Intracardiac thrombus is relatively rare in patients with coronavirus disease 2019 (COVID-19). However, if it occurs, thrombotic complications are likely to develop. In this case, we performed a successful thr… Read More
Month: January 2023
Surgeon-modified fenestrated endograft for urgent an aortic arch aneurysm: case report
We report the case of an endovascular repair of an aortic arch aneurysm by a surgeon-modified fenestrated endograft with a single fenestration in a high-risk patient unfit for open surgery. A patient of 84 yea… Read More
Journey Toward Improved Long-Term Outcomes After Norwood-Sano Procedure: Focus on the Aortic Arch Reconstruction
World J Pediatr Congenit Heart Surg. 2022 Sep;13(5):581-587. doi: 10.1177/21501351221116766.
ABSTRACT
The disadvantage of right ventricle-to-pulmonary artery (RV-PA) shunt is the need for more unplanned interventions to address stenosis in the shunt or branch pulmonary arteries, as compared to the modified Blalock-Taussig shunt group. Ring-enforced RV-PA PTFE conduit and dunk technique minimized these complications and right ventricle (RV) damage. Aortic arch obstruction increases afterload and leads to ventricular dysfunction and tricuspid regurgitation; therefore, most surgeons prefer to use homograft, autologous pericardium, or bovine pericardium to reconstruct the neoaorta. Artificial materials decrease the elastic properties, increase wall stiffness, and decrease the distensibility of the aorta; and as a result, RV function gradually deteriorates. This inelastic reconstructed aorta may be one of the reasons why long-term outcomes after the Fontan procedure are worse in hypoplastic left heart syndrome (HLHS) patients, in comparison to non-HLHS. Reconstruction of the neoaorta without any patch materials, or at least techniques that largely minimize the use of non-autologous materials, will offer a further refinement of our ability to optimize ventriculoarterial coupling and thereby long-term RV function.
PMID:36053099 | DOI:10.1177/21501351221116766
Attaining competency and proficiency in minimally invasive mitral valve repair: a learning curve assessment using cumulative sum analysis
To evaluate the learning curve of minimally invasive mitral valvuloplasty (MVP).
Cavernous mediastinal hemangioma presenting with persistent cough: a rare case report and review of literature
Cavernous hemangioma is a rare benign tumor which can sometimes mimic the clinical presentation and radiological findings of malignant tumors. Here we present a rare presentation of cavernous hemangioma in the… Read More
The use of lyophilized bovine pericardium (Tutopatch®) in the management of third nerve palsy following prior conventional strabismus surgery – a case series
Strabismus. 2022 Dec;30(4):171-182. doi: 10.1080/09273972.2022.2123943. Epub 2022 Sep 30.
ABSTRACT
To study the secondary management of strabismus due to third nerve palsy using bovine pericardium (Tutopatch®) when previous conventional surgical therapy had failed. Review of our clinic records of selected patients with third nerve palsy, in whom residual deviation had been managed using Tutopatch® after previous surgical correction. The squint angle was measured preoperatively, and at 1 day, 3 months, and if possible 6 months postoperatively. Nine patients were enrolled in this study. One patient had mainly residual vertical deviation and was corrected with tendon elongation of the contralateral superior rectus. Three patients were operated on with tendon elongation of the lateral rectus muscle with or without medial rectus muscle resection and/or advancement (Group 1). Lateral rectus splitting after tendon elongation in addition to the resection and/or advancement of the medial rectus was performed in five patients with complete third nerve palsy (Group 2). In Group 1, the preoperative median squint angle was -20° (range -17° to -25°), which improved postoperatively to -4.5° (range -12° to +3°). In Group 2, the preoperative horizontal and vertical median squint angles were -27° (range -20° to -40°) and 0.5° (range 0° and 20°), respectively. Postoperatively, they had improved to -12.5° (range-2° to -25°), and 1.5° (range 0° to 7°), respectively. Two patients of Group 2 were re-operated due to residual exotropia. No postoperative complications were observed in any patient. In this small series several complex re-do situations of patients with third nerve palsy were evaluated in which Tutopatch® markedly improved outcomes after an initially ineffective surgical management. For better evaluation of its usefulness a study with more patients is recommended.
PMID:36178167 | DOI:10.1080/09273972.2022.2123943
Partial Inferior Vena Cava Reconstruction with Cryopreserved Aortic Homograft Following Resection for Malignancy
Vasc Endovascular Surg. 2023 Jan;57(1):79-82. doi: 10.1177/15385744221124297. Epub 2022 Aug 27.
ABSTRACT
Malignant invasion of the inferior vena cava (IVC) often necessitates complete tumor thrombectomy and IVC reconstruction. Bovine pericardial xenografts and prosthetic grafts are frequently used for partial or entire IVC reconstruction with adequate subsequent patency and freedom from thrombosis. Cryopreserved aortic homografts represent an alternative conduit for vena cava replacement with resistance to infection in contaminated fields or following extensive retroperitoneal dissection. Specific reports of aortic homograft use for IVC reconstruction are scarce. Described are 2 cases of cryopreserved aortoiliac artery allograft use for long segment cava patch repair while avoiding extensive caval reconstruction, mobilization and the need for renal vein and hepatic vein re-implantation.
PMID:36031948 | DOI:10.1177/15385744221124297
Nationwide outcome analysis of primary carotid endarterectomy in symptomatic patients depending on closure technique and patch type
Eur J Vasc Endovasc Surg. 2023 Jan 2:S1078-5884(22)00875-9. doi: 10.1016/j.ejvs.2022.12.033. Online ahead of print.
ABSTRACT
OBJECTIVES: Current European guidelines recommend both eversion CEA and conventional CEA with routine patch closure, rather thar routine primary closure. Polyester and polytetrafluoroethylene (PTFE) have been used as patch material for a long time. More recently, bovine pericardium has been used, however there are few studies comparing long-term results between bovine pericardium and other patch types. The aim of this study was to investigate the short- and long-term results after CEA depending on surgical technique and patch material.
METHODS: Registry-based study on all primary CEAs (n=9205) performed for symptomatic carotid artery stenosis in Sweden from July 2008 to December 2019, cross linked with data from the Swedish stroke registry, Riksstroke, and chart review for evaluation of any events occurring during follow-up. Primary endpoint was ipsilateral stroke <30days. Secondary endpoints were reoperations due to neck haematoma and <30day ipsilateral stroke >30days, all stroke >30days and all-cause mortality.
RESULTS: 2495 patients had undergone eversion CEA and 6710 conventional CEA for symptomatic carotid stenosis. The most commonly used patch-material was Dacron (n=3921), followed by PTFE (n=588) and Bovine pericardium (n=413). 1788 patients underwent conventional CEA with primary closure. 273 patients(3.0%) had a stroke<30days. Primary closure was associated with an increased risk of ipsilateral stroke and stroke or death <30days, OR 1.7(95%CI1.2-2.4), p=0.002; and 1.5(95% CI 1.2-2.0) respectively. During follow up (median 4.2 years), 592 patients had any form of stroke and 1492 died. There was no significant difference in long term risk of ipsilateral stroke, all stroke or death depending on surgical technique or patch material.
CONCLUSIONS: There was an increased risk of ipsilateral stroke <30days in patients operated with primary closure compared to eversion-CEA and patch angioplasty. There was no difference between primary closure, different patch types or eversion after the perioperative phase.
PMID:36603661 | DOI:10.1016/j.ejvs.2022.12.033
Subannular repair for functional mitral regurgitation with reduced systolic ventricle function: rationale and design of REFORM-MR registry
Functional mitral regurgitation (FMR) is one of the most common heart valve diseases that is a sequel of left ventricular remodelling. Although mitral valve annuloplasty is a standard treatment of FMR, the rec… Read More
Atrial approaches in mitral valve surgery: a propensity analysis of differences in the incidence of clinically relevant adverse effects
The lack of evidence on complications using mitral valve approaches leaves the choice of risk exposure to the surgeon’s preference, based on individual experience, speed, ease, and quality of exposure.