Omental Flap as Primary Surgical Treatment in Post-Operative Mediastinitis After Cardiac Surgery

Poststernotomy mediastinitis continues to be an infrequent but serious complication after cardiac surgery. We present a case of a 59-year-old man who developed a deep sternal wound infection after an emergency cardiac surgery. Omental transposition flap was used to cover the sternal defect. Several days later, the patient developed a transverse colon herniation into the anterior mediastinum that required emergency exploration and colon resection. The patient survived after a difficult hospital course. Indications, technical points, and possible complications of using omental flap transposition are discussed.

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Reality of surgical treatment of atrial fibrillation in the Czech Republic - Data from the National Register of Cardiac Surgery (2010-2015)

Cor et Vasa ◽

10.1016/j.crvasa.2017.05.010 ◽

2017 ◽

Vol 59 (4) ◽

pp. e305-e311

Author(s):

Petr Budera ◽

Vojtěch Kurfirst ◽

Štěpán Černý ◽

Petr Němec ◽

Jan Pirk ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Surgery ◽

Czech Republic ◽

Surgical Treatment ◽

National Register ◽

The Czech Republic

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CRT-135 Transapical Aortic Valve Implantation Has Simplified Surgical Treatment Of Sever Aortic Valve Stenosis In Elderly High Risk Patients With Previous Cardiac Surgery: A Propensity Analysis

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2013.01.062 ◽

2013 ◽

Vol 6 (2) ◽

pp. S44

Author(s):

Nestoras Papadopoulos ◽

Nina Schiller ◽

Andres Beiras Fernandez ◽

Stephan Fichtelscherer ◽

Ralph Lehmann ◽

...

Keyword(s):

Cardiac Surgery ◽

Surgical Treatment ◽

High Risk ◽

Aortic Valve ◽

Aortic Valve Stenosis ◽

High Risk Patients ◽

Propensity Analysis ◽

Risk Patients ◽

Aortic Valve Implantation ◽

Valve Implantation

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Kairiosios širdies hipoplazijos sindromo pirmo chirurginio gydymo etapo pradinė patirtis

Lietuvos chirurgija ◽

10.15388/lietchirur.2007.3.2224 ◽

2007 ◽

Vol 5 (3) ◽

pp. 0-0

Author(s):

Virgilijus Tarutis ◽

Virgilijus Lebetkevičius ◽

Kęstutis Versockas ◽

Asta Bliūdžiūtė ◽

Žydrė Jurgelienė ◽

...

Keyword(s):

Cardiac Surgery ◽

Surgical Treatment ◽

Hypoplastic Left Heart Syndrome ◽

University Hospital ◽

Norwood Procedure ◽

Initial Experience ◽

Left Heart ◽

Hypoplastic Left Heart ◽

Vilnius University ◽

Left Heart Syndrome

Virgilijus Tarutis1, Virgilijus Lebetkevičius1, Kęstutis versockas2, Asta Bliūdžiūtė2, Žydrė Jurgelienė2, Solveiga Umbrasaitė1, Rita Sudikienė3, Daina Liekienė1, Kęstutis Lankutis3, Vidmantas Jonas Žilinskas1, Vytautas Sirvydis11 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Anesteziologijos,intensyviosios terapijos ir skausmo gydymo centras3 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Kairiosiosios širdies hipoplazijos sindromas (KŠHS) yra viena sunkiiausių įgimtų širdies ydų. KŠHS turi 1 iš 4000–6000 naujagimių. Negydant mirštamumas pirmaisiais gyvenimo metais būna didesnis kaip 90%. Apžvelgiame pradinę KŠHS chirurginio gydymo patirtį. Ligoniai ir metodai Nuo 2005 m. iki dabar operuoti 9 naujagimiai, turintys KŠHS. 6 pacientai operuoti stabilizavus jų būklę, 3 operuoti nestabilios būklės esant kraujotakos nepakankamumui. 4 pacientams atlikta klasikinė Norwoodo operacija su modifikuota Blalocko ir Taussig jungtimi, likusiems 5 atlikta Norwoodo operacijos Sano modifikacija. Rezultatai Pirmas Norwoodo korekcijų etapas buvo sėkmingas 5 (55,6%) naujagimiams: 3 buvo padaryta modifikuota B-T jungtis, 2 – Sano jungtis. Išvada KŠHS chirurginis gydymas mūsų centre kol kas yra vadinamosios mokymosi kreivės laikotarpio. Norwoodo I etapo korekcijos rezultatai turėtų gerėti padidėjus operacijų skaičiui ir griežčiau atrenkant pacientus, atsižvelgiant į rizikos veiksnius. Pagrindiniai žodžiai: kairiosios širdies hipoplazijos sindromas, Norwoodo operacija Initial experience in first-stage surgical treatment of hypoplastic left heart syndrome Virgilijus Tarutis1, Virgilijus Lebetkevičius1, Kęstutis versockas2, Asta Bliūdžiūtė2, Žydrė Jurgelienė2, Solveiga Umbrasaitė1, Rita Sudikienė3, Daina Liekienė1, Kęstutis Lankutis3, Vidmantas Jonas Žilinskas1, Vytautas Sirvydis11 Vilnius University, Cardiac Surgery Centre, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“,Anesthesiology, Intensive Care and Pain Management Center3 Vilnius University Hospital „Santariškių klinikos“,Cardiac Surgery Centre Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objective Hypoplastic left heart syndrome (HLHS) is one of the most complex congenital heart defects. The incidence of HLHS is 1 in 4000 to 6000 live births. The mortality rate exceeds 90% without treatment in the first year of life. We review the initial experience in the surgical treatment of HLHS at our Centre. Patients and methods There were 9 children operated on for HLHS from the year 2005 till now. Six of them went to operation in hemodinamically stable condition and three had a substantial insufficiency of systemic circulation. Four underwent Norwood I procedure with modified Blalock–Taussig shunt and five had Sano modification. Results The first-stage Norwood procedure was successful in five (55.6%) cases – three with B-T shunt and 2 with Sano. Conclusions Surgical treatment of HLHS remains in the learning curve period at our institution. We expect the rise of survival rate with the increase of case load and a more selective approach considering the risk factors. Key words: hypoplastic left heart syndrome, Norwood procedure

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SURGICAL TREATMENT OF ATRIAL FIBRILLATION IN ELDERLY PATIENTS UNDERGOING HIGH RISK CARDIAC SURGERY

10.22541/au.162214407.72009074/v1 ◽

2021 ◽

Author(s):

Mohsin Uzzaman ◽

Imthiaz Manoly ◽

Mohini Panikkar ◽

Maciej Matuszewski ◽

Nicolas Nikolaidis ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Surgery ◽

Surgical Treatment ◽

High Risk ◽

Elderly Patients ◽

Control Group ◽

Surgical Ablation ◽

Af Ablation

BACKGROUND/AIM To evaluate outcomes of concurrent Cox-Maze procedures in elderly patients undergoing high-risk cardiac surgery. MEHODS We retrospectively identified patients aged over 70 years with Atrial Fibrillation (AF) from 2011 to 2017 who had two or more other cardiac procedures. They were subdivided into two groups: 1. Cox-Maze IV AF ablation 2. No-Surgical AF treatment. Patients requiring redo procedures or those who had isolated PVI or LAAO were excluded. Heart rhythm assessed from Holter reports or 12-lead ECG. Follow-up data collected through telephone consultations and medical records. RESULTS There were 239 patients. Median follow up was 61 months. 70 patients had Cox-Maze IV procedures (29.3%). Demographic, intra- and post-operative outcomes were similar between groups although duration of pre-operative AF was shorter in Cox-Maze group (p=0.001). One (1.4%) patient in Cox maze group with 30-day mortality compared to 14 (8.2%) the control group (p=0.05). Sinus rhythm at annual and latest follow-up was 84.9% and 80.0% respectively in Maze group - significantly better than No-Surgical AF treatment groups (P<0.001). 160 patients (66.9%) were alive at long-term follow-up with better survival curves in Cox Maze group compared to No-Surgical treatment group (p=0.02). There was significantly higher proportion of patients in NYHA 1 status in Cox-Maze group (p=0.009). No differences observed in freedom from stroke (p=0.80) or permanent pacemaker (p=0.33). CONCLUSIONS. Surgical ablation is beneficial in elderly patients undergoing high-risk surgery - promoting excellent long-term freedom from AF and symptomatic/prognostic benefits. Therefore, surgical risk need not be reason to deny benefits of concomitant AF-ablation.

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