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Reversed valved Potts shunt for refractory primary pulmonary arterial hypertension.
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• Pediatric and Congenital Cardiac Surgery, LMU University Hospital, Munich, Germany • Congenital Cardiac Surgery, German Heart Center Munich, Munich, Germany • European Pediatric Heart Center EKHZ Munich, Munich, Germany.
This procedure is carried out via a full sternotomy using standard aortic and bicaval cannulations. For the aortic and pulmonary anastomoses, selective antegrade unilateral cerebral perfusion is used after cooling the body temperature to 26 °Celsius. A 12-mm Hancock conduit is interposed between the pulmonary artery and the proximal descending aorta using standard running suture techniques.
View Article and Find Full Text PDFColonic Derotation Revisited: The "Deloyers Procedure" for Long-Segment Hirschsprung Disease.
Cureus
December 2024
Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, USA.
Long-segment Hirschsprung disease (HSCR) presents significant challenges in surgical management, often requiring extensive bowel mobilization and creative techniques to achieve tension-free anastomosis. Colonic derotation offers a viable solution for preserving bowel length and maintaining the ileocecal valve, which is crucial for postoperative bowel function. The procedure involves extensive colonic mobilization and strategic vascular divisions of the right and middle colic vessels while preserving the ileocolic and marginal arteries, followed by a 180° counterclockwise rotation of the colon around the ileocolic vascular axis.
View Article and Find Full Text PDFCould Pulsed Wave Tissue Doppler Imaging Solve the Diagnostic Dilemma of Right Atrial Masses and Pseudomasses? A Case Series and Literature Review.
J Clin Med
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Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy.
Even if rarely detected, right atrial (RA) masses represent a diagnostic challenge due to their heterogeneous presentation. Para-physiological RA structures, such as a prominent Eustachian valve, Chiari's network, and lipomatous atrial hypertrophy, may easily be misinterpreted as pathological RA masses, including thrombi, myxomas, and vegetations. Each pathological mass should always be correlated with adequate clinical, anamnestic, and laboratory data.
View Article and Find Full Text PDFA technique avoiding cardioplegia delivery complications: a case using systemic hyperkalemia cardiopulmonary bypass combined with circulatory arrest.
J Extra Corpor Technol
December 2024
Department of Clinical Engineering, Kitaharima Medical Center, 926-250, Ichiba-cho, Ono-shi, Hyogo, 675-1392, Japan.
We conducted a high-risk redo mitral valve replacement through a right mini-thoracotomy without rib spreading (redo-MICS MVR) under systemic hyperkalemia combined with circulatory arrest to circumvent complications associated with cardioplegia delivery. The patient, a 75-year-old man, had a predicted mortality rate of 20%. Initial antegrade cardioplegia successfully induced cardiac arrest, which was administered every 30 min.
View Article and Find Full Text PDFArticle Synopsis
- Transcatheter closure of paravalvular leaks (PVL) is a viable treatment for high-risk patients, yet limited research exists on its effectiveness using Amplatzer devices in Japanese patients with mitral PVL.
- A study involving 12 patients (average age 78) showed successful closure procedures were performed, with a reduction in PVL severity and no major complications reported within 30 days.
- One year later, an all-cause mortality rate of 16.7% was noted, with 25% of patients needing further intervention due to symptom recurrence, indicating the treatment's potential but also the need for monitoring.
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