Background: Repair of esophageal atresia is usually performed through the right thoracic cavity. However, when the upper pouch of the esophagus and tracheoesophageal fistula (TEF) is located in the thoracic inlet and completely on the left side of trachea, it is difficult to dissect and anastomose the esophagus through the right thoracic cavity. We present a case of esophageal atresia, with the esophageal upper pouch located high and completely on the left side of trachea, successfully repaired via the median sternotomy approach.
Case Presentation: A male neonate with a birth weight of 1766 g was prematurely delivered via cesarean section at 34 weeks of gestation. Contrast-enhanced computed tomography (CT) showed that the upper pouch of the esophagus was located at the thoracic inlet and completely on the left side of the trachea; hence, a diagnosis of esophageal atresia was made. Moreover, a TEF was connected to the trachea at the level of the lower end of the upper esophageal pouch. An aberrant right subclavian artery and persistent left superior vena cava were also detected. Esophageal dissection and anastomosis were determined to be very difficult if approached from the right thoracic cavity. Therefore, we performed median sternotomy one day after the neonate was born. The upper pouch of the esophagus and TEF were easily dissected via the median sternotomy approach. Anastomosis of the esophagus was performed, with a good visual field, to the left of the trachea. The postoperative course was uneventful.
Conclusions: This is the first reported case of a median sternotomy approach for esophageal atresia. This technique may be useful when a right thoracic approach is difficult, especially if the esophageal upper pouch is located completely to the left of the trachea or if it is higher than the normal position.
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http://dx.doi.org/10.1186/s40792-022-01523-5 | DOI Listing |
Cureus
December 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
The patient was a 33-year-old male. He was noted to have a systolic murmur in the aortic valve region during childhood and underwent balloon valvuloplasty at a pediatric clinic. However, he was not followed up thereafter.
View Article and Find Full Text PDFAnn Card Anaesth
November 2024
Department of Cardiovascular Surgery, CHU Gabriel Montpied, Rue Montalembert, BP 69, 63003 Clermont-Ferrand, France.
Background: The aim of this study was to assess whether parasternal block with multihole catheters inserted before surgical incision enables to alleviate postoperative analgesia and opioid reduction in cardiac surgery patients with sternotomy.
Methods: Twenty-six adult patients scheduled for cardiac surgery with sternotomy aged between 18 and 84 olds were included in this prospective, monocentric, open, single-group trial. Two parasternal multihole catheters were inserted on each side of the sternum before the surgical skin incision for cardiac surgery and 10 mL of ropivacaine 7.
Medicina (Kaunas)
December 2024
Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, 06230 Ankara, Turkey.
: This study aims to assess the postoperative outcomes and complications of sutureless and sutured aortic valve replacement in patients with infective endocarditis. : A total of 58 patients who underwent redo aortic valve replacement for bacterial or non-bacterial endocarditis between January 2018 and March 2023 were included in our study. Surgical procedures were performed through a full median sternotomy due to redo cases and to provide optimal access.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia.
This study was undertaken to determine the incidence and risk factors associated with the development of sternal wound infection in neonates after surgery for congenital heart disease. A case-control study was conducted to examine the influence of perioperative risk factors on the development of sternal infection. In total, 253 neonates with CHD underwent a complete median sternotomy.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg Cases
January 2025
Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
Patients with coronary artery disease undergoing trans-catheter aortic valve implantation (TAVI) often receive TAVI alone. However, in cases of severe coronary lesions or anticipated difficulty in coronary access post-TAVI, percutaneous coronary intervention or coronary artery bypass grafting may be necessary. We performed simultaneous gastroepiploic artery to posterior descending artery bypass and TAVI in two patients with severe calcification of the right coronary artery ostium which is unsuitable for percutaneous intervention.
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