Aortic arch de-branching for suspected expanding perigraft haematoma after previous acute type-A dissection repair with AMDS stent: a technique for a potential future problem

Acute Stanford type- A aortic dissections make up a large part of emergency cardiac surgery. They also carry a significant burden of morbidity. New techniques to aid aortic remodelling include the Ascyrus Medi…  Read More

Sex-based disparities in ascending aortic aneurysm surgery outcomes: a comprehensive analysis of 1148 consecutive patients with propensity-score matching

Women undergoing cardiac surgery have been historically recognized to carry higher periprocedural mortality risk. We aimed to investigate the influence of sex on clinical presentation, perioperative, and long-…  Read More

Double patch repair for complete atrioventricular septal defect using the Invengenx® patch

Complete congenital Atrio-Ventricular (AV) septal defect repair is a complex technique and can be performed as a single patch, modified single patch or a double patch technique. In addition, reconstructive surgeries make it more challenging as the native pericardium available for the repair is limited and of poor quality. Thus, the use of engineered bovine pericardium can help in the reconstruction of large AV canal defects. We used the Invengenx® patch for the repair of a complete AV canal defect and Pulmonary Artery (PA) plasty in a 20 month old female child with a previous PA banding. The patch had good flexibility, mechanical strength, suturability and there were no complications such as thrombosis or infection on follow up.

Reconstructive surgery in congenital cardiac anomalies is fraught with challenges due to surgical complexities and the limited availability of native pericardium for performing the repair of large defects. We used the Invengenx® bovine pericardial tissue patch for the repair of a complete AVSD (post-pulmonary artery banding) and found the patch to be suitable for the re-do procedure and noted uniform thickness, good flexibility, mechanical strength, suture retention and no infection or thrombosis.

Full Publication

Reconstruction of Fibrous Skeleton of the Heart for Double-Valve Replacement in A Pediatric Patient – Modified Commando Procedure

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2024;27:61-62. doi: 10.1053/j.pcsu.2024.01.006. Epub 2024 Jan 24.

ABSTRACT

The so-called Commando procedure, initially described by David and colleagues, consists in the reconstruction of the mitro-aortic fibrous lamina by a patch that enlarges both annuli. Its use has been described to upsize the aortic and mitral annulus for double valve replacement in adolescents. We describe a modified technique of this reconstruction of the fibrous skeleton of the heart, combined with Konno procedure to further enlarge the aortic annulus. In modified Commando procedure, following the reconstruction of aortomitral continuity with a bovine pericardium CardioCel patch (Admedus Regen Pty Ltd, Perth, WA, Australia), an aortic valved conduit that was made on the bench in order to have bottom skirt that enabled the suturing of the composite conduit far inside the left ventricle outflow tract. Coronary buttons were implanted at the supra-commissural level. The advantages of this modified Commando procedure are (1) the creation of a new aortic annulus when the integrity of this annulus has been compromised, (2) the upsizing of both annuli to any possible size of aortic and mitral prostheses, and (3) the relief of any residual left ventricular outflow tract obstruction.

PMID:38522874 | DOI:10.1053/j.pcsu.2024.01.006

Efficacy of autologous blood patch injection for pneumothorax rate after CT-guided percutaneous transthoracic lung biopsy: a systematic review and meta-analysis

Pneumothorax is the most frequent complication after CT-guided percutaneous transthoracic lung biopsy (CT-PTLB). Many studies reported that injection of autologous blood patch (ABP) during biopsy needle withdr…  Read More

Co-occurrence of posterior chest wall pilonidal sinus with melanocytic nevus: a challenging presentation: a case report

To date, only a limited number of case reports have documented the co-occurrence of PNS and melanocytic nevus in the medical literature. This study aims to report an exceptionally rare case of posterior chest …  Read More