Regardless of its rare occurrence, Thymoma remains the most frequently encountered primary tumor of the anterior mediastinum comprising about 50% of all masses in the region. Surgical resection, via thymectomy… Read More
Category: General
A mid- and long-team follow-up study of the application of single-valved bovine pericardium patches in right ventricular outflow tract reconstruction
Transl Pediatr. 2023 Apr 29;12(4):600-607. doi: 10.21037/tp-23-97. Epub 2023 Apr 26.
ABSTRACT
BACKGROUND: Pulmonary regurgitation following right ventricular outflow tract (RVOT) reconstruction may cause right heart dysfunction and even right heart failure. Installation of a single valve at this time point can effectively reduce pulmonary regurgitation, thereby protecting right heart function. Here, we analyzed the outcomes and mid- and long-term follow-up data of patients undergoing single-valved bovine pericardium patch (svBPP) placement for reconstruction and explored the effectiveness and gaps of svBPP in preventing right heart failure.
METHODS: A retrospective analysis was performed on patients undergoing RVOT reconstruction using BalMonocTM svBPP from October 2010 to August 2020. The follow up procedures included outpatient visits and collection of outcomes. The cardiac ultrasound-related indicators during the follow-up visits included ejection fraction (EF), right ventricular end-diastolic diameter (EDD), pulmonary regurgitation, and pulmonary artery stenosis. The survival rates and reoperation-free rate were analyzed by Kaplan-Meier method.
RESULTS: Patients includes tetralogy of Fallot, pulmonary atresia and other complex congenital heart disease. A total of 5 patients (5.7%) died during the perioperative period. Early complications included pleural effusion, cardiac insufficiency, respiratory insufficiency, chylothorax, and atelectasis, all of which were cured. After discharge, 83 patients (94.3%) were effectively followed up. During follow-up, 1 patient died and 1 patient underwent reoperation. The 1-, 5-, and 10-year survival rates were 98.8%, 98.8%, and 98.8%, respectively, and the reintervention-free rates for the same intervals were 98.8%, 98.8%, and 98.8%, respectively. The last follow-up ultrasound revealed severe pulmonary stenosis in 0 cases, moderate stenosis in 2 cases, mild stenosis in 7 cases, and no stenosis in 73 cases. Pulmonary regurgitation was not found in 12 patients; however, there were 2 cases of severe pulmonary regurgitation, 20 cases of moderate pulmonary regurgitation, and 48 cases of mild pulmonary regurgitation.
CONCLUSIONS: As shown in the mid- and long-term follow-up studies, BalMonocTM svBPP has good performance in RVOT reconstruction. It can effectively eliminate or reduce pulmonary valve regurgitation and protect right heart function. Both réparation à l’Etage ventriculaire (REV) and the modified Barbero-Marcial procedure can bring growth potential and reduce reoperation rate.
PMID:37181028 | PMC:PMC10167393 | DOI:10.21037/tp-23-97
Locally advanced thymoma; does neoadjuvant chemotherapy make a difference?
Regardless of its rare occurrence, Thymoma remains the most frequently encountered primary tumor of the anterior mediastinum comprising about 50% of all masses in the region. Surgical resection, via thymectomy… Read More
Revision Surgery is Possible in Patients With Previous Bovine Pericardium Inferior Vena Cava Reconstruction: A Case Series and Review of Literature
Vasc Endovascular Surg. 2023 Jul 10:15385744231189021. doi: 10.1177/15385744231189021. Online ahead of print.
ABSTRACT
There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence. The first case underwent resection of the BP graft with a second IVC reconstruction using BP, the second case underwent resection of the BP graft without reconstruction due to extensive thromboses. Neither case experienced perioperative complication or morbidity following their redo procedure, and previous IVC reconstruction with BP did not present significant intraoperative technical challenges. One case showed evidence of endothelialisation of the excised BP graft, however, it was not possible to definitively conclude if endothelialisation was present in the second case. Overall, these cases demonstrate that previous IVC reconstruction using BP should not be considered an absolute contraindication for redo surgery in the context of disease recurrence.
PMID:37427756 | DOI:10.1177/15385744231189021
Who needs their descending thoracic aorta anyway? Extra-anatomic bypass for aorto-bronchial fistula after TEVAR
Aortobronchial fistula after TEVAR remains a vexing clinical problem associated with high mortality. Although a combination of endovascular and open surgical strategies have been reported in managing this path… Read More
Mid-term results of endoscopic mitral valve repair and insights in surgical techniques for isolated posterior prolapse
The adoption of minimally invasive techniques to perform mitral valve repair surgery is increasing. This is enhanced by the compelling evidence of satisfactory short-term results and lower major morbidity. We … Read More
The role of delayed aortic surgery in type A aortic dissection and mesenteric ischemia: a systematic review and meta-analysis
Approximately one third of patients with Acute Type A Aortic Dissection (ATAAD) present with pre-operative malperfusion syndromes (MPS). Of these, mesenteric malperfusion represents the greatest risk to patien… Read More
Application of postmortem computed tomography angiography to settle a medical dispute after aortic dissection surgery: a forensic case report
In the present case, we applied postmortem computed tomography angiography (PMCTA) in a medical dispute involving sudden death after cardiovascular surgery.
Mitral valve replacement with annuloplasty in a patient with infected mitral annular calcification
Clin Case Rep. 2023 Aug 15;11(8):e7802. doi: 10.1002/ccr3.7802. eCollection 2023 Aug.
ABSTRACT
KEY CLINICAL MESSAGE: Extensive resection of the infected calcified annulus and the reconstruction with a pericardial patch for the debrided annulus is an effective surgical option for the treatment of infectious endocarditis in patients with mitral annular calcification.
ABSTRACT: A 78-year-old woman was referred to our hospital because of left-sided hemiparesis. During the treatment for cerebral infarction, the patient became feverish and lost consciousness. Transthoracic echocardiography revealed mitral annular calcification and a tumor-like mass on the posterior leaflet despite no findings of mitral regurgitation. She underwent successful mitral valve replacement with debridement of the infected mitral annulus and reconstruction of the posterior annulus (annuloplasty) with bovine pericardium after removal of the mitral annular calcification.
PMID:37593342 | PMC:PMC10427749 | DOI:10.1002/ccr3.7802
Surgical treatment of esophago-tracheobronchial fistulas after esophagectomy
Dis Esophagus. 2023 Aug 17:doad054. doi: 10.1093/dote/doad054. Online ahead of print.
ABSTRACT
The aim of this study was to evaluate the surgical treatment of esophago-tracheobronchial fistulas (ETBFs) that occurred after esophagectomy with gastric conduit reconstruction in a tertiary referral center for esophageal surgery. All patients who underwent surgical repair for an ETBF after esophagectomy with gastric conduit reconstruction were included in a tertiary referral center. The primary outcome was successful recovery after surgical treatment for ETBF, defined as a patent airway at 90 days after the surgical fistula repair. Secondary outcomes were details on the clinical presentation, diagnostics, and postoperative course after fistula repair. Between 2007 and 2022, 14 patients who underwent surgical repair for an ETBF were included. Out of 14 patients, 9 had undergone esophagectomy with cervical anastomosis and 5 esophagectomy with intrathoracic anastomosis after which 13 patients had developed anastomotic leakage. Surgical treatment consisted of thoracotomy to cover the defect with a pericardial patch and intercostal flap in 11 patients, a patch without interposition of healthy tissue in 1 patient, and fistula repair via cervical incision with only a pectoral muscle flap in 2 patients. After surgical treatment, 12 patients recovered (86%). Mortality occurred in two patients (14%) due to multiple organ failure. This study evaluated the techniques and outcomes of surgical repair of ETBFs following esophagectomy with gastric conduit reconstruction in 14 patients. Treatment was successful in 12 patients (86%) and generally consisted of thoracotomy and coverage of the defect with a bovine pericardial patch followed by interposition with an intercostal muscle.
PMID:37592909 | DOI:10.1093/dote/doad054