RESUMO
Ascending aortic aneurysms associated with a bicuspid valve are generally treated by replacement with a tubular graft because the aortic wall is claimed to be genetically pathological. We describe 9 cases in which patients with an ascending aortic aneurysm and an associated diseased bicuspid valve underwent aneurysmal resection and end-to-end anastomosis. This technique permitted us to remove the entire aneurysmal wall, avoiding graft interposition.
Assuntos
Aorta/cirurgia , Aneurisma Aórtico/cirurgia , Doenças das Valvas Cardíacas/cirurgia , Adulto , Idoso , Anastomose Cirúrgica , Aneurisma Aórtico/complicações , Valva Aórtica , Procedimentos Cirúrgicos Cardiovasculares , Feminino , Doenças das Valvas Cardíacas/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Chylothorax is a rare complication of adult cardiothoracic surgery that can affect the postoperative course as it can lead to respiratory insufficiency, protein loss, fluid imbalance, and immunodeficiency. We report the case of a 51-year-old man who developed a persistent high-flow chylothorax after replacement of the descending thoracic aorta for an aneurysm. After a week of complete oral intake cessation and total parenteral nutrition, we started administration of octreotide, a somatostatin analog. It led to rapid cessation of chyle production, and the patient was discharged without further complications and chylothorax relapses.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Quilotórax/cirurgia , Fármacos Gastrointestinais/administração & dosagem , Octreotida/administração & dosagem , Complicações Pós-Operatórias/cirurgia , Terapia Combinada , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral TotalRESUMO
This study was designed to evaluate the effect of cryopreservation on the glycosaminoglycan (GAG) content of the aortic allografts. Twenty-one porcine aortic valves were obtained. Five aortic roots were immediately analyzed without cryopreservation, eight were cryopreserved in closed leaflet position, and eight in open leaflet position. The groups were compared in terms of GAG concentration and subclass proportion in three different zones including the aortic root wall, the commissures, and the leaflets. GAG content at the commissures was significantly lower in the closed leaflet group than in the other groups (P = 0.001). The electrophoretic analysis did not show any significant difference in the zonal distribution of GAG classes between groups. Quantitative analysis in various aortic valve zones suggests that cryopreservation can alter the GAG content. Cryopreservation of the aortic valve in an open leaflet position can preserve the matrix more efficiently and might prolong the durability of the aortic allograft.