Category: General

Combination of CEACAM5, EpCAM and CK19 gene expressions in mediastinal lymph node micrometastasis is a prognostic factor for non-small cell lung cancer

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Lung cancer is known as the most common and highly metastatic form of cancer worldwide. Tumour node metastasis (TNM) staging is the gold standard classification system for the decision-making process for appro…  Read More

Granulomatous inflammation mimicking a hematoma around the replaced ascending aorta in magnetic resonance imaging: a case report

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Granulomatous inflammation results from various causes including infections and allergic reactions. It can appear as high signal intensity in T2-weighted or contrast-enhanced T1-weighted magnetic resonance ima…  Read More

Unconventional surgery for thoracic esophageal rupture with empyema and mediastinitis: a case report and literature review

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Treatment of esophageal perforation or rupture is complicated and controversial, especially in advanced cases. In fact, it is generally accepted that this disease must be treated individually according to the …  Read More

Uniportal video-assisted thoracoscopic anatomical resection of the right anterior pulmonary segment in a 10-year-old child with congenital pulmonary airway malformation

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Congenital pulmonary airway malformation (CPAM) is a very rare phenomenon subject to malignant transformation that requires surgical resection. In an asymptomatic 10-year-old girl, we identified a single cysti…  Read More

A Case of Hepatocellular Carcinoma Extending into Right Atrium Was Resected Successfully Using Cardiopulmonary Bypass

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Gan To Kagaku Ryoho. 2023 Jan;50(1):99-101.

ABSTRACT

A 59-year-old male was referred to our hospital for a thorough examination of liver function abnormality in the background of chronic hepatitis C. Abdominal contrast-enhanced CT showed multiple tumors in the right lobe of the liver, and an 8 cm tumor occupying S7, a tumor thrombus extending from the right hepatic vein to the inferior vena cava, and a tumor thrombus in the right branch of the portal vein. The patient was diagnosed with hepatocellular carcinoma, cT4N0M0, cStage ⅣA. After 5 courses of hepatic arterial infusion therapy, the intrahepatic lesion was significantly reduced, but micropulmonary metastasis appeared, and the tumor thrombus in the inferior vena cava increased to the thoracic inferior vena cava and just below the tricuspid valve. The patient had difficulty blocking blood flow in the inferior vena cava in the pericardial sac. The patient underwent right hepatectomy, tumor thrombus resection of the inferior vena cava, combined resection of the inferior vena cava, and bovine pericardial patch reconstruction under artificial cardiopulmonary support. He was discharged on the 23rd day after surgery and has been under outpatient observation for 16 months while receiving molecular-targeted drugs for lung metastasis.

PMID:36759999

Low Morbidity Anatomical Revascularisation for an Infected Aorto-Bifemoral Graft Using a Staged Hybrid Procedure

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Cureus. 2023 Mar 28;15(3):e36805. doi: 10.7759/cureus.36805. eCollection 2023 Mar.

ABSTRACT

A 66-year-old woman presented with a right femoral false aneurysm following an aortobifemoral bypass for lifestyle-limiting claudication. A computed tomography (CT) angiogram revealed features of complete aortobifemoral graft infection. A two-stage procedure was performed. The first hybrid stage involved the excision of only the femoral components and covered stenting of the aortic stump, along with recanalization of bilateral native iliac systems. The second stage, six weeks later, involved aortic stent and graft explant via midline laparotomy with aortic bovine pericardium patch repair (LeMaitre Vascular Inc, Burlington, Massachusetts). Follow-up imaging demonstrated no residual infection, and the patient remained without complication at the 12-month follow-up. This novel approach utilizes hybrid surgical techniques and modern bioprosthetic material to safely manage an infected aortobifemoral bypass graft.

PMID:36998918 | PMC:PMC10044328 | DOI:10.7759/cureus.36805

A rare variant of a ruptured sinus of valsalva aneurysm forming an aorto-atrial fistula: a case report and review of literature

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Eur Heart J Case Rep. 2023 Feb 1;7(2):ytad018. doi: 10.1093/ehjcr/ytad018. eCollection 2023 Feb.

ABSTRACT

BACKGROUND: Sinus of valsalva aneurysms (SOVAs) are infrequent findings and generally diagnosed incidentally. A SOVA may be at risk for rupture, which would lead to an aorto-cardiac shunt. These patients present similarly to decompensated heart failure.

CASE PRESENTATION: We present a case of a 44-year-old female with a ruptured non-coronary SOVA diagnosed by echocardiogram during evaluation for exertional dyspnoea. A trans-oesophageal echocardiogram (TEE) revealed a 2.1 cm non-coronary SOVA with windsock communication to the right atrium. The patient refused surgery, and two years later, presented with florid right heart failure with preserved left ventricular function. The right ventricle was severely dilated and hypokinetic with right atrial enlargement. After finally agreeing to surgery, a pre-operative catheterization revealed non-obstructive coronaries and a significant left to right shunt with elevated pulmonary pressure. The patient had suboptimal response to diuretic therapy and was sent for successful repair of the aneurysm with the closure of the aorto-atrial fistula via bovine pericardial patch and resolution of the left to right shunt as demonstrated by intra-operative TEE. Her right-sided heart failure symptoms subsequently resolved.

DISCUSSION: SOVA is a rare finding but should still be considered in the differential in young and middle-aged patients with symptoms of acute heart failure, hemodynamic compromise, and a new continuous heart murmur. Early surgical repair is highly recommended to prevent acute and long-term complications.

PMID:36751420 | PMC:PMC9897235 | DOI:10.1093/ehjcr/ytad018