RESUMO
Scarcity of donors leads transplant surgeons to consider extended-criteria lungs and occasionally to accept the unlikely. Here we report a case of successful single lung transplantation from a donor 8 months after double lung transplantation.
Assuntos
Morte Encefálica , Pneumopatias/cirurgia , Transplante de Pulmão/métodos , Doadores de Tecidos/provisão & distribuição , Obtenção de Tecidos e Órgãos , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Transplantados , Resultado do TratamentoRESUMO
Bridging critically ill pediatric patients to lung transplantation still remains a major challenge. Although still controversial, within the last 5 years, ECMO has been increasingly used as a bridge to lung transplantation concept in adult and pediatric patients with acceptable outcomes. The outstanding developments in the field of extracorporeal devices and the introduction of awake ECMO concepts with the avoidance of mechanical ventilation have led to a real paradigm shift in the ICU management of pretransplant candidates with severe respiratory failure. Therefore, ECMO is no longer seen as a contraindication for lung transplantation at least at our center. Nevertheless, how to bridge these patients on ECMO still remains controversial. Thus, we introduced an ambulatory ECMO approach in adolescent lung transplant candidates with acute respiratory failure using a dual cannulation strategy and hereby present first results from this procedure.
Assuntos
Cateterismo/métodos , Fibrose Cística/complicações , Oxigenação por Membrana Extracorpórea/métodos , Transplante de Pulmão , Insuficiência Respiratória/terapia , Adolescente , Feminino , Hospitalização , Humanos , Masculino , Insuficiência Respiratória/etiologia , CaminhadaRESUMO
Replacement of heart valves appears to be prevailing method of surgical correction of end stage valvular heart defects. Main drawback of contemporary artificial valves is lack of growth, potential for remodeling, and inclination to degeneration. To overcome these limitations the modern science in the last decade focuses on tissue engineering of valves as an alternative to their prostheses. Basic idea of the technique is the use of decellularized xenogenic allogenic matrix or biopolymers seeded with autologous cells under special conditions created in bioreactor. This literature review is devoted to a novel direction in experimental cardiosurgery - tissue engineering of heart valves which in a unique way combines biological, engineering, and technological achievements.
Assuntos
Valvas Cardíacas , Engenharia Tecidual/métodos , Bioprótese , Próteses Valvulares Cardíacas , HumanosRESUMO
Represented herein is an option of successful surgical treatment of a 55-year-old male patient diagnosed with type IIIB aortic dissection and aneurysmatic dilatation of the entire thoracic aorta, being the most vulnerable spot within the area of the descending thoracic aorta, by means of a promising technique of two-stage treatment. The first stage consisted in prosthetic repair of the descending thoracic aorta using the proximal "elephant trunk" technique in order to facilitate the second stage of the reconstruction, i. e. prosthetic repair of the ascending aorta and aortic arch.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Dissecção Aórtica/cirurgia , Prótese Vascular , Dissecção Aórtica/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aortografia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Presented herein is own experience in successful management of a female patient diagnosed with a primary aortoesophageal fistula secondary to a rupture of a chronic posttraumatic dissecting aneurysm of the descending thoracic aorta into the oesophagus. The contained herein review of the literature deals with the problems concerning surgical policy of and indications for different variants of reconstructive operations on the aorta and oesophagus.