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Thoracic and Cardiovascular Surgeon Reports

Malgorzata Gozdzik, Sergio Mariotti, Michele Genoni, Alicja Zientara
Background  Homozygous sickle cell disease (SCD) compounded with bacterial endocarditis makes open-heart surgery a multidisciplinary challenge. Case description  A 45-year-old African male patient with homozygous SCD presented with right heart decompensation, tricuspid regurgitation, and endocarditis of the aortic valve. Blood coulters were positive for coagulase-negative staphylococci. An emergent double valve replacement was successfully performed involving a multidisciplinary team. Conclusion  Homozygous SCD is associated with an increased risk of preoperative vaso-occlusive complications...
January 2019: Thoracic and Cardiovascular Surgeon Reports
Osamu Sakai, Katsuhiko Oka, Tomoya Inoue, Hitoshi Yaku
The transfemoral approach is the least invasive transcatheter aortic valve implantation (TAVI) approach, but the diameter of the iliofemoral arteries needs to exceed 5 mm. We report a case of limited access transfemoral TAVI by the "internal endoconduit technique," which is well known as a safe and effective dilatational technique for thoracic endovascular aortic repair. Subsequently, we could deliver the device without iliac artery injury and we performed transfemoral TAVI.
January 2019: Thoracic and Cardiovascular Surgeon Reports
Ashraf Rad, Ulrich Lange, Bartholomaeus Makowski, Thomas Held, Jürgen Schönwälder, Michael Schmoeckel
Background  According to current guidelines, acute pericarditis is an inflammatory pericardial syndrome with or without pericardial effusion. Case Description  We report on a patient who was treated for purulent pericarditis and developed a fistula from the ascending aorta to the right ventricle (RV), leading to cardiac decompensation. Operative closure of the aortic and RV perforation solved the problem. Conclusion  Bacterial pericarditis may lead to life-threatening complications. Early diagnosis and immediate therapy are essential for a successful outcome...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Jamila Kremer, Nico Tom Mutters, Matthias Karck, Katharina Last
Background   Coxiella burnetii is a gram-negative bacterium assigned to the family of Rickettsiaceae . Less than 1% of Q-fever infection leads to infective endocarditis (IE). Cases of reported pulmonary valve (PV) prosthesis endocarditis are scarce. Case Description  A patient with a PV prosthesis endocarditis caused by Coxiella burnetii was seeking asylum in Germany. Prosthesis replacement was performed. All obtained blood cultures showed no growth as well as microbiological cultures of the prosthetic valve tissue...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Wei Wei, Xuemei Jiang, Bo Xu, Yikuan Chen
Stents have been widely used to restore the patency of the iliac vein in the treatment of its obstruction. However, various complications related to those stents have been reported. This case report covers a 67-year-old male who was diagnosed with left iliofemoral venous post-thrombotic syndrome with recurrent acute deep venous thrombosis. Thrombosis of the inferior vena cava was induced by pronounced extension of left iliac vein stents. Extending stents in this way covers the outlet of the contralateral common iliac vein and may induce thrombosis in the inferior vena cava...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Andreas Böning, Bernd Niemann
No abstract text is available yet for this article.
January 2018: Thoracic and Cardiovascular Surgeon Reports
Greg J Haro, Eric J Seeley, David M Jablons, Johannes R Kratz
Background  Tracheal glomus tumors are rare mesenchymal neoplasms that have the potential to cause malignant, central airway obstruction. They require a thoughtful approach to safely secure the airway and definitively resect the tumor. Case Description  We report the clinical course of a 25-year-old man in severe respiratory distress secondary to tracheal glomus tumor and the subsequent surgical management. Conclusion  Due to their hypervascular nature, greater familiarity with tracheal glomus tumors is needed to ensure appropriate preoperative planning and intervention...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Andreas Kirschbaum, Timm Greulich, Nikolas Mirow, Detlef K Bartsch
In a 28-year-old female, seven recurrent pneumothoraces occurred during a period of 2 years despite multiple thoracic interventions, all on the left thoracic side. Despite profound differential diagnostic analysis, the underlying cause remains unclear. An accumulation of conditions in this patient affecting only the left half of the body is remarkable: sinistral glaucoma as an infant, a sinistral pigmentation disorder, and a sinistral Bochdalek hernia.
January 2018: Thoracic and Cardiovascular Surgeon Reports
Andreas Boening, Heiko Burger
No abstract text is available yet for this article.
January 2018: Thoracic and Cardiovascular Surgeon Reports
Bernd Panholzer, Katharina Huenges, Jochen Cremer, Assad Haneya
The persistent global shortage of organ donors is still a major limitation for transplantation. Experiences of heart transplantation from donors with extracorporeal support are rare. Here, we report from two cases of donors who were supported by extracorporeal membrane oxygenation due to acute circulatory failure. In both cases, the direct postoperative course was uneventful and free from major complications. The patients were discharged to a rehabilitation clinic. Our experience suggests that the use of heart organ from carefully selected donors with extracorporeal support is possible and may lead to an excellent outcome...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Felix Fleißner, Jan D Schmitto, Christian Napp, Issam Ismail
Background  A rupture of the free wall of the left ventricle is a rarely seen complication of myocardial infarction and represents an absolute cardiac emergency. Case Description  We hereby present a case of a 64-year-old patient with a rupture of the free left ventricular wall. The patient was treated in an emergent operation with a novel reconstruction method of the left ventricular wall and was discharged 30 days after the initial operation. Conclusion  Left ventricular free wall rupture is rarely described in the literature, which might be because of high mortality in underdiagnosed cases...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Joel L Ramirez, Anatoly Urisman, Jasleen Kukreja, Johannes R Kratz
Background  Pulmonary mucormycosis is a rare fungal infection that carries a high mortality. Given the rarity of this disease, its management has not been well established. Case Description  We report a 36-year-old female presenting with right middle and lower lobe pulmonary mucormycosis during the third trimester of pregnancy. Diagnosis was established using chest computed tomography followed by bronchoalveolar lavage and lung biopsy. Prompt initiation of amphotericin B and right middle and lower lobe lobectomy resulted in maternal survival and fetal viability...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Magdalena L Laux, Michael Erb, Frank Hoelschermann, Johannes M Albes
Background  Acute endovascular aneurysm repair with stent grafts (thoracic endovascular aortic repair [TEVAR]) is safe and feasible. Case Description  A 64-year-old female presented with a perforated aortic aneurysm of the thoracic descending aorta. Primary TEVAR resulted in good management of the perforation but a type Ib endoleakage remained postoperatively. To place another stent, abdominal debranching with saphenous vein bypass to the celiac trunk was required. In the same session, another endograft was inserted successfully...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Felix Fleißner, Ulrich Molitoris, Wiebke Rösler, Christian Kühn
Background  Pacemaker infections rates are high compared with the incidence of primary malignant cardiac tumors. However, they can look alike in diagnostics and patient presentation. Case Description  We hereby report a rare case of a suspected pacemaker endocarditis which in fact turned out to be a primary cardiac B cell lymphoma. The lymphoma was removed surgically. Conclusion  Sometimes we encounter the unexpected. Suboptimal preoperative diagnostics certainly lead to the faulty conclusion of an endocarditis...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Rosa G M Lammerts, Marc J van Det, Rob H Geelkerken, Ewout A Kouwenhoven
Anastomotic leakage of the gastric conduit following surgical treatment of esophageal cancer is a life-threatening complication. An important risk factor associated with anastomotic leakage is calcification of the supplying arteries of the gastric conduit. The patency of calcified splanchnic arteries cannot be assessed on routine computed tomography (CT) scans for esophageal cancer and, as such, in selected patients with known or assumed mesenteric artery disease, additional CT angiography of the abdominal arteries with 1 mm slices is strongly encouraged...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Ahmed F Elmahrouk, Tamer Hamouda, Mohamed F Ismail, Ahmed Jamjoom
Background  The coronary artery anatomy in patients with transposition of the great artery (TGA) is a contributing factor for outcome in arterial switch procedure. Case Presentation  A full-term, 7-day-old baby boy diagnosed as dextro-TGA (dTGA) with intact ventricular septum. Intraoperatively, the left coronary sinus had a blind indentation from which a firm cord-like left main coronary artery originates. Procedure completed as usual for a routine arterial switch operation. Conclusion  About 5% of patients with D-TGA have a single coronary artery...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Ahmed F Elmahrouk, Mohamed F Ismail, Abdulbadee Bugis, Nashwa Badawy, Hesham Mohamed Aboelghar, Tamer Hamouda, Ahmed Jamjoom
Background  Factor X deficiency (also known as Stuart-Prower factor deficiency) is an autosomal recessive extremely rare hereditary hematologic disorder, affecting around 1:1,000,000 of the general population. Case Presentation  This case report describes a patient with hypoplastic left heart syndrome and severe factor X deficiency, who underwent staged surgical palliation. From stage 1 Norwood palliation, through superior cavopulmonary anastomosis and ending with total cavopulmonary connection with satisfactory hemostasis and no significant perioperative bleeding complication...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Nawras Diab, Clarence Pingpoh, Matthias Siepe, Friedhelm Beyersdorf, Ahmed Kharabish, Martin Czerny
A 63-year-old female with a history of kidney transplantation was admitted for emergency repair of a perforated mycotic aneurysm of the right subclavian artery (RSA) in combination with a paravertebral and posterior mediastinal abscess. After resection of the aneurysm and after radical local debridement, orthotopic repair was performed with a self-made pericardial tube graft from the brachiocephalic bifurcation to the thoracic outlet. The paravertebral and posterior mediastinal abscess was drained. The postoperative course was uneventful...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Torulv Holst, Thorsten Großwendt, Majd Makarious Laham, Mehdy Roosta-Azad, Afsaneh Zandi, Markus Kamler
Endovascular stent placement for chronic postthrombotic iliofemoral venous obstructive lesions is an effective therapeutic option and might be complicated by stent migration. We report a case of a venous stent that was lost from the iliac vein into the right ventricle rescued by emergent open-heart surgery.
January 2018: Thoracic and Cardiovascular Surgeon Reports
Georg Schlachtenberger, Stephen Gerfer, Axel Kröner, Thorsten Wahlers
Background  Primary cardiac tumors are rare, and many diagnosed tumors are benign with an incidence of 0.001% to 0.03%. The primary angiosarcoma is one of the malignant entities. Discussion  We discuss a case report of a 76-year-old male who underwent a preoperative diagnosis for an upcoming shoulder operation when his cardiologist diagnosed a large cardiac tumor. The patient was referred to our department where he received further diagnostics. The transesophageal echocardiography and the cardiac-magnetic resonance imaging showed a massive tumor with a dimension of 8...
January 2018: Thoracic and Cardiovascular Surgeon Reports
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