Advantages of upper brachial artery cannulation in aortic surgery.

Background: The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings.

A simple technique to reduce tension on coronary button anastomosis in aortic root surgery.

The permanency of the coronary ostial anastomosis is an important predictor of morbidity in aortic root surgery. We introduced a technique to reduce coronary reimplantation-related complications in aortic surgery. We believe that plicating the folds of the graft at both sides of the coronary ostial anastomosis reduces the tension on the suture line and may be advantageous to avoid pseudoaneurysm formation, detachment of the coronary button from the graft, distortion of the coronary geometry, or bleeding from the suture line.

Direct approach to hydatid cyst of the interventricular septum.

A 37-year-old woman who had undergone an operation for hydatid cyst of the liver 10 years earlier decided to have a check-up for echinococcosis, because she had not been seen by a clinician for 4 years. The case is of particular interest not only because it enabled a rare preliminary diagnosis of cardiac echinococcosis by simple electrocardiographic analysis, but also because our technique of excision appears to be one never before reported in connection with interventricular hydatid cysts. In such an instance, we recommend a direct approach (if possible) through the interventricular septum without entering the cardiac chambers, in order to avoid dissemination; and we recommend enucleation of the germinative membrane without capitonnage, to avoid impairment of the atrioventricular conduction pathway or of myocardial contraction.

Surgical approaches in left anterior descending artery in-stent stenosis.

Background: In-stent stenosis remains the major disadvantage of coronary interventions. Extensive applications of the intracardiac devices especially involving long segments of coronary arteries have resulted in an increase in the number of cases of in-stent stenosis. That may require aggressive surgical approaches.

Effect of neostigmine on organ injury in murine endotoxemia: missing facts about the cholinergic antiinflammatory pathway.

Electrical and pharmacologic stimulation of the efferent cholinergic antiinflammatory pathway suppress the systemic inflammatory response and can prevent lethal endotoxemia. Neostigmine, a cholinergic agent, has not been tested to determine if it can prevent histopathologic organ injury in endotoxemia. In the present study, the effects of neostigmine treatment on the histopathologic organ injury inflicted by Escherichia coli endotoxin in a mouse model of septic shock was investigated.