Bronchopleural fistula is a major cause of morbidity and mortality after pulmonary resection. Different techniques of reinforcing the bronchial stump to prevent this complication have been described. Pledgeted sutures have been suggested for this purpose but have the potential to erode into the bronchus years after resection. We report an unusual case of airway obstruction 13 years after lung resection where pledgeted sutures had been used to reinforce a lobectomy stump. Bronchoscopic management of this rare complication consisted of endobronchial débridement and placement of a silicon stent to allow remodeling of the stenotic airway.
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In surgery for acute type A aortic dissection, controlling bleeding from the posterior wall of the proximal anastomosis is particularly challenging. To address this, we use the "reversed turn-up technique." For the reinforcement of the proximal aortic stump, Teflon felt strips were placed inside and outside the suture line with 4-0 polypropylene continuous transverse mattress sutures, and BioGlue was applied to the false lumen.
View Article and Find Full Text PDFLeft ventricular perforation by Impella 5.5 during surgery for postinfarction ventricular septal rupture.
Egypt Heart J
November 2024
Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Background: The perioperative use of the Impella 5.5 has been increasing recently; however, the left ventricular perforation by this device during surgery has not been reported to date.
Case Presentation: Postinfarction ventricular septal rupture in a 75-year-old man was successfully repaired with support of a single Impella 5.
A mattress suture with pledgets can partially occlude intrahepatic shunts in 23 dogs: evaluation of long-term survival.
J Am Vet Med Assoc
February 2025
2Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
Objective: To explore the differences in outcomes between dogs with intrahepatic portosystemic shunts (IHPSSs) partially occluded with a mattress suture with pledgets or attenuated with cellophane banding.
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The use of pledget-reinforced sutures during surgical aortic valve replacement: A systematic review and -analysis.
Int J Cardiol Heart Vasc
October 2024
Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Objective: Literature presents conflicting results on the pros and cons of pledget-reinforced sutures during surgical aortic valve replacement (SAVR). We aimed to investigate the effect of pledget-reinforced sutures versus sutures without pledgets during SAVR on different outcomes in a systematic review and -analysis.
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Aortic annular enlargement with Y-incision/rectangular patch.
Ann Cardiothorac Surg
May 2024
Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
The Y-incision/rectangular patch aortic annular enlargement (Y-incision AAE) is our go-to technique for aortic annular/root enlargement at the University of Michigan for its simplicity and effectiveness. A complete aortotomy is used for first-time surgical aortic valve replacements (SAVRs), and a partial aortotomy is frequently used in reoperative SAVR. The Y-incision is made through the left-non commissure, underneath the aortic annulus to the left and right fibrous trigones.
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