Iatrogenic STEMI in a male trauma patient due to coronary artery compression by a left sided chest tube.

Iatrogenic ST segment elevation myocardial infarction (STEMI) after insertion of a left sided thoracic tube is a rare insertional complication. We present a case of coronary artery compression of the left anterior descending artery (LAD) caused by a left sided chest tube placed after blunt thoracic trauma with pneumothorax resulting in a STEMI. A 53-year-old male patient with severe blunt thoracic trauma presented in the emergency department.

Increased cardiovascular comorbidities in patients with myelodysplastic syndromes and chronic myelomonocytic leukemia presenting with systemic inflammatory and autoimmune manifestations.

Myelodysplastic syndromes (MDS) and associated diseases, like chronic myelomonocytic leukemias (CMML), are heterogeneous, clonal disorders affecting the hematopoietic stem cells. They are characterized by dysplasia and a propensity to evolve toward acute myeloid leukemia. Systemic inflammatory and autoimmune manifestations (SIAMs) occur with a prevalence of 10% to 20% in myeloid malignancies, but the underlying pathogenetic mechanisms remain obscure.

Tuberculosis in a Swiss army training camp: contact investigation using an Interferon gamma release assay.

Background: In tuberculosis (TB), the risk of exposure is determined mainly by the proximity to and the hours of direct contact with an infectious patient. We describe the contact investigation after detection of an infectious form of TB in a military camp using an Interferon-g-Release-Assay (IGRA, QuantiFERON-TB Gold In Tube [QTF-GIT]) eight weeks after detection of the index case. INDEX PATIENT: The index patient presented with fever, cough and weight loss in the military hospital six weeks after entering the camp.

Totally arterial off-pump vs. on-pump coronary revascularization: comparison of early outcome.

Our objective was to assess differences in early outcome after completely arterial myocardial revascularization with (on-pump coronary artery bypass grafting or ONCAB) or without cardiopulmonary bypass (off-pump coronary artery bypass grafting or OPCAB). Fifty-eight OPCAB and 91 ONCAB patients receiving exclusively arterial grafts were analyzed. OPCAB patients had more single-vessel (P<0.

Delayed visceral malperfusion in aortic dissection-successful surgical revascularization using a saphenous vein graft.

Obstruction of the thoracoabdominal aorta and/or its branches with subsequent organ ischemia is a frequent complication of aortic dissection. Surgical and percutaneous fenestrations have been used and endovascular stenting has emerged as an additional less invasive approach. In some cases, surgical revascularization may be the most successful procedure.

Total arterial off-pump versus on-pump coronary revascularization: comparison of early outcome.

Background And Aim: To assess differences in the early outcome after complete arterial myocardial revascularization with (ONCAB) or without cardiopulmonary bypass (OPCAB).

Methods: Out of 870 consecutive CABG procedures 58 OPCAB and 91 ONCAB patients receiving exclusive arterial grafts were analyzed. OPCAB patients had more single-vessel (p < 0.

Improvement of quality of life after surgery on the thoracic aorta: effect of antegrade cerebral perfusion and short duration of deep hypothermic circulatory arrest.

Background: We have recently demonstrated that the use of deep hypothermic circulatory arrest (DHCA) during surgery for acute type A aortic dissections or thoracic aortic aneurysms adversely affect mid-term quality of life (QoL). The aim of this study is to assess the impact of DHCA duration and the potential effects of antegrade cerebral perfusion (ACP) on mid-term QoL.

Methods And Results: Between January 1994 and December 2002, 363 patients underwent surgery of the thoracic aorta with the use of DHCA at our institution.

Giant anastomotic pseudoaneurysm complicating aortic xenograft replacement.

A 74-year-old woman was referred for investigation of a 2-week history of progressive dyspnea. Her medical history included an aortic valve replacement with a stentless bioprosthesis followed 13 months later by the replacement of the aortic root with a porcine xenograft. Transesophageal echocardiography revealed a giant circular pseudoaneurysm of the aortic xenograft with compression of the prosthetic aortic valve and concomitant severe aortic regurgitation.

Risk-stratification in thoracic aortic surgery: should the EuroSCORE be modified?

Objectives: Risk-stratification in cardiac surgical procedures is of major interest. Recent studies have shown, that the EuroSCORE is a very good and reliable risk-stratification score in CABG and in valve surgery. The aim of the study was to evaluate the EuroSCORE in patients undergoing surgery on the thoracic aorta.

Endothelial and smooth muscle cell dysfunction in human atherosclerotic radial artery: implications for coronary artery bypass grafting.

The radial artery (RA) is increasingly used as coronary artery bypass graft. In rare cases, however, it is macroscopically atherosclerotic at time of harvest. We examined how the regulation of vascular tone is altered under such circumstances.

Aortic root replacement with a new stentless aortic valve xenograft conduit: preliminary hemodynamic and clinical results.

Background And Aim Of The Study: Beside aortic valve-sparing surgery, a composite graft, homograft or (more rarely) an autograft are the most common options to replace a diseased or destroyed aortic root in adults. Recently, a new stentless xenograft valved conduit (Shelhigh, No-React) was introduced in Europe. This totally biologic conduit is glutaraldehyde cross-linked, detoxified and heparin-treated with No-React; this process eliminates residual glutaraldehyde and ensures stable tissue cross-linking.

[The Sorin pericardial bioprosthesis--a stentless aortic valve with very good hemodynamic performance].

Background: The Sorin Pericarbon Freedom Stentless aortic valve has the potential to provide superior hemodynamic function and durability. In this study we assessed the hemodynamic performance of this valve and its impact on LV-mass regression after aortic valve replacement.

Methods: 31 consecutive patients who received a Sorin Pericarbon Freedom Stentless aortic valve were analysed.

Is reduced systemic heparinization justified with heparin-bonded bypass circuits in cardiac surgery?--Experience with and without aprotinin.

The effects of aprotinin combined with heparin-bonded bypass circuits and reduced systemic heparinization on haemostasis and inflammatory reactions were measured in patients with elective CABG operation. Patients were randomized to be operated on either without aprotinin (NOAPRO, n=15) or with aprotinin (APRO, n=15) at a low dose of 2 Mio KIU in the priming volume. Activated clotting time was adjusted to 400 +/- 50 s during cardiopulmonary bypass (CPB).

Aprotinin in coronary operation with cardiopulmonary bypass: does "low-dose" aprotinin inhibit the inflammatory response?

Background: Cardiopulmonary bypass induces a systemic inflammatory response. Aprotinin, a nonspecific proteinase inhibitor is known to improve postoperative hemostasis and may modify the inflammatory reaction. This study evaluates the effects of low-dose aprotinin on inflammatory markers in patients scheduled for elective coronary artery bypass grafting.

Delayed heart perforation after blunt trauma.

A 33-year-old patient was hospitalized after a blunt chest trauma with a left flail chest. Six hours after admission to the intensive care unit the patient suddenly developed hypotension and tachycardia. His left chest tube drained 1.

Quality of life after interventions on the thoracic aorta with deep hypothermic circulatory arrest.

Objective: Assessment of quality of life (QL) in patients undergoing major surgical procedures is of increasing interest. We focused on surgery of the thoracic aorta requiring deep hypothermic circulatory arrest (DHCA). Aim of this study was to assess QL after thoracic aortic surgery with DHCA, using the Short Form 36 Health Survey (SF-36) questionnaire.

The reversed and bidirectional elephant trunk technique in the treatment of complex aortic aneurysms.

Background: The elephant trunk technique with a free-floating vascular prosthesis was originally developed to facilitate a subsequent operation on the downstream aorta. We present here our experience with further developments of this technique, which we call the reversed elephant trunk and bidirectional elephant trunk.

Methods: Between January 1, 1995, and December 31, 2000, 505 adult and adolescent patients underwent operations of the thoracic aorta.

Determination of plasma volume by indocyanine green--validation of the method and use in patients after cardiopulmonary bypass.

Objective: Validation of plasma volume (PV) determination by indocyanine green (ICG) in comparison to the gold-standard method with radioiodinated albumin, and investigation of the effect of commonly used plasma expanders (albumin, hydroxyethyl starch, and polygelatine) on PV in the early postoperative phase in patients undergoing cardiac surgery.

Design: Prospective clinical study.

Setting: Department of medicine and intensive care unit at a university hospital.

Embolization of a ruptured intercostal artery aneurysm in type I neurofibromatosis.

We present the case of a female with history of a ruptured lumbar aneurysm years ago. She was known to have neurofibromatosis type I with the typical clinical signs. The patient was transferred to us with a hematothorax and an aortic lesion was suspected on the outside CT scan.

Rare presentation of cardiac hemangiomas.

Cardiac hemangiomas are exceptionally rare tumors with an incidence of 1% to 2% of all detected benign heart neoplasms. The clinical appearance of the tumor varies considerably and may mimic other pathological findings of definite heart structures. We report two cases of cardiac hemangiomas presenting with an unusual location and clinical course.

Outcome of thoracoabdominal aortic operations using deep hypothermia and distal exsanguination.

Background: Operation of the descending and thoracoabdominal aorta may be affected by a significant perioperative morbidity, mainly because of ischemic damage of the spinal cord and malperfusion of the abdominal organs.

Methods: A comparative analysis was performed on two consecutive series of patients operated between 1982 and 1998. Group 1 consisted of 90 patients operated with moderate hypothermic left heart bypass.