The minimally invasive extracorporeal circulation (MiECC) system was developed to minimize the contact of blood with air and foreign surfaces during conventional cardiopulmonary bypass (CPB). It is also aimed … Read More
Category: General
Surgical Treatment of Hemifacial Spasm via Microvascular Decompression of a Large, Ectatic Vertebral Artery
J Neurol Surg Rep. 2024 Feb 12;85(1):e23-e24. doi: 10.1055/a-2244-1143. eCollection 2024 Jan.
ABSTRACT
Hemifacial spasm is a neuromuscular disorder caused by compression of the facial nerve at the nerve root entry zone, often due to ectatic or aberrant vasculature. Pathologic compression of the nerve-brainstem interface results in involuntary, paroxysmal contractions of ipsilateral facial muscles that may cause considerable impairments in quality of life. For those with severe symptoms, have positive imaging demonstrating vascular compression, or who fail other management modalities, 1 2 3 4 microvascular decompression offers potential definitive treatment. 5 6 Traditionally, nonabsorbable packing agent is used to pack between the nerve and offending vascular structure. However, for large and more complex arterial structures, simple nonabsorbable padding is often not sufficient. In this operative video, we demonstrate microvascular decompression for intractable hemifacial spasm in a 52-year-old female using a specialized sling tacked to the petrous dura for management of a large, ectatic vertebral artery. Following a standard left retrosigmoid craniotomy, an atheromatous ectatic vertebral artery was identified. We fashioned a bovine pericardium sling around the vessel and used a permanent aneurysm clip to secure it to an incision portion of petrous dura. We subsequently identified potential additional facial nerve root compression by anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) branches, which were elevated and secured using Teflon felt packing. Following elevation of all three vessels, the lateral spread response resolved. At 2 weeks postoperatively, the patient reported substantial relief in her hemifacial spasms and endorsed highly improved quality of life.
PMID:38348014 | PMC:PMC10861316 | DOI:10.1055/a-2244-1143
Comparison of the effects of using feedback devices for training or simulated cardiopulmonary arrest
High-quality chest compression is essential for successful cardiac arrest resuscitation. High-quality cardiopulmonary resuscitation (CPR) can effectively improve the survival rate of patients with cardiopulmon… Read More
Tricuspid repair: short and long-term results of suture annuloplasty techniques and rigid and flexible ring annuloplasty techniques
Functional tricuspid regurgitation may arise from left heart valve diseases or other factors. If not addressed concurrently with primary surgical intervention, it may contribute to increased morbidity and mort… Read More
Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort
For Veterans who cannot be seen in a timely fashion or must travel long distances to be seen, the Veterans Health Administration (VHA) offers funded care in the community. The use of this program has rapidly i… Read More
Sub-coronary aortic root replacement post-aortic valve dehiscence: a case report
This is a case report of a 78-year-old male who underwent a sub-coronary aortic valve and root replacement due to valve dehiscence and aortic root pseudoaneurysm. The patient had complex anomalous coronary ana… Read More
Robotic portal resection for mediastinal tumours: a prospective observational study
To demonstrate the effectiveness and feasibility of robotic portal resection (RPR) for mediastinal tumour using a prospectively collected database.
Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort
For Veterans who cannot be seen in a timely fashion or must travel long distances to be seen, the Veterans Health Administration (VHA) offers funded care in the community. The use of this program has rapidly i… Read More
Hemorrhagic pericardial tamponade in a hemodialysis patient with catheter-related superior vena cava syndrome: a case report
Iatrogenic complications of endovascular treatment for central venous stenosis have not yet been reported. Here we present a case of a patient on maintenance hemodialysis who developed catheter-related superio… Read More
Choice of the prosthetic valve in patients aged between 55 and 70 years
G Ital Cardiol (Rome). 2024 Apr;25(4):252-261. doi: 10.1714/4244.42206.
ABSTRACT
About 280 000 heart valve replacements are performed worldwide every year. Since the first prosthetic valve implantation in 1952 there have been notable developments. There are a lot of types of prosthetic valves that can be summarized into two categories: biological prosthetic valves or mechanical prosthetic valves. Biological prostheses, made of bovine or porcine pericardium, homografts, or autografts, degenerate over time becoming dysfunctional. Mechanical prostheses have a potentially unlimited lifespan but require oral anticoagulation which can affect patients’ quality of life. Generally, biological prostheses are particularly suitable for elderly patients while mechanical prostheses for young people, with some distinctions. For example, in case of age <60 years, in the presence of preoperative oral anticoagulant therapy, metabolic syndrome, hemodialysis or hyperparathyroidism, a mechanical valve is the preference. The choice of the prosthesis in patients aged between 55 and 70 years is particularly challenging because the advantages and disadvantages of the two categories of prosthesis overlap in middle-aged patients. The choice of the prosthesis should be made after discussion with the surgeon, according to the patient’s preferences, and keeping in mind the pros and cons of biological and mechanical prostheses.
PMID:38526361 | DOI:10.1714/4244.42206