Intrathoracic neurogenic tumors arise from sympathetic nerve trunks and intercostal nerves; more than 90% are benign. Schwannomas are the most common histological variety, but fatalities due to giant schwannom… Read More
Month: November 2023
Aortoesophageal fistula treated using one-stage total reconstruction: a case report from a high-volume center
Aortoesophageal fistula (AEF) is a rare but typically life-threatening condition. Although several treatment strategies exist, including conservative treatment with intraluminal stent graft and open thoracic a… Read More
Simultaneous upper and lower body perfusion using hypothermia during thoracoabdominal aortic surgery
In open thoracoabdominal aortic aneurysm (TAAA) repair, we have been performing vascular reconstruction under moderate to deep hypothermia and assisted circulation using simultaneous upper and lower body perfu… Read More
Mitral valve replacement using a collar-reinforced mitral prosthesis for severe mitral annular calcification, which secures implantation in both the supra-annular and intra-atrial positions: a case report
J Cardiothorac Surg. 2023 Nov 11;18(1):319. doi: 10.1186/s13019-023-02429-5.
ABSTRACT
BACKGROUND: Appropriate management of mitral annular calcification associated with mitral valve surgery must be determined on a case-by-case basis. However, an established procedure remains uncertain.
CASE PRESENTATION: This report describes a surgical case of severe mitral and aortic valve stenosis associated with severe mitral annular calcification in a 71-year-old woman who underwent mitral valve replacement with a collar-reinforced mitral prosthesis. The patient underwent surgical repair after the treatment for heart failure. As the present patient was deemed to be at high risk for conventional mitral valve replacement, we applied a composite prosthetic valve that was enlarged circumferentially on the ventricular side of the prosthesis with a bovine pericardial patch. First, the solid calcium bar was left untouched and only the friable calcified mass that was easily scattered was removed. Subsequently, the prosthesis was secured by two mattress sutures placed in the intra-atrial position at the region of the extended calcified myocardium. Additionally, ten mattress sutures were placed in the supra-annular position at the other regions capable of passing stitches from the ventricular side to the atrial side. Finally, a 1.5 cm wide trimmed bovine pericardial collar was sutured circumferentially from the annulus to the atrial wall using running 4-0 polypropylene for reinforcement. Although temporary hemodialysis was performed for acute renal failure, the patient remained asymptomatic.
CONCLUSIONS: The present case suggests that mitral valve replacement using a collar-reinforced mitral prosthesis may be an effective technique for severe mitral annular calcification. To avoid catastrophic complications associated with treatment for severely calcified annulus, it is crucial to make a prudent preoperative decision regarding the surgical strategy under circumstances where conventional mitral valve replacement is impossible.
PMID:37951918 | PMC:PMC10638697 | DOI:10.1186/s13019-023-02429-5
Aortic annulus rupture after transcatheter aortic valve replacement: successful management of a dangerous complication
Aortic annulus rupture remains one of the most fatal complications of TAVR. While attempts have been made to describe and predict this complication, the data remains insufficient without evidence-based guideli… Read More
Resection and double pericardial patch repair of a congenital aneurysm of the mitral-aortic intervalvular fibrosa
Multimed Man Cardiothorac Surg. 2023 Aug 14;2023. doi: 10.1510/mmcts.2023.049.
ABSTRACT
Mitral-aortic intervalvular fibrosa aneurysms and pseudoaneurysms are rare entities but can lead to different, unpredictable and sometime dramatic complications. We report the case of a young woman presenting a congenital form of this aneurysm. Given the clinical and symptomatological progression, surgical treatment is mandatory. After a transverse aortotomy, we resected the aneurysm. Performing a pulmonary arteriotomy allows adequate control of the left main coronary artery, adjacent to the lesion. We repaired the remaining cavity, not far from the left coronary aortic cusp, with a double patch of bovine pericardium.
PMID:37578351 | DOI:10.1510/mmcts.2023.049
Advanced lung cancer patient benefits from minimally invasive costal resection and reconstruction: an effective palliative approach for costal metastasis
We hereby describe the resection and reconstruction of a rib infiltrated by a lung cancer metastasis. Despite prior radiation therapy aimed at mitigating pain from rib infiltration in a stage IV non-small cell… Read More
Crizotinib combined with bronchoscopic interventional treatment in ALK-positive inflammatory myofibroblastic tumor of left main stem bronchus: a case report
Inflammatory myofibroblastic tumor (IMT), also known as an inflammatory pseudotumor, is a unique type of intermediate soft tissue tumor that commonly occurred in the lung. Its unclear etiology and cellular act… Read More
Concomitant minimally invasive surgery for tricuspid valve papillary fibroelastoma and right lung cancer in an elderly patient: a case report and review of the literature
It is very common for patients with newly diagnosed lung masses to have heart disease. However, papillary fibroelastomas (PFEs) of the tricuspid valve (TV) combined with lung cancer are rarely reported. It is … Read More
Total arch replacement with frozen elephant trunk technique for Kommerell’s diverticulum with a right-sided aortic arch and aberrant left subclavian artery
Kommerell’s diverticulum with a right-sided aortic arch and aberrant left subclavian artery is uncommon. We perforemed a single-stage procedure with the frozen elephant trunk technique.