scholarly journals Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults

2015 ◽  
Vol 4 (1) ◽  
pp. 47-49
Author(s):  
Ali Refatllari ◽  
Ermal Likaj ◽  
Selman Dumani
Keyword(s):  
Spinal Cord ◽  
Congenital Heart ◽  
Coarctation Of The Aorta ◽  
Bypass Grafting ◽  
Pressure Gradients ◽  
Aortic Bypass ◽  
Early Results ◽  
The Mean ◽  
Dacron Prostheses ◽  
Spinal Cord Vascularization

BACKGROUND: Coarctation represents 5-8% of congenital heart disease. Residual hypertension remains the main problem after late correction. Surgical treatment in the adult remains a challenge for the surgeon. Our prefered method used in this category is the Subclavian-aortic bypass.MATERIAL AND METHODS: We have reviewed our registry for the period of 12 years (1998- 2010) and we found a group of 18 adult patients being operated for coarctation of the aorta. The mean age of this group of patients was 24.7 ± 8.43 years (range 16-42 years). 13 were males and 5 females. RESULTS: Sugical technique: Most of the patients (13 pts, 72%) which were obviously treated with subclavian-aortic bypass with a Dacron prostheses. Mean preoperative and postoperative pressure gradients measured by echocardiography were 77.7 ± 20.16 mmHg and 22.3 ± 9.14 mmHg respectively. No mortality was observed in this series of patients. Chylothorax was the only complication observed in one patient in the early postoperative period.CONCLUSION: Coarctation of the aorta in adults is treated with optimal early results at our surgical centre. Subclavian-aortic bypass grafting requires less aortic dissection, can be performed with a partially occluding clamp, and does not compromise the spinal cord vascularization.

scholarly journals Original paper. Do Umbilical Cord Wrapped Around the Fetal Body Can Mimic Signs of Aortal Coarctation?

2016 ◽  
Vol 6 (1) ◽  
pp. 82-86
Author(s):  
Katarzyna Więckowska ◽  
Katarzyna Zych-Krekora ◽  
Maciej Słodki ◽  
Maria Respondek-Liberska
Keyword(s):  
Umbilical Cord ◽  
Lower Limb ◽  
Maternal Age ◽  
Congenital Heart ◽  
Coarctation Of The Aorta ◽  
Chamber View ◽  
Cardiac Blood ◽  
Cardiology Department ◽  
False Diagnosis ◽  
The Mean

Abstract Objectives: Coarctation of the aorta (CoA) is an irreversible congenital heart defect. Its prenatal diagnosis is not rare a subject to false-positive conclusion. We present a novel hypothesis explaining the basis of this error. Methods: Ten cases of prenatal suspicion of the coarctation of the aorta (based on disproportion at the level of 4 chamber view and mediastinum) coincidenced with the umbilical cord wrapped around the fetal body were found in the Filemaker datebase of the Fetal Cardiology Department. Only single pregnancies were taken into account. In all cases another cardiac and extracardiac malformations were excluded. Results: The mean maternal age was 29,6 years. The mean gestational age was 33 7/8 weeks. All fetuses were in a good cardiovascular condition. The usual position of the umbilical cord was neck, but they were also location such as nucha, abdomen or lower limb. At birth, all newborns had normal anatomy of the heart. We conclude that the explanation of the false diagnosis was haemodynamic, resulting from the compression of the fetal neck by the umbilical cord that resulted in a disproportion of cardiac blood flow, “mimicking” CoA. Conclusions: 1. Functional disturbances can mimic prenatal CoA. 2. Umbilical cord position (specially enlacing the fetus neck) should be taken into consideration in suspected cases of fetal CoA.

scholarly journals Establishing Cardiac Surgery in Eastern Nepal: Early Results

2018 ◽  
Vol 16 (3) ◽  
pp. 257-263
Author(s):  
Lokesh Shekher Jaiswal ◽  
Jagat Narayan Prasad ◽  
Prashant Shah ◽  
Narendra Pandit
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Left Atrial Myxoma ◽  
Early Results ◽  
The Mean

Background: Only few dedicated cardiac centres provide cardiac surgery service in Nepal. We are the only government affiliated centre outside the capital providing this service. In this study, we aim to present our early results of cardiac surgery.Methods: This retrospective study was conducted at B P Koirala Institute of Health Sciences with objective of analysing the early results of cardiac surgery in the patients operated from July 2016 to March 2017.The data were analysed for patient demographics, type of surgery and cardiac disease, mortality, hospital and intensive care unit stay, valve related complications.Results: Total 51 major cardiac surgeries (42 on pump and nine off pump) were performed. There were 27 (53%) males and 24 (47%) females with median age of 36 years (range: 1 to 70 years).The cardiac diseases consisted of 28 rheumatic heart disease, 12 congenital heart diseases, five coronary artery disease, five chronic constrictive pericarditis and one left atrial myxoma. The mean cardiopulmonary bypass and cross clamp times were 106 ±35 and 80±26 minutes respectively. The mean intensive care unit and hospital stay was 4±2 and 8±3 days respectively. Two (4%) patients required re-exploration for mediastinal bleeding. There was no prosthetic valve thrombosis or infection.Two patients (4%) had superficial wound infections.There were four (7.8%) in hospital mortalities. Remaining 47 patients (91.8%) are in NYHA class I aftermean follow up duration of five months.Conclusions: Our early result of cardiac surgery is encouraging and has established the safety and feasibility of starting open heart surgery in other parts of Nepal.Keywords: CABG; cardiac surgery; congenital heart disease; early results; RHD.

Outcomes of the Extracardiac Fontan Procedure Using Cardiopulmonary Bypass: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 173 ◽  
Author(s):  
Murat Ugurlucan ◽  
Eylem Yayla Tuncer ◽  
Fusun Guzelmeric ◽  
Eylul Kafali ◽  
Omer Ali Sayin ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Arterial Oxygen Saturation ◽  
Vena Cava ◽  
Arterial Oxygen ◽  
Shunt Operation ◽  
Early Results ◽  
The Mean ◽  
Extracardiac Fontan

<p><strong>Background</strong>: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass.</p><p><strong>Methods</strong>: Between September 2011 and April 2013,  9 consecutive patients (3 males and 6 females) underwent extra-cardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon.  The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the infe-rior vena cava and right pulmonary artery.</p><p><strong>Results</strong>: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged with-out complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventila-tion within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ±  1.9 days, respectively.</p><p><strong>Conclusions</strong>: The extracardiac Fontan operation per-formed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favor-able postoperative hemodynamics and morbidity rates.</p>

Hybrid Endovascular Repair of Thoracoabdominal Aorta: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 146
Author(s):  
Osman Tansel Darcin ◽  
Mehmet Kalender ◽  
Ayse Gul Kunt ◽  
Okay Guven Karaca ◽  
Ata Niyazi Ecevit ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Therapeutic Option ◽  
Complete Recovery ◽  
Aortic Aneurysms ◽  
Thoracoabdominal Aorta ◽  
Mortality And Morbidity ◽  
Early Results ◽  
The Mean ◽  
Procedural Success

<p><b>Background:</b> Thoracoabdominal aortic aneurysms (TAAA) present a significant clinical challenge, as they are complex and require invasive surgery. In an attempt to prevent considerably high mortality and morbidity in open repair, hybrid endovascular repair has been developed by many authors. In this study, we evaluated the early-term results obtained from this procedure.</p><p><b>Methods:</b> From November 2010 to February 2013, we performed thoracoabdominal hybrid aortic repair in 18 patients. The mean age was 68 years (12 men, 6 women). All of the patients had significant comorbidities. Follow-up computed tomography (CT) scans were performed at 1 week, 3 months, 6 months, and annually thereafter.</p><p><b>Results:</b> All patients were operated on in a staged procedure and stent graft deployment was achieved. Procedural success was achieved in all cases. All patients were discharged with complete recovery. No endoleaks weres detected in further CT examination.</p><p><b>Conclusion:</b> Our results suggests that hybrid debranching and endovascular repair of extensive thoracoabdominal aneurysms represents a suitable therapeutic option to reduce the morbidity and mortality of TAAA repair, particularly in those typically considered at high risk for standard repair.</p>

Emergency Management for Critical Left Main Coronary Artery Stenosis

2011 ◽  
Vol 14 (1) ◽  
pp. 12
Author(s):  
Onur Sokullu ◽  
Numan Ali Aydemir ◽  
Erol Kurc ◽  
Batuhan Ozay ◽  
Fuat Bilgen ◽  
...  
Keyword(s):  
Survival Rate ◽  
Left Main Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Bypass ◽  
Percutaneous Intervention ◽  
Bypass Grafting ◽  
Left Main ◽  
Bypass Group ◽  
The Mean ◽  
Late Survival

Background: Increased experience and improvements in technology seem to have encouraged the use of percutaneous interventions for left main coronary artery (LMCA) occlusions. There is no consensus, however, and the data are inadequate on whether surgery or percutaneous procedures should be the intervention of choice for critical occlusions.Methods: From January 2002 to December 2006, 108 patients with unprotected LMCA stenosis >80% were treated at our center. Eighty-three patients (77%) underwent bypass grafting and 20 (18%) underwent percutaneous intervention for the purpose of myocardial revascularization. We analyzed parameters demonstrated as risk factors for myocardial revascularization and their predicted effects on outcome.Results: Five patients (5%) died following emergency cardiopulmonary resuscitation before any intervention was performed. The early survival rate was 84.1% in the coronary bypass group and 63% in the percutaneous intervention group. The mean (SD) survival time was 55.7 2.6 months in the bypass group and 7.6 1.3 months in the percutaneous group. The late-survival rate was also significantly higher in the bypass group. The mean late-survival time was 44.5 3.6 months in the bypass group and 2.3 0.8 months in the percutaneous group.Conclusion: Although emergency percutaneous interventions are lifesaving in some cases, these results clearly demonstrate that coronary bypass grafting should be the intervention of choice for myocardial revascularization in patients with critical LMCA occlusion.

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

Treatment of middle aortic syndrome with thoraco-abdominal aortic bypass grafting assisted by endoscope in adult

Perfusion ◽  
2021 ◽  
pp. 026765912098677
Author(s):  
Chuntian Li ◽  
Xin Mao ◽  
Xu Zhao ◽  
Guiqing Liu ◽  
Gang Xu ◽  
...  
Keyword(s):  
Case Report ◽  
Effective Treatment ◽  
Rare Disease ◽  
Abdominal Aorta ◽  
Surgical Approach ◽  
Endoscopic Technique ◽  
Bypass Grafting ◽  
Middle Aortic Syndrome ◽  
Aortic Bypass ◽  
Abdominal Aortic

Middle aortic syndrome (MAS) is a rare disease characterized by distal thoracic aorta or abdominal aorta coarctation, and thoraco-abdominal aortic bypass grafting is an effective treatment for this condition. However, significant trauma is associated with the conventional surgical approach. We report a 26-year-old woman with MAS who presented with hypertension and needed thoraco-abdominal bypass grafting. In this operation, we adopted the endoscopic technique to improve the conventional surgical approach (reduce the incision). This case report shows that it is safe and feasible to use an endoscopic technique to reduce the trauma during this kind of operation, and provides a reference for similar treatments.

scholarly journals Anomalous Origin of the Left Anterior Descending Coronary Artery in an Adult

2021 ◽  
Vol 10 (01) ◽  
pp. e9-e10
Author(s):  
Keisuke Shibagaki ◽  
Chikara Shiiku ◽  
Hiroyuki Kamiya ◽  
Yoichi Kikuchi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Left Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Anomalous Origin ◽  
Bypass Grafting

AbstractAn anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Among the variants, an anomalous origin of the left anterior descending coronary artery from the pulmonary artery (ALADPA) is extremely rare. Here, we report a case of ALADPA in an adult that was treated with coronary artery bypass grafting using the left internal thoracic artery.

High prevalence of ascending aortic dilation in adults with repaired coarctation of the aorta

2021 ◽  
pp. 1-6
Author(s):  
Daniel Rinnström ◽  
Mikael Dellborg ◽  
Ulf Thilén ◽  
Peder Sörensson ◽  
Niels-Erik Nielsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Valve Disease ◽  
Congenital Heart ◽  
Coarctation Of The Aorta ◽  
Valve Disease ◽  
Aortic Dilation ◽  
Factors Associated ◽  
High Prevalence ◽  
Life Threatening

Abstract Background: Ascending aortic dilation is a feared complication in adults with repaired coarctation of the aorta, as the condition is associated with life-threatening complications such as aortic dissection and rupture. However, the data are currently limited regarding factors associated with ascending aortic dilation in these patients. Methods and results: From the national register of congenital heart disease, 165 adult patients (≥ 18 years old) with repaired coarctation of the aorta, and echocardiographic data on aortic dimensions, were identified (61.2% male, mean age 35.8 ± 14.5 years). Aortic dilation (aortic diameters > 2 SD above reference mean) was found in 55 (33.3%) of the 165 included patients, and was associated with manifest aortic valve disease in univariable logistic regression analysis (OR 2.44, 95% CI [1.23, 4.83]). Conclusions: Aortic dilation is common post-repair of coarctation of the aorta, and is associated with manifest aortic valve disease and thus indirectly with the presence of a bicuspid aortic valve. However, no association was found between aortic dilation and age or blood pressure.

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