Achalasia (AC) is an esophageal dyskinetic disorder characterized by loss of function of ganglion cells of the intermuscular plexus of the distal esophagus and lower esophageal sphincter. Although there have b… Read More
Month: July 2025
The role of thoracic surgeons in spinal surgery: our clinical experiences
In the thoracic area, the outside edge of the vertebrae exhibits intricate anatomical features. A multidisciplinary approach is necessary, particularly in scoliosis surgery, while performing manipulations on t… Read More
Clinical significance of lncRNA PAX8-AS1 and miR-96-5p in non-small cell lung cancer
This study aims to examine the potential value of lncRNA PAX8-AS1 and miR-96-5p as diagnostic markers in non-small cell lung cancer (NSCLC). The goal is to provide a reference for improving adverse outcomes in… Read More
Cardiac calcified amorphous tumor in the right atrium: a rare cardiac neoplasm
Cardiac calcified amorphous tumors (CATs) represent rare, nonneoplastic intraluminal heart masses, with limited case reports in existing literature. Asymptomatic cases localized in the right atrium are particu… Read More
[MEP-41] Management of Diaphgramatic Dehiscence and Wound Infection After Open Repair of Thoracoabdominal Aortic Aneurysm
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):138-139. doi: 10.5606/tgkdc.dergisi.2024.mep-41. eCollection 2024 Nov.
ABSTRACT
Herein, we presented a case of thoracoabdominal aneurysm that was surgically treated and was complicated with diaphragmatic dehiscence and wound infection. Management and treatment methods of this challenging complication were discussed. A 59-year-old male patient with a history of renal operation underwent an open surgical treatment for thoracoabdominal aortic aneurysm. After extubation, the chest radiograph revealed left pneumothorax, and diaphragmatic dehiscence was detected on computed tomography. In the reoperation, steel wires attaching to the arcus costarum were broken off, and the diaphragmatic dehiscence and eventration of organs were observed. Diaphragmatic defect was closed with a Dacron patch, as it was very large for primary closure. Chylothorax was noticed and treated by somatostatin infusion. Vacuum therapy was applied as a purulent discharge started, and necrotic tissue was observed with evidence of infection when debridement was performed. Antibiotic therapy was started according to antibiogram. Vacuum therapy of thoracal incision was stopped as granulation tissue was observed, and the wound was closed by retention sutures. The wound in the abdominal region was closed with an advancement flap by subcutaneous detachment by plastic surgery, and a hemovac drain was placed. Since purulent discharge persisted, the Dacron graft was replaced by bovine pericardium for the diaphragmatic defect. The wound in the abdominal region was closed with retention sutures. The skin was closed primarily. When the infection resolved, the patient was discharged with peroral antibiotics. In open surgical repair of thoracoabdominal aortic aneurysm, rapid diagnosis and surgical intervention in case of diaphragm dehiscence, closure of the wound with appropriate treatment methods, reduction of the wound size with vacuum assisted closure, and initiation of effective antibiotic therapy by taking serial cultures are important in the treatment process.
PMID:40322089 | PMC:PMC12045207 | DOI:10.5606/tgkdc.dergisi.2024.mep-41
Cardiac calcified amorphous tumor in the right atrium: a rare cardiac neoplasm
Cardiac calcified amorphous tumors (CATs) represent rare, nonneoplastic intraluminal heart masses, with limited case reports in existing literature. Asymptomatic cases localized in the right atrium are particu… Read More
Factors contributing to transient and persistent worsening renal function in elderly patients with acute decompensated heart failure
The aim of this study is to analyze the distinct characteristics and risk factors contributing to the development of worsening renal function (WRF) in elderly patients with acute decompensated heart failure (A… Read More
Thoracic outlet syndrome induced by extrathoracic giant lipoma: first case in the literature due to the atypical location
Lipoma is one of the most common mesenchymal tumours. It is mostly benign in character. Those whose size is > 10 centimetres are called giant lipomas. Although its incidence is low in the extrathoracic axillar… Read More
The impact of systemic inflammation index on prolonged mechanical ventilation after cardiac surgery: a retrospective study
Despite advancements in surgical techniques and intensive care management, the incidence of prolonged mechanical ventilation (PMV) following cardiac surgery remains a significant concern.
Left Main Coronary Artery Fistula Presenting as Heart Failure: A Case Report
Am J Case Rep. 2025 Apr 16;26:e947122. doi: 10.12659/AJCR.947122.
ABSTRACT
BACKGROUND Coronary artery fistulas are rare and typically congenital but can result from various acquired conditions. They involve abnormal connections between a coronary artery and a cardiac chamber or vessel, often creating a left-to-right shunt. Most coronary artery fistulas are asymptomatic and found incidentally, though larger fistulas can cause symptoms like ischemia or heart failure, requiring intervention. Management depends on the fistula size and clinical findings. Many small fistulas close spontaneously. CASE REPORT A 44-year-old woman with massive left atrial dilation and longstanding persistent atrial fibrillation due to an undiagnosed left-main-coronary-artery-to-left-atrium fistula after cardiothoracic surgeries (mechanical mitral valve replacement, childhood left main coronary aneurysm repair), presented with new-onset heart failure and reduced ejection fraction. Multimodal imaging detected a large (6.0 cm) left main coronary aneurysm with a connecting fistula to the left atrium resulting in a significant jet of turbulent flow on the atrial aspect of the mitral valve. The left atrium had become massive in size and the gradient across the prosthetic mitral valve was high at 10 mmHg. Hemodynamic parameters revealed pulmonary hypertension and a slightly low cardiac output. She underwent redo sternotomy, resection of the left main coronary artery aneurysm, and replacement with an 8 mm ringed Gore-Tex graft, closure of the left-main-coronary-artery-to-left-atrium fistula, and bovine pericardial patch exclusion of the left atrial appendage. Symptoms resolved after surgical repair. CONCLUSIONS Unexplained cardiac chamber enlargement and heart failure should prompt consideration of the presence of a coronary artery fistula, an important yet frequently overlooked treatable cause of heart failure.
PMID:40238726 | PMC:PMC12013956 | DOI:10.12659/AJCR.947122