Sternectomy Reconstruction Using a Customized Three-Dimensional-Printed Polyetheretherketone Implant.

Complex sternal and chest wall reconstruction can be a challenging clinical situation, with the main objectives being restoration of chest wall rigidity, protection of intrathoracic organs, preservation of respiratory function, and reduction of pain and clicking. The treatment of choice is varied, with several different materials available to aid in adequate reconstruction. We present the case of a 60-year-old male with a post-sternectomy defect and debilitating symptoms who underwent reconstruction with a customized, three-dimensional (3D)-printed polyetheretherketone (PEEK) implant and pectoralis muscle flaps.

Traumatic Atrial Septal Defect Repair via Primary Endovascular Suture Method: Case Report and Operative Technique.

We report a case of a 20-year-old male with no prior medical history who was found to have an atrial septal defect on echocardiography following a motor vehicle accident (MVA). The patient underwent primary percutaneous defect closure using the NobleStitch EL (Heartstitch, Fountain Valley, California) cardiovascular suturing system with intra-operative Doppler echocardiogram showing no residual shunt or color flow. There were no operative complications.

Concurrent Primary Cardiac Tumors in a High-Risk Patient Presenting With Tamponade.

Primary cardiac tumors are rare, particularly in the elderly population. The patient described in this report presented with symptoms of dyspnea on exertion, leg swelling, and weight gain and was found to have two histologically distinct cardiac masses: atrial myxoma with concurrent aortic fibroelastoma. Given her history of cirrhosis and end-stage renal disease, the patient was a poor surgical candidate but opted for excision of both masses.

Point of care ultrasound facilitated diagnosis of right ventricular mass as the etiology of syncope; A case report of intravenous leiomyomatosis.

Syncope is a common emergency department (ED) chief complaint. Rarely, syncope can be the result of right ventricular outflow obstruction from an intracardiac tumor, such as an intracardiac extension of intravenous leiomyomatosis (IVL). Typically, this type of tumor is confined to the pelvic veins, but in very rare cases, it can extend through the inferior vena cava into the right atrium.

A Large, Severely Obstructive, Calcified Mass in the Midsegment of Aortic Arch.

Severe obstructive lesions in the aortic arch are rare. Crossing such lesions poses additional challenges in patients who require cardiac catheterizations. Oftentimes, specialized catheters are required to negotiate the lesion.

Incidence of general surgical procedures in adult patients on extracorporeal membrane oxygenation.

Purpose: Extracorporeal membrane oxygenation use may predispose patients to developing conditions that require either consultation with a general surgeon or a general surgical procedure. We aimed to evaluate the incidence and outcomes of adult extracorporeal membrane oxygenation patients who underwent general surgical procedure.

Methods: This was a single institution retrospective study of adult extracorporeal membrane oxygenation patients from 2012 to 2015.

Incidence of nosocomial infections in adult patients undergoing extracorporeal membrane oxygenation.

Introduction: Critically ill patients requiring extracorporeal membrane oxygenation (ECMO) are at increased risk for developing nosocomial infections owing to their underlying disease process along with numerous invasive monitoring devices.

Methods: We retrospectively analyzed the rate, type, pathogens, outcomes, and risk factors of nosocomial infections that developed during adult patients on ECMO at our institution from 2012-2015.

Results: Compared to current ELSO reported adult nosocomial infections rate of 20.

Combined clopidogrel and aspirin therapy in patients undergoing carotid endarterectomy is associated with an increased risk of postoperative bleeding.

This present study investigated the influence of combined preoperative clopidogrel and aspirin (ASA) administration on adverse postoperative outcomes and bleeding risk in patients undergoing carotid endarterectomy (CEA). A retrospective cohort study of all consecutive patients undergoing isolated CEA (n = 1488) between 1998 and 2005 was performed. Patients were classified into three groups: patients receiving combined preoperative clopidogrel/ASA therapy (n = 315), patients receiving preoperative ASA only (n = 639) and patients receiving no preoperative antiplatelet therapy (n = 518).

Predicting mortality in high-risk coronary artery bypass: surgeon versus risk model.

Background: Risk models are useful in evaluating and comparing surgical outcomes, but surgeons may not always agree with the risk estimates derived from these models, particularly in high-risk cases. We examined the concordance between surgeons' and a risk model's predictions of operative mortality in high-risk coronary artery bypass grafting (CABG) patients, and we attempted to identify the reasons for any discrepancies.

Methods: From the Veterans Affairs Continuous Improvement in Cardiac Surgery Program (CICSP), a prospective database and cardiac surgery risk model, we obtained data regarding 181 high-risk, isolated CABG cases performed at a single institution between April 1998 and April 2008.

Hepatic angioembolization in trauma patients: indications and complications.

Background: Hepatic angiography (HA) and hepatic angioembolization (HAE) are increasingly used to diagnose and treat intrahepatic arterial injuries. This study was performed to review indications, outcomes, and complications of HA/HAE in blunt trauma patients who underwent HAE as adjunct management of hepatic injury.

Methods: A retrospective review of consecutive cases of HA/HAE at a Level I trauma center during an 8-year period.

Isolated popliteal vein entrapment by the popliteus muscle: a case report.

Isolated popliteal vein entrapment is a very rare occurrence. We present a case of a young man who developed isolated popliteal venous entrapment resulting from extrinsic compression by the popliteus muscle soon after initiating an exercise program.