ABSTRACT
BACKGROUND: The aim of this study was to analyze the results of pulmonary endarterectomy (PEA) performed simultaneously with additional cardiac procedures in a single tertiary-level center. METHODS: Data of patients who underwent PEA with additional cardiac procedures for chronic thromboembolic pulmonary hypertension (CTEPH) in our clinic were retrospectively reviewed using patient records. RESULTS: Between March 2011 and April 2019, 56 patients underwent PEA with additional cardiac surgery. The most common additional procedure was coronary artery bypass grafting (21 patients; 38%). The median intensive care unit and hospital stays were 4 (3-6) days and 10 (8-14) days. Mortality was recorded in six patients (11%). In multivariate analysis, only preoperative pulmonary vascular resistance (PVR) (p = 0.02; odds ratio [OR]: 1.003) and cardiopulmonary bypass duration (p = 0.02; OR: 1.028) were associated with mortality. When the cutoff value of 1000 dyn.s.cm-5 was taken in the receiver operating characteristic curve analysis, preoperative PVR predicted mortality with 83% sensitivity and 94% specificity (area under curve = 0.89; p < 0.01). CONCLUSION: PEA for CTEPH may be performed safely with other cardiac operations. This type of surgery is a complex procedure that should be performed only in expert centers. Patients with high preoperative PVR are at increased risk of perioperative complications.
Subject(s)
Cardiac Surgical Procedures , Endarterectomy , Hypertension, Pulmonary/surgery , Pulmonary Artery/surgery , Pulmonary Embolism/surgery , Adult , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/mortality , Chronic Disease , Endarterectomy/adverse effects , Endarterectomy/mortality , Female , Hospital Mortality , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/mortality , Hypertension, Pulmonary/physiopathology , Length of Stay , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/mortality , Pulmonary Artery/physiopathology , Pulmonary Embolism/diagnosis , Pulmonary Embolism/mortality , Pulmonary Embolism/physiopathology , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
Ectopic thyroid tissue is a result of abnormal migration of thyroid tissue during the embryonic state. Most of these rare cases, almost 90% of them, are located in the base of the tongue and a minority of them is located anteriorly near the hyoid bone area. Below we report the case of a young patient with an intracardiac mass first diagnosed with three-dimensional echocardiography and afterward successfully treated surgically. Once a careful histological examination has revealed a follicular adenoma, the prognosis is good especially if successful surgical excision is part of the management.
Subject(s)
Choristoma/diagnostic imaging , Heart Failure/diagnostic imaging , Thyroid Gland , Ventricular Dysfunction, Right/diagnostic imaging , Adult , Choristoma/complications , Choristoma/surgery , Diagnosis, Differential , Heart Failure/etiology , Heart Ventricles , Humans , Male , Treatment Outcome , Ultrasonography , Ventricular Dysfunction, Right/complications , Ventricular Dysfunction, Right/surgeryABSTRACT
We present a retrospective analysis of three cases of cardiac hydatidosis, who underwent surgery between 2010 and 2012. Two patients had a lesion in the interventricular septum, whereas one patient had the lesion in apicoinferior wall of LV. The diagnosis was made by echocardiography, but magnetic resonance imaging was utilized to assess cyst activity and extend of disease. All patients were placed on cardiopulmonary bypass. No postoperative complication or death occurred. The patients discharged uneventfully and all of them were free from hydatid disease at two years follow-up. We concluded that cardiac hydatid cysts should be removed surgically regardless of their location or extent, even in asymptomatic patients.