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Tricuspid Valve Incompetency Due to the Grenade Chip Embolization to the Heart. 手榴弹芯片栓塞心脏导致三尖瓣功能不全。
Pub Date : 2019-06-05 eCollection Date: 2019-01-01 DOI: 10.1177/1179065219853587
Hossein Sarmast, Ahmad Takriti

Migration of foreign bodies into the heart, although unusual, has been reported since 1834 when Davis published the first bullet embolus. Our case was a 29-year-old woman who suffered from a grenade explosion wound with a residual burst fragment inside her arm soft tissue. Two months later, she was admitted with progressive fatigue, palpitation, shortness of breath, and swelling in legs and neck. She was taking hormonal therapy for infertility as medical history. Ascultation detected holosystolic respiratory variable murmur maximal over the left lower sternal border. Severe tricuspid regurgitation and an obliterating mass on tricuspid valve (TV) with characteristic of central linear echogenicity were detected by transthoracic echocardiography. The diagnosis of "the embolized missile into heart with superimposed thrombosis" was determined. The patient underwent open heart surgery and the thrombotic rod shape chip that was embedded in anterior tricuspid leaflet was removed and then TV was repaired.

自1834年戴维斯发表第一个子弹栓子以来,尽管不寻常,但异物迁移到心脏的报道已经出现。我们的病例是一名29岁的女性,她受到手榴弹爆炸的伤害,在她的手臂软组织中有残留的爆炸碎片。两个月后,患者因进行性疲劳、心悸、呼吸急促、腿部和颈部肿胀入院。她的病史是接受不孕激素治疗。全收缩期呼吸可变杂音在左胸骨下缘最大。经胸超声心动图检查发现严重三尖瓣反流及三尖瓣上有一中心线状回声特征的闭塞性肿块。诊断为“栓塞飞弹入心合并血栓形成”。患者行心内直视手术,取出嵌入前三尖瓣小叶的血栓状棒状芯片,然后修复电视。
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引用次数: 1
Trans-Iliac Aortic Valve Replacement: Feasibility, Safety, and Medium-Term Follow-up. 经髂主动脉瓣置换术:可行性、安全性和中期随访。
Pub Date : 2019-06-02 eCollection Date: 2019-01-01 DOI: 10.1177/1179065219853582
Marco Gennari, Piero Trabattoni, Mauro Pepi, Gianluca Polvani, Luca Salvi, Marco Agrifoglio

Background: Transcatheter aortic valve replacement (TAVR) is nowadays generally accepted as the treatment of choice for high- to intermediate-risk patients with severe aortic stenosis not suitable for the standard surgical replacement. Many vascular accesses have been described for the valve delivery, comprising the common iliac artery as the arterial site of access.

Methods: From September 2008 to June 2014, 440 patients underwent TAVR at our institution. We report a series of 12 patients that have undergone TAVR via a trans-iliac (TI) retroperitoneal surgical approach and also discuss its feasibility, security, and medium-term follow-up.

Results: The 30-day survival rate was 92%. Only 1 local vascular access major complication occurred requiring an iliac-femoral bypass grafting with a vascular graft. Two patients experienced transient neurological ischemic attack. At 3-year follow-up, all the 11 patients were alive and well and the echocardiographic evaluation revealed good function of the prosthesis.

Conclusions: The TI route seems to be feasible with a low profile of local complications. It may be a reasonable access alternative to the femoral artery and to the trans-apical approach. A broader, prospective study is advisable to gain general consensus on this approach.

背景:经导管主动脉瓣置换术(TAVR)目前被普遍接受为不适合标准手术置换术的主动脉瓣狭窄的高至中危患者的治疗选择。许多血管通路已被描述为瓣膜输送,包括髂总动脉作为动脉通路。方法:2008年9月至2014年6月,440例患者在我院行TAVR手术。我们报告了12例经髂(TI)腹膜后手术入路行TAVR的患者,并讨论了其可行性、安全性和中期随访。结果:30天生存率为92%。仅发生1例局部血管通路严重并发症,需行髂股旁路血管移植术。2例患者出现短暂性神经缺血发作。随访3年,11例患者均存活,超声心动图评价显示假体功能良好。结论:TI路径可行,局部并发症少。这可能是股动脉和经根尖入路的一个合理的替代入路。建议对这种方法进行更广泛的前瞻性研究以获得普遍共识。
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引用次数: 0
A Combined Radial and Pedal Access to Treat a Flush Chronic Total Occlusion of the Superficial Femoral Artery in a Critical Limb Ischemia Patient. 联合桡动脉和踝关节入路治疗重度肢体缺血患者的股浅动脉冲洗性慢性全闭塞。
Pub Date : 2019-03-10 eCollection Date: 2019-01-01 DOI: 10.1177/1179065219834523
Nicolas W Shammas, Qais Radaideh

We present a case of a flush chronic total occlusion of the superficial femoral artery treated successfully with a combined antegrade approach using radial access and a retrograde approach using a pedal access. Patient has total occlusion of the contralateral left external iliac and common femoral artery. Our case illustrates the feasibility of the combined pedal-radial approach in treating flush occlusions of the superficial femoral artery.

我们介绍了一例股浅动脉齐平型慢性全闭塞病例,该病例采用桡动脉入路的前向入路和足底入路的逆行入路联合治疗,取得了成功。患者的对侧左侧髂外动脉和股总动脉完全闭塞。我们的病例说明了踏板-桡动脉联合入路治疗股浅动脉齐平闭塞的可行性。
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引用次数: 0
Volvulus of the Transverse Colon in A Young Adult Female; Case Report 年轻成年女性横结肠扭转的研究病例报告
Pub Date : 2019-01-01 DOI: 10.22259/2639-3611.0201004
A. Obeid, Kenan Hallon, Miriam Obeid, Subhi Mansour, Safi Khuri
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引用次数: 0
Medial Approach for the Mastopexy with Breast Implants. (MAMBI) 内侧入路植乳乳房固定术。(MAMBI)
Pub Date : 2019-01-01 DOI: 10.22259/2639-3611.0202002
O. Jorge, Martinez B. Luz Ariana
Background and Objective: Describes a technique with an initial approach into the breast in the middle line, using the superior pedicle flap narrated by Arie, and the implant is positioned below the muscle producing a greater breast projection, makes the Mastopexy be more durable. Methods: Was performed77 Mastopexy between 2010 and 2018, with Medial approach for the Mastopexy with breast implants (MAMBI). Twenty eight round retropectoral implants were applied using the superior pedicle flap. Results: Medial approach for the Mastopexy with breast implants in unique time in both breasts, to avoid areolar flap currently not recommended. All of them had ptosis in different degrees. In all cases we obtained good projection and adequate volume increase. Conclusions: The Mastopexy techniques do not have to include the submammary fold, the most compromising is the submammary scar, avoid it with the Medial approach for the Mastopexy with breast implants. And with the technique of superior flap the resultant must be with an increased upper pole, so that during the evolution process it decreases proportionally to the lower pole.
背景与目的:描述了一种采用Arie介绍的上蒂皮瓣从乳房中线入路的技术,植入物位于肌肉下方,产生更大的乳房投影,使乳房固定术更持久。方法:于2010年至2018年期间,采用内侧入路乳房植入物乳房固定术(MAMBI)进行了77例乳房固定术。采用上蒂皮瓣应用28个圆形逆行皮瓣。结果:双侧乳房植乳术在特殊时间采用内侧入路避免乳晕瓣,目前不推荐采用内侧入路。均有不同程度的上睑下垂。在所有情况下,我们都获得了良好的投影和足够的体积增加。结论:乳房内固定术不一定要包括乳下褶皱,最妥协的是乳下瘢痕,避免采用内侧入路进行乳房内固定术。而采用上瓣技术时,其结果必然是上极增大,使其在演化过程中与下极成比例减小。
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引用次数: 0
The π-Circuit Technique in Coronary Surgery: Analysis of 1359 Consecutive Cases 冠状动脉手术中π-环路技术:1359例连续病例分析
Pub Date : 2019-01-01 DOI: 10.1177/1179065219871948
S. Prapas, Ioannis A Pangiotopoulos, V. Leivaditis, K. Katsavrias, Vasiliki S Prapa, I. Linardakis, E. Koletsis, K. Grapatsas
Coronary artery bypass surgery still has its unique role in the treatment of coronary artery disease. It faces, however, the continuous challenge of becoming even less invasive and more effective as cases become more complex. We here present the results of 1359 cases treated with the π-circuit technique which consists of an off-pump total myocardial revascularization using composite arterial grafts. The results demonstrate that it is a safe technique providing low mortality, stroke, renal failure, wound infection, and other complication rates. We suggest the application of this technique, as well as of other similar techniques regarding similar principles, especially in high-risk patients.
冠状动脉搭桥术在治疗冠状动脉疾病中仍有其独特的作用。然而,随着病例变得更加复杂,它面临着不断减少侵入性和提高有效性的挑战。本文报道了1359例经复合动脉移植的非体外循环心肌血管重建术治疗的结果。结果表明,这是一种安全的技术,死亡率、中风、肾衰竭、伤口感染和其他并发症发生率低。我们建议应用这项技术,以及其他类似的技术基于类似的原则,特别是在高危患者。
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引用次数: 3
Omental Torsion as a Cause of Acute Abdomen 大网膜扭转是引起急腹症的原因
Pub Date : 2019-01-01 DOI: 10.22259/2639-3611.0201001
Abdulaziz A Sadeq, Nasser A Abdelall, Mohammad Al Ghadhban
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引用次数: 0
Repair of Inguinal Hernia in an Ambulatory Way 腹股沟疝的门诊修复术
Pub Date : 2019-01-01 DOI: 10.22259/2639-3611.0202004
P. Rodríguez, Olga Caridad Leòn Gonzàlez, J. S. Rocha, E. C. García, Luis Manuel Danta Fundora, Elisa Puentes Rizo, Angelica Ortiz
Dr. Pedro Rolando Lòpez Rodrìguez *, Dr. Olga Caridad Leòn Gonzalez , Dr. Jorge Satorre Rocha , Dr. Eduardo Castillo Garcia , Dr. Luis Manuel Danta Fundora , DraM. Elisa Puentes Rizo and Dr. Angelica Lais Ceruto Ortiz Consultant Professor in General Surgery, Auxiliary Researcher Auxiliary Assistant in General Surgery, Auxiliary Researcher Assistant Professor in General Surgery, Aggregate Investigator Auxiliary Teacher in MGI, Associate Researcher Resident rst year in General Surgery
Pedro Rolando博士Lòpez Rodrìguez *, Olga Caridad博士Leòn Gonzalez, Jorge Satorre Rocha博士,Eduardo Castillo Garcia博士,Luis Manuel Danta Fundora博士,DraM。Elisa Puentes Rizo和Angelica Lais Ceruto Ortiz博士,普通外科顾问教授,普通外科辅助研究员,普通外科辅助研究员助理教授,MGI总调查员辅助教师,普通外科一年级的副研究员
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引用次数: 0
Active Learning Methodologies in the Teaching of Surgical Principles 主动学习方法在外科原理教学中的应用
Pub Date : 2019-01-01 DOI: 10.22259/2639-3611.0201003
Jonas Augusto Ramos, Leticia Possas Spangler, Mirian Diena Pastorini Jurgilas
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引用次数: 0
Frailty Patient and Surgery 虚弱病人和手术
Pub Date : 2019-01-01 DOI: 10.22259/2639-3611.0201006
Jordi Castellví Valls
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引用次数: 0
期刊
Open journal of cardiovascular surgery
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