S. Singh, P. Rajashekar, S. Choudhary
Background: Junctional ectopic tachycardia (JET) is one troublesome supraventricular arrhythmia in postoperative pediatric cardiac surgical patients. Unless treated timely and effectively it may lead to morbidity and even mortality. Aim: To understand the role of Ivabradine in the treatment of JET in postoperative pediatric cardiac surgical patients. Case: We present a postoperative case of complete repair of Tetralogy of Fallot who was in normal sinus rhythm in the preoperative period and developed JET 4 hours later in postoperative period which was persistent despite measures to optimize the internal milieu of the body and conventional antiarrhythmics, that was successfully treated with Ivabradine at a dose of 0.05 mg/kg/12 hourly. Conclusion: Ivabradine can be used to successfully treat postoperative JET in cases ofrefractory to other antiarrhythmic drugs like Digoxin and Amiodarone.
{"title":"Ivabradine—The Final Crusader for Postoperative Junctional Ectopic Tachycardia, a Case Report with Literature Review","authors":"M. Sahu, H. Niraghatam, N. Bansal, S. Singh, P. Rajashekar, S. Choudhary","doi":"10.4236/WJCS.2019.98009","DOIUrl":"https://doi.org/10.4236/WJCS.2019.98009","url":null,"abstract":"Background: Junctional ectopic tachycardia (JET) is one troublesome supraventricular arrhythmia in postoperative pediatric cardiac surgical patients. Unless treated timely and effectively it may lead to morbidity and even mortality. Aim: To understand the role of Ivabradine in the treatment of JET in postoperative pediatric cardiac surgical patients. Case: We present a postoperative case of complete repair of Tetralogy of Fallot who was in normal sinus rhythm in the preoperative period and developed JET 4 hours later in postoperative period which was persistent despite measures to optimize the internal milieu of the body and conventional antiarrhythmics, that was successfully treated with Ivabradine at a dose of 0.05 mg/kg/12 hourly. Conclusion: Ivabradine can be used to successfully treat postoperative JET in cases ofrefractory to other antiarrhythmic drugs like Digoxin and Amiodarone.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87274756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Maheshwari, S. Saha, T. Mondal, H. Minhas, M. Geelani
Anomalous origin of coronary arteries may be encountered coincidentally in the presence of unrelated pathology or when these are affected directly. This may directly be responsible for affecting the procedure or outcome. Various types of anomalies of origin, as well as course of coronary arteries, have been classified in the past. Here we report 3 cases of anomalous origin of coronary arteries in different scenarios. First case had anomalous coronary with bicuspid aortic valve with dilated ascending aorta for which Bentall’s procedure was done, while the second and third cases were anomalous coronaries with coronary artery disease for which coronary artery bypass grafting was done.
{"title":"Anomalous Origin and Course of Coronary Artery—Presentation of Three Cases","authors":"A. Maheshwari, S. Saha, T. Mondal, H. Minhas, M. Geelani","doi":"10.4236/wjcs.2019.98011","DOIUrl":"https://doi.org/10.4236/wjcs.2019.98011","url":null,"abstract":"Anomalous origin of coronary arteries may be encountered coincidentally in the presence of unrelated pathology or when these are affected directly. This may directly be responsible for affecting the procedure or outcome. Various types of anomalies of origin, as well as course of coronary arteries, have been classified in the past. Here we report 3 cases of anomalous origin of coronary arteries in different scenarios. First case had anomalous coronary with bicuspid aortic valve with dilated ascending aorta for which Bentall’s procedure was done, while the second and third cases were anomalous coronaries with coronary artery disease for which coronary artery bypass grafting was done.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89712671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazuhiro Higuchi, K. Furukawa, E. Nakamura, E. Nakamura, Y. Asada, H. Nakada, Kunihide Nakamura
Cardiac blood cysts are benign congenital cardiovascular tumors that are rare in adults. A 70-year-old woman who underwent left mastectomy for left breast cancer 9 years ago was referred to our institution for a right atrial mass that measured 35 × 30 mm and was detected incidentally by computed tomography for metastatic breast cancer and transthoracic echocardiography. The mass was attached to the interatrial septum by a stalk. Although it was asymptomatic, surgical resection was performed because of the risk of pulmonary embolism. The mass contained blood, and histopathological findings were suggestive of a blood cyst. We described a rare case of a right atrial blood cyst incidentally found during evaluation for metastatic breast cancer in a woman.
{"title":"Right Atrial Blood Cyst Incidentally Detected by Computed Tomography for Metastatic Breast Cancer in an Adult Female Patient: A Case Report","authors":"Kazuhiro Higuchi, K. Furukawa, E. Nakamura, E. Nakamura, Y. Asada, H. Nakada, Kunihide Nakamura","doi":"10.4236/WJCS.2019.95006","DOIUrl":"https://doi.org/10.4236/WJCS.2019.95006","url":null,"abstract":"Cardiac blood cysts are benign congenital cardiovascular tumors that are rare in adults. A 70-year-old woman who underwent left mastectomy for left breast cancer 9 years ago was referred to our institution for a right atrial mass that measured 35 × 30 mm and was detected incidentally by computed tomography for metastatic breast cancer and transthoracic echocardiography. The mass was attached to the interatrial septum by a stalk. Although it was asymptomatic, surgical resection was performed because of the risk of pulmonary embolism. The mass contained blood, and histopathological findings were suggestive of a blood cyst. We described a rare case of a right atrial blood cyst incidentally found during evaluation for metastatic breast cancer in a woman.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"24 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81797369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A left ventricular (LV) pseudoaneurysm is one of the complications of acute myocardial infarction. It is also reported after chest trauma, cardiac surgery, and endocarditis. We report a rare case of an LV pseudoaneurysm induced by an LV venting catheter through the right superior pulmonary vein during thoracic aortic surgery. A 77-year-old man was referred for surgical repair of a distal aortic arch aneurysm. He underwent total aortic arch reconstruction with the frozen elephant trunk technique. The early postoperative period was uneventful. Postoperative contrast computed tomography and transthoracic echocardiography (TTE) revealed a pseudoaneurysm with a narrow neck at the apex of the LV that had sub-clinically progressed. Because of the risk of spontaneous rupture, an urgent aneurysmectomy was performed via a repeat sternotomy. Under cardioplegic arrest, the pseudoaneurysm was opened and the small orifice, which communicated with the LV, was confirmed. No myocardial ischemic changes were observed around the orifice. The pseudoaneurysm was thought to be induced by endocardial laceration by the tip of the venting catheter. The pseudoaneurysm was closed by linear repair reinforced with felt strips. The patient recovered well and was discharged 18 days after the second surgery. TTE showed no recurrence of LV aneurysm at the last follow-up.
{"title":"Left Ventricular Pseudoaneurysm Caused by a Left Ventricular Venting Catheter via the Right Superior Pulmonary Vein during Thoracic Aortic Surgery: A Case Report","authors":"Taiju Watanabe, Tetsuya Yoshida","doi":"10.4236/WJCS.2019.94005","DOIUrl":"https://doi.org/10.4236/WJCS.2019.94005","url":null,"abstract":"A left ventricular (LV) pseudoaneurysm is one of the complications of acute myocardial infarction. It is also reported after chest trauma, cardiac surgery, and endocarditis. We report a rare case of an LV pseudoaneurysm induced by an LV venting catheter through the right superior pulmonary vein during thoracic aortic surgery. A 77-year-old man was referred for surgical repair of a distal aortic arch aneurysm. He underwent total aortic arch reconstruction with the frozen elephant trunk technique. The early postoperative period was uneventful. Postoperative contrast computed tomography and transthoracic echocardiography (TTE) revealed a pseudoaneurysm with a narrow neck at the apex of the LV that had sub-clinically progressed. Because of the risk of spontaneous rupture, an urgent aneurysmectomy was performed via a repeat sternotomy. Under cardioplegic arrest, the pseudoaneurysm was opened and the small orifice, which communicated with the LV, was confirmed. No myocardial ischemic changes were observed around the orifice. The pseudoaneurysm was thought to be induced by endocardial laceration by the tip of the venting catheter. The pseudoaneurysm was closed by linear repair reinforced with felt strips. The patient recovered well and was discharged 18 days after the second surgery. TTE showed no recurrence of LV aneurysm at the last follow-up.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86150054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coronary malperfusion is a complication of aortic dissection, and can lead to ventricular failure. We report 2 cases of right ventricular (RV) failure, following aortic dissection, successfully bridged to recovery using right ventricular assist devices (RVADs). The first was a 54 year-old man, who had difficulty weaning from bypass due to a stunned RV following aortic root replacement. The second was a 34 year-old woman, who after replacement of the ascending aorta, suffered episodes of ventricular fibrillation (VF), and RV failure. Both had an RVAD implanted, allowing eventual recovery. We recommend more widespread use of VADs in such cases.
{"title":"Right Ventricular Failure Following Acute Type A Aortic Dissection: An Alternative Strategy","authors":"R. Mashar, R. Birla, P. Waterworth","doi":"10.4236/WJCS.2019.93004","DOIUrl":"https://doi.org/10.4236/WJCS.2019.93004","url":null,"abstract":"Coronary malperfusion is a complication of aortic dissection, and can lead to ventricular failure. We report 2 cases of right ventricular (RV) failure, following aortic dissection, successfully bridged to recovery using right ventricular assist devices (RVADs). The first was a 54 year-old man, who had difficulty weaning from bypass due to a stunned RV following aortic root replacement. The second was a 34 year-old woman, who after replacement of the ascending aorta, suffered episodes of ventricular fibrillation (VF), and RV failure. Both had an RVAD implanted, allowing eventual recovery. We recommend more widespread use of VADs in such cases.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"144 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79819495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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