RESUMEN
Mycobacterium chimaera is a slow-growing nontuberculous mycobacterium. It has been identified as a contaminant during open-heart surgery. It contaminates water in heater-cooler units that then become aerosolized, contaminating the surgical field. We report a 56-year-old male who presented with culture-negative endocarditis six years after his initial open-heart surgery.
RESUMEN
Transcatheter valve-in-valve replacement has become a viable option for patients with degenerated bioprosthetic valves at high risk for redo surgery. We report a case of a patient who had degenerated mitral and tricuspid bioprosthesis causing severe tricuspid and mitral regurgitation. We performed simultaneous mitral and tricuspid valve-in-valve replacement via a transfemoral approach. Although the data on performing both valve-in-valve procedures are limited, this case demonstrated that these procedures can be safely done as a single procedure.
Asunto(s)
Bioprótesis , Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Cateterismo Cardíaco/métodos , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Válvula Mitral/cirugía , Diseño de Prótesis , Falla de Prótesis , Resultado del TratamientoRESUMEN
Missile embolism to the pulmonary artery is a rare event. We present a complicated case of missile embolism from the inferior vena cava to the pulmonary artery. The case illustrates the potential pitfalls in the management of these patients.
Asunto(s)
Arteria Pulmonar/patología , Embolia Pulmonar/etiología , Embolia Pulmonar/cirugía , Vena Cava Inferior/patología , Heridas por Arma de Fuego/complicaciones , Adulto , Angiografía/métodos , Estudios de Seguimiento , Humanos , Masculino , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/cirugía , Neumonectomía/métodos , Arteria Pulmonar/diagnóstico por imagen , Embolia Pulmonar/diagnóstico por imagen , Radiografía Torácica , Medición de Riesgo , Toracotomía/métodos , Resultado del Tratamiento , Vena Cava Inferior/diagnóstico por imagenRESUMEN
BACKGROUND: The ascending aorta is the customary site for arterial cannulation for cardiopulmonary bypass. Favorable experience at our institution and elsewhere using axillary artery cannulation in treating type A aortic dissections has caused us to broaden our indications for using this site for arterial cannulation for cardiopulmonary bypass. METHODS: Medical records, operative notes, and perfusion records were reviewed in all patients in whom the axillary artery was cannulated directly or by a graft for cardiopulmonary bypass from January 1, 2000 through August 30, 2002. RESULTS: Seventy-five patients underwent axillary artery cannulation during the 32-month interval. Eleven patients had ascending aortic dissections, 20 had extensively diseased ascending aortas, and 44 were individuals undergoing repeat cardiac procedures. The right axillary artery was used in 72 patients and the left in 3. In 16 patients the artery was cannulated directly, and in 59 the arterial cannula was inserted into a prosthetic graft that had been anastomosed to the axillary artery. Axillary artery cannulation was satisfactory in 95% (71 of 75) of the cases in which it was used. CONCLUSIONS: Cannulation of the axillary artery for cardiopulmonary bypass is a dependable approach for procedures including reoperations, aortic dissections, and extensively diseased ascending aortas.
