RESUMO
Aortic arch replacement extended to the ascending and/or descending thoracic aorta with a single vascular graft may cause kinking of the prosthesis. We propose an artifact to obtain a curved prosthesis from a straight one for total aortic arch replacement without the risk of kinking.
Assuntos
Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Aterosclerose/cirurgia , Prótese Vascular , Idoso , Aneurisma da Aorta Torácica/complicações , Doenças da Aorta/complicações , Doenças da Aorta/cirurgia , Aterosclerose/complicações , Humanos , Masculino , Desenho de PróteseRESUMO
Redo sternotomy is a challenging surgical procedure performed with increasing frequency; catastrophic hemorrhage is a rare but highly lethal complication. We report our experience in treating this complication in 3 cases of 307 reoperations and propose a simple method to control catastrophic hemorrhage during sternal reentry.
Assuntos
Hemostasia Cirúrgica/métodos , Toracotomia/efeitos adversos , Idoso , Perda Sanguínea Cirúrgica , Feminino , Humanos , Masculino , Reoperação/efeitos adversosRESUMO
Quadrangular resection of the posterior leaflet of the mitral valve is a well-established technique for the treatment of mitral regurgitation from prolapse of P2. Recently, Suri described triangular resection of the prolapsing scallop, a technique that, avoiding the plication of the annulus corresponding to the resected leaflet, maintains the geometry of the mitral annulus, allowing a more physiologic function of the mitral valve. In this paper, we report multiple triangular resection for the treatment of multiple prolapse of the posterior leaflet.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Prolapso da Valva Mitral/cirurgia , HumanosRESUMO
A 44-year-old woman with a history of transient ischemic attack underwent closure of atrial septal defect with a 26 mm Amplatzer device. The device was released without residual shunt or impingement on intracardiac structures. Within seconds, the transesophageal echocardiography showed the initial dislodgement of the device from the atrial septum and its consequent slipping back into the right atrium close to the tricuspid valve. Soon after the device disappeared from the right atrium and it could be founded into the right ventricle under the tricuspid valve. The patient was transferred in the operating room for an emergency operation. The device could not be found in the right ventricle because its downstream migration. The Amplatzer septal occluder was identified by palpation into the pulmonary artery trunk: it was retrieved from the right ventricle through the pulmonary valve and the atrial septal defect was closed by running suture.
Assuntos
Migração de Corpo Estranho/cirurgia , Comunicação Interatrial/cirurgia , Embolia Pulmonar/etiologia , Embolia Pulmonar/cirurgia , Adulto , Ecocardiografia Transesofagiana , Falha de Equipamento , Feminino , Comunicação Interatrial/diagnóstico por imagem , Humanos , Embolia Pulmonar/diagnóstico por imagemRESUMO
The axillary artery is the preferred site for arterial cannulation in operations for ascending aorta and aortic arch replacement in order to reduce perfusion-related morbidity in acute dissection and to prevent cerebral embolism in atherosclerotic aneurysm. We present the case of a patient with a chronic dissection presenting as pseudocoarctation of the aortic arch in which bilateral axillary artery inflow was necessary to perfuse both ascending and descending aorta.