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He J, Guliyeva G, Wu P, Qing L, Yu F, Tang J. Reconstruction of Large Soft Tissue Defects in the Distal Lower Extremity: Free Chain-Linked Bilateral Anterolateral Thigh Perforator Flaps versus Extended Latissimus Dorsi Musculocutaneous Flaps. J Pers Med 2022; 12. [PMID: 36143185 DOI: 10.3390/jpm12091400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Reconstruction of the large soft-tissue defects in the lower extremity still constitutes a challenge for plastic surgeons. This retrospective study was conducted to compare the surgical and clinical outcomes of the chain-linked bilateral anterolateral thigh perforator flaps and extended latissimus dorsi musculocutaneous flap in the reconstruction of the large soft tissue defects of the lower extremity. Methods: From January 2012 to December 2021, 34 patients aged between 20 and 66 years received chain-linked bilateral anterolateral thigh perforator flaps (15 cases) or extended latissimus dorsi musculocutaneous flaps (19 cases) for the reconstruction of extensive soft-tissue defects in the lower extremity. The two groups were homogeneous in terms of age, etiology, comorbidities, and flap area. In addition, the intraoperative data, outcomes, complications, and long-term follow-up results were collected and analyzed. Results: The extended latissimus dorsi musculocutaneous flap group had a shorter operation time (271.8 ± 59.5 min vs. 429.6 ± 51.9 min), harvest time (58.9 ± 24.8 min vs. 152.7 ± 41.4 min), and anastomosis time (27.2 ± 10.4 min vs. 53.7 ± 8.1 min) than the chain-linked bilateral anterolateral thigh perforator flaps group (p < 0.05). Based on patient self-assessment, the donor site temporary muscle weakness in the extended latissimus dorsi musculocutaneous flap group was significantly more than that in the chain-linked bilateral anterolateral thigh perforator flaps group (p < 0.05). Conclusion: Both methods can repair large defects and restore the function of the injured limbs at a single stage. However, considering the operation time and flap-harvesting time, the authors recommend the extended latissimus dorsi musculocutaneous flap, especially for those who cannot tolerate a prolonged surgery.
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Petrides GA, Hicks G, Dunn M, Froggatt C, Wallace C, Howes D, Leinkram D, Low THH, Ch'ng S, Wykes J, Palme CE, Clark JR. Dentoalveolar outcomes in maxillary reconstruction: A retrospective review of 85 maxillectomy reconstructions. ANZ J Surg 2021; 91:1472-1479. [PMID: 34124825 DOI: 10.1111/ans.17001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/23/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although microvascular free flaps are often used to reconstruct maxillary defects, dentoalveolar rehabilitation is arguably less common despite its importance to midface function and aesthetics. The aim of this study is to review the contemporary management of maxillary defects in a single quaternary referral institution to identify factors that assist or impede dentoalveolar rehabilitation. METHODS A retrospective review of maxillary reconstructions performed between February 2017 and December 2020 was performed. Patient characteristics, defect classification, operative techniques, complications and dentoalveolar outcomes were recorded. RESULTS A total of 85 maxillary reconstructions were performed in 73 patients. Of the 64 patients where dental rehabilitation was required, 31 received a functional denture (48%) with 24 (38%) being implant-retained. Significant predictors of successful rehabilitation included the use of virtual surgical planning (VSP; 86% vs. 25%, p < 0.001), preoperative prosthodontic assessment (82% vs. 21%, p < 0.001), prefabrication (100% vs. 40%, p = 0.002) and use of the zygomatic implant perforator flap technique (100% vs. 39%, p = 0.001). Preoperative prosthodontic consultation was associated with 21-fold increase in the odds of rehabilitation (odds ratio 20.9, 95% confidence interval 6.54-66.66, p < 0.005). CONCLUSION Preoperative prosthodontic evaluation, VSP and reconstructive techniques developed to facilitate implant placement are associated with increased dental rehabilitation rates. Despite using an institutional algorithm, functional dentures are frequently prevented by factors including soft tissue constraints, disease recurrence and patient motivation.
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Affiliation(s)
- George A Petrides
- Faculty of Medicine and Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Gabrielle Hicks
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Catriona Froggatt
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Christine Wallace
- Department of Oral Restorative Sciences, Westmead Centre for Oral Health, NSW Health, Sydney, New South Wales, Australia
| | - Dale Howes
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - David Leinkram
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Tsu-Hui Hubert Low
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sydney Ch'ng
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.,Department of Plastic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - James Wykes
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Carsten E Palme
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jonathan R Clark
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia
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Filippone G, Calia C, Finazzo M, Fazzari F, Caruana G, Argano V. Modified Danielson Technique for Prosthetic Aortic Valve Endocarditis and Aortoventricular Discontinuity. Tex Heart Inst J 2020; 47:117-120. [PMID: 32603453 DOI: 10.14503/thij-17-6506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Endocarditis is a devastating complication of prosthetic aortic valve replacement. The infective process can destroy aortic annulus tissue, making conventional surgical valve replacement difficult or impossible and causing aortoventricular discontinuity. Several treatment techniques have been proposed. One of these, the Danielson technique, involves translocating the aortic valve to the native ascending aorta, débriding the abscess cavity, closing the coronary ostia, and bypassing the coronary arteries with a Y anastomosis between 2 vein grafts. We describe our use of a modified Danielson technique in a 68-year-old man with advanced prosthetic valve endocarditis that was associated with aortic annulus destruction and aortoventricular discontinuity. This modified technique enables safer, more secure anchoring of a replacement valve, reduces the risks and concerns associated with bypass grafts, and successfully treats aortoventricular discontinuity.
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Affiliation(s)
| | - Claudia Calia
- Division of Cardiac Surgery, University of Palermo, 90127 Palermo, Italy
| | - Mario Finazzo
- Division of Radiology, University of Palermo, 90127 Palermo, Italy
| | - Fabio Fazzari
- Division of Cardiology, University of Palermo, 90127 Palermo, Italy
| | - Giovanni Caruana
- Division of Radiology, University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Argano
- Division of Cardiac Surgery, University of Palermo, 90127 Palermo, Italy
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ZHAO X, DAI Y, YUE X. [Application of modified vermillion flap and orbicularoris oris bundle anastomosis in repair of transverse facial cleft]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2019; 48:499-503. [PMID: 31901023 PMCID: PMC8800682 DOI: 10.3785/j.issn.1008-9292.2019.10.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/08/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To improve the method of vermillion flap and orbicularis oris bundle anastomosis in repair of transverse facial cleft. METHODS Based on the precise fixed point, the modified vermillion flap was designed slender at the new corner of the upper lip, and was inserted into the lower lip after removing part tissue. The orbicularis oris was divided into two bands and cross-stitched. RESULTS Fifteen patients with unilateral transverse facial cleft form the Children's Hospital of Zhejiang University during September 2016 and December 2018 were operated, and the position and shape of the commissure were almost normal. CONCLUSIONS The cosmetic effect and oral function are satisfactory when the modified vermillion flap and bundle anastomosis of orbicularis oris is used to repair transverse facial cleft.
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Affiliation(s)
- Xiong ZHAO
- ZHAO Xiong, E-mail:
,
https://orcid.org/0000-0003-2118-7778
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Abstract
Effective obliteration of dead space after reconstructive surgery facilitates a good cosmetic outcome and prevention of delayed wound healing and recurrent infection.We evaluated the efficacy of a keystone-designed buried de-epithelialized (KBD) flap for the obliteration of small to moderately sized surgical dead spaces.We reviewed the medical records of patients who received a KBD flap following removal of a mass or debridement of necrotic tissue from September 2015 to February 2016. The diagnosis, site, dead space dimensions, flap width, drain data, complications, and follow-up duration were recorded.Twenty-eight KBD flaps were evaluated, including 9 cases of fat necrosis, 7 cases of epidermal cyst, and 12 cases of lipoma. Dead space dimensions ranged from 2 × 1.5 × 1 cm to 10 × 5 × 3 cm, with a mean depth of 2.01 cm. Flap sizes ranged from 2.5 × 1 cm to 11 × 3 cm, with a mean flap width of 2.01 cm. No postoperative complications, such as seroma or hematoma, occurred. The cosmetic results were favorable, and all patients were satisfied with their final outcomes.The KBD flap is useful for the obliteration of small to moderately sized surgical dead spaces both spatially and physiologically and shows excellent cosmetic outcomes.
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Affiliation(s)
- Hoon Kim
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, University of Konyang College of Medicine, Myunggok Medical Research Center, Daejeon
| | - Wan Cheol Ryu
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, University of Konyang College of Medicine, Myunggok Medical Research Center, Daejeon
| | - Chi Sun Yoon
- Department of Plastic and Reconstructive Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyu Nam Kim
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, University of Konyang College of Medicine, Myunggok Medical Research Center, Daejeon
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Krivoshchekov EV, Ackerman JP, Yanulevich OS, Sokolov AA, Ershova NV, Dearani JA, Cetta F. Modified Cone Reconstruction of the Tricuspid Valve for Ebstein Anomaly as Performed in Siberia. Tex Heart Inst J 2017; 44:39-42. [PMID: 28265211 DOI: 10.14503/thij-16-5832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The cone reconstruction technique, first described by da Silva and modified by Dearani and by others, has become the repair method of choice in patients with Ebstein anomaly of the tricuspid valve. This report details the outcome of the modified cone reconstruction technique in 6 children who underwent surgical correction of Ebstein anomaly at the Tomsk Institute of Cardiology in Siberia. From 2012 through 2015, 4 boys and 2 girls (age range, 11 mo-12 yr) underwent surgery to correct Ebstein anomaly. All had presented with cyanosis, exertional dyspnea, fatigue, or new-onset atrial arrhythmia, and none had undergone previous cardiac surgery. All survived the operation. One patient needed tricuspid valve replacement with a bioprosthesis after early breakdown of the cone reconstruction. As of December 2016, all the patients had no symptoms, tricuspid stenosis, or arrhythmia. This series indicates that cone reconstruction-the most anatomic repair technique for the dysmorphic Ebstein tricuspid valve-can be successfully performed in pediatric heart centers with a large experience.
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Lieberson RE, Eckermann J, Meyer W, Trang T. An Automated, Gravity-driven CSF Drainage System Decreases Complications and Lowers Costs. Cureus 2017; 9:e1009. [PMID: 28331772 PMCID: PMC5338987 DOI: 10.7759/cureus.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND FlowSafeTM (BeckerSmith Medical, Irvine, CA, USA) is a novel, robotic, external lumbar drainage (ELD) system, which was designed to control cerebrospinal fluid (CSF) drainage, reduce complications, and decrease treatment costs. METHODS Forty-seven consecutive neurosurgical patients requiring ELD were treated using the FlowSafe system. RESULTS In 39 of 40 patients with traumatic and surgical dural openings, potential CSF leaks were avoided. In seven patients with suspected normal pressure hydrocephalus, post-infectious ventriculomegaly, or pseudotumor cerebrum, we were able to assess the likelihood of improvement with shunting. The system, therefore, produced what we considered to be the "desired result" in 46 of 47 patients (98%). Our one treatment failure (2%) involved a patient with unrecognized hydrocephalus who, following a Chiari repair with a dural patch graft, was drained for six days. A persistent CSF leak eventually required a reoperation. Two patients (4%) described low-pressure headaches during treatment. Both responded to temporarily suspending or reducing the drainage rate. We saw no complications. Required nursing interventions were minimal. Conclusions: The FlowSafe system was safe and effective. In our experience, there were fewer complications compared to currently available ELD systems. The FlowSafe was well tolerated by our patients. The near elimination of nursing interventions should allow lumbar drainage to be delivered in less costly, non-intensive care unit settings. Larger trials will be needed.
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Affiliation(s)
- Robert E Lieberson
- Department of Neurosurgery and Kern NeuroScience Institute, Kern Medical Center
| | - Jan Eckermann
- Department of Neurosurgery and Kern NeuroScience Institute, Kern Medical Center
| | - William Meyer
- Department of Neurosurgery and Kern NeuroScience Institute, Kern Medical Center
| | - Tung Trang
- Department of Otolaryngology, Kern Medical Center
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Clement RGE, Ray AG, MacDonald DJ, Wade FA, Burnett R, Moran M. Trabecular Metal Use in Paprosky Type 2 and 3 Acetabular Defects: 5-Year Follow-Up. J Arthroplasty 2016; 31:863-7. [PMID: 26711861 DOI: 10.1016/j.arth.2015.10.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/12/2015] [Accepted: 10/23/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The reconstructive challenge of achieving a stable acetabulum in revision total hip arthroplasties in the presence of major osteolytic lesions has led to debate about the most appropriate surgical strategy to minimize implant-related failures. Trabecular metal (TM) implants have become popular but ongoing surveillance of their performance is required. METHODS We reviewed the clinical and radiological outcome of a consecutive series of 52 patients (55 hips) who had undergone revision total hip arthroplasty for Paprosky type 2 or 3 acetabular defects with TM revision acetabular shells between 2002 and 2008. RESULTS Four implant failures occurred (2 infections and 2 dislocations). Eleven patients from this cohort died (representing 12 hips) before the 5-year follow-up period giving us a follow-up of 78.2%. Implant survival at 5 years was 92% (95% confidence interval: 80.2%-96.9%). There were no cases of radiological loosening. The mean Oxford hip score was 34 (range, 5-48) at a mean follow-up of 63 months (range, 34-105 months). CONCLUSIONS We conclude that the use of TM revision shells for complex acetabular reconstruction yields satisfactory results.
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Affiliation(s)
- Rhys G E Clement
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Andrew G Ray
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Deborah J MacDonald
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Frazer A Wade
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Richard Burnett
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Matthew Moran
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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Abstract
Primary chondromyxoid fibroma is a benign bone tumor. Its localization in the sternum is quite rare; we found only 6 relevant reports. We report our diagnosis and treatment of a chondromyxoid fibroma in the sternum of a 63-year-old woman. The patient underwent subtotal sternectomy and chest-wall reconstruction with use of a titanium rib bridge system and Prolene mesh. The patient's clinical course was uneventful, and she had no local recurrence 41 months postoperatively. Our review herein of the 6 previous cases reveals that our patient is the oldest thus far to have been diagnosed with a sternal chondromyxoid fibroma.
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Jiang WJ, Cui YC, Li JH, Zhang XH, Ding HH, Lai YQ, Zhang HJ. Is autologous or heterologous pericardium better for valvuloplasty? A comparative study of calcification propensity. Tex Heart Inst J 2015; 42:202-8. [PMID: 26175630 DOI: 10.14503/thij-14-4296] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium. We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at 4 months in group C, and at 6 months in group D. Each collected sample was divided into 2 parts, one for calcium-content measurement by means of atomic-absorption spectroscopy, and one for morphologic and histopathologic examinations. When compared with the autologous pericardium, calcium levels in the heterologous pericardium were higher in groups B, C, and D (P <0.0001, P <0.0002, and P <0.0006, respectively). As embedding time increased, calcium levels in the heterologous pericardium increased faster than those in the autologous, especially in group D. Disorganized arrangements of collagenous fibers, marked calculus, and ossification were seen in the heterologous pericardium. Inflammatory cells-mainly lymphocytes and small numbers of macrophages-infiltrated the heterologous pericardium. The autologous pericardium showed a stronger ability to resist calcification. Our results indicate that autologous pericardium might be a relatively better choice for valvuloplasty.
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Song MG, Yang HS, Choi JB, Shin JK, Chee HK, Kim JS. Aortic valve reconstruction with use of pericardial leaflets in adults with bicuspid aortic valve disease: early and midterm outcomes. Tex Heart Inst J 2015; 41:585-91. [PMID: 25593520 DOI: 10.14503/thij-13-3619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In this study, we retrospectively analyzed the outcomes of adults with bicuspid aortic valve (BAV) disease who underwent aortic valve reconstructive surgery (AVRS), consisting of replacement of the diseased BAV with 2 or 3 pericardial leaflets plus fixation of the sinotubular junction for accurate and constant leaflet coaptation. From December 2007 through April 2013, 135 consecutive patients (mean age, 49.2 ± 13.1 yr; 73.3% men) with symptomatic BAV disease underwent AVRS. Raphe was observed in 84 patients (62.2%), and the remaining 51 patients had pure BAV without raphe. A total of 122 patients (90.4%) underwent 3-leaflet reconstruction, and 13 (9.6%) underwent 2-leaflet reconstruction. Concomitant aortic wrapping with an artificial graft was performed in 63 patients (46.7%). There were no in-hospital deaths and 2 late deaths (1.5%); 6 patients (4.4%) needed valve-related reoperation. The 5-year cumulative survival rate was 98% ± 1.5%, and freedom from valve-related reoperation at 5 years was 92.7% ± 3.6%. In the last available echocardiograms, aortic regurgitation was absent or trivial in 116 patients (85.9%), mild in 16 (11.9%), moderate in 2 (1.5%), and severe in one (0.7%). The mean aortic valve gradient was 10.2 ± 4.5 mmHg, and the mean aortic valve orifice area index was 1.3 ± 0.3 cm(2)/m(2). The 3-leaflet technique resulted in lower valve gradients and greater valve areas than did the 2-leaflet technique. Thus, in patients with BAV, AVRS yielded satisfactory early and midterm results with low mortality rates and low reoperation risk after the initial procedure.
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Kaya SO, Sevinc S, Ceylan KC, Usluer O, Unsal S. One-stoma carinoplasty: right upper sleeve lobectomy with hemicarinectomy for resection of right-tracheobronchial-angle tumors. Tex Heart Inst J 2013; 40:435-438. [PMID: 24082374 PMCID: PMC3783130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Tracheobronchial-angle tumors involve the right main bronchus, the right upper lobar bronchus, and the lateral wall of the lower trachea. Resecting these tumors is one of the most complex procedures in thoracic surgery. In cases of high-caliber mismatch, the selection of a suitable anastomotic technique can be challenging. We found that our use of a one-stoma carinoplasty technique overcame high-caliber mismatch after the resection of these tumors. From 2009 through 2012, 8 men (mean age, 59 ± 6.2 yr; range, 46-66 yr) underwent complete resection of non-small-cell right-tracheobronchial-angle tumors at our institution. In every case, right upper sleeve lobectomy, wedge carinal resection, and one-stoma carinoplasty were applied. After tumor resection, one patient with hemoptysis and bronchopleural fistula underwent a completion pneumonectomy and died 10 days postoperatively. Bronchoscopy was necessary in 2 patients who had atelectasis in the contralateral lung. At a mean follow-up duration of 19.43 ± 8.4 months (range, 0.2-27.1 mo), 6 patients were alive and free of disease. We conclude that our one-stoma carinoplasty technique enables the resection of tumors at the right tracheobronchial angle, with acceptable morbidity and mortality rates. This method saves the unaffected part of the ipsilateral lung and can overcome high-caliber mismatch. Because of these and other advantages, we suggest that using our method first might preclude having to perform a right carinal sleeve pneumonectomy or using Barclay's method.
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Affiliation(s)
- Seyda Ors Kaya
- General Thoracic Surgery Clinic, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Investigation Hospital, 35360 Izmir, Turkey
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David TE. Cusp repair in aortic valve procedures: advanced techniques. Tex Heart Inst J 2013; 40:547-548. [PMID: 24391316 PMCID: PMC3853832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Tirone E David
- Division of Cardiovascular Surgery of Toronto General Hospital, Peter Munk Cardiac Centre and the University of Toronto, Toronto, Ontario M5G 2C4, Canada
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Levart TK, Klokocovnik T. Mid-aortic syndrome in a 3-year-old girl successfully treated by aorto-aortic grafting and renal artery implantation into the graft. Tex Heart Inst J 2012; 39:657-661. [PMID: 23109761 PMCID: PMC3461691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mid-aortic syndrome, an uncommon acquired or congenital condition characterized by segmental narrowing of the abdominal or distal descending thoracic aorta, is frequently accompanied by ostial stenosis of the aorta's branches. If left untreated, it can result in life-threatening complications secondary to severe hypertension.We report the case of a 3-year-old girl with congenital mid-aortic syndrome, who was diagnosed by chance in the course of a viral illness, and whose high blood pressure values were first dismissed as inaccurate. Attempts to achieve medical or endovascular control of her hypertension were unsuccessful. She was thereafter successfully treated by aorto-aortic bypass grafting, resection of the stenotic segments of both renal arteries, and implantation of the patent arterial segments into the graft.
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Affiliation(s)
- Tanja Kersnik Levart
- Departments of Pediatric Nephrology, University Medical Centre Ljubljana, 1525 Ljubljana, Slovenia
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Popa BA, Diena M, Cerin G, Lanzillo G, Tesler UF. Severe post-ischemic elongation of the anterior papillary muscle: an unusual cause of mitral insufficiency in a 75-year-old man. Tex Heart Inst J 2007; 34:222-4. [PMID: 17622374 PMCID: PMC1894715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
As a complication of myocardial ischemia, severe elongation of the anterior papillary muscle with resultant mitral valve insufficiency is a rare clinical finding. Using echocardiography, we accurately diagnosed this condition in a 75-year-old man. The patient underwent successful plication of the elongated anterior papillary muscle and the implantation of polytetrafluoroethylene neochordae tendineae.
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Affiliation(s)
- Bogdan Adrian Popa
- Department of Cardiology, Policlinico di Monza, Presidio San Gaudenzio, 28100 Novara, Italy
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