1/66. Repair of coarctation of the aorta with simultaneous coronary artery bypass grafting without cardiopulmonary bypass.The article describes the management of aortic coarctation associated with coronary artery disease by a one stage surgical procedure without cardiopulmonary bypass in a 44-year-old woman. The vascular prosthesis was anastomosed end-to-end to the descending aorta and a venous bypass was subsequently formed between circumflex coronary artery and the anastomosed vascular prosthesis. There were no postoperative complications.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/66. Highly effective compensatory mechanisms in a 76-year-old man with a coarctation of the aorta.We present a man who was diagnosed with coarctation of the aorta (CA) at the age of 76. He had developed an extensive collateral circulation for maintaining the circulation below the CA. This compensatory mechanism was highly effective, since the patient had remained asymptomatic and in good health during most of his life. He died from intrahospitalary pneumonia, unrelated to CA. Long-term survival in patients with untreated CA is exceptional, with only 11 patients living into their 70s being previously reported. A review of these cases is included.- - - - - - - - - - ranking = 0.17912265574313keywords = circulation (Clic here for more details about this article) |
3/66. Considerations in biventricular repair after the Norwood procedure.OBJECTIVE: The Norwood procedure can be applicable as a first stage palliation in children who can eventually undergo a biventricular repair. Although usual management of these patients is a primary neonatal repair, in selected patients staged approach with a Norwood procedure in the neonatal period followed by a Rastelli procedure in the infancy for conversion to two-ventricle physiology has been used alternatively. methods: We report our experiences on two infants who underwent a previous palliation with the Norwood procedure for lesions other than hypoplastic left heart syndrome and converted to two-ventricle physiology by the use of a Rastelli-type procedure. This report examines considerations in biventricular repair after the Norwood procedure especially need for ventricular septal defect enlargement and approach to placement of the right ventricle to pulmonary artery conduit. RESULTS: Both of the infants who underwent staged approach with an initial Norwood procedure for lesions other than hypoplastic left heart syndrome survived the operations and were clinically well at mid-term follow-up. CONCLUSION: In selected patients, the staged approach is an alternative in management of malformations other than hypoplastic left heart syndrome which share the important physiologic features of aortic outlet obstruction and ductal dependency of systemic circulation. We recommend routine enlargement of ventricular septal defect and proper positioning of the conduit at the time of subsequent biventricular repair.- - - - - - - - - - ranking = 0.089561327871566keywords = circulation (Clic here for more details about this article) |
4/66. Coarctation of the aorta, aortic valvar stenosis, and supravalvar aortic stenosis with left coronary artery ostial stenosis: management using a staged hybrid approach.In this report, we describe a case of coarctation of the aorta, congenital aortic stenosis with bicuspid valve, and supravalvar aortic stenosis with left coronary artery ostial stenosis. The child underwent staged treatment using a hybrid approach employing both surgical and interventional cardiology methods. A single pericardial patch repair technique for supravalvar aortic stenosis associated with left coronary ostial stenosis is also described.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
5/66. Precoronary stenosis after stage I palliation for hypoplastic left heart syndrome.We report a patient with stenosis of the native ascending aorta after palliation of hypoplastic left heart syndrome and aortic atresia. We describe the approach to diagnosis, temporary support with extracorporeal membrane oxygenation, and successful surgical reintervention. Stenosis of the native ascending aorta is an important, potentially reversible cause of acute, early postoperative ventricular dysfunction.- - - - - - - - - - ranking = 0.66666666666667keywords = coronary (Clic here for more details about this article) |
6/66. Hybrid management of coronary artery disease and coarctation of aorta.The treatment of coarctation of aorta with an additional cardiac lesion in adults remains a difficult surgical challenge. We present here an alternative, two-stage, hybrid approach that combined stent repair of aortic coarctation followed by coronary artery bypass operation in an adult with critical coronary lesions and a poor ventricle. This method may be a potentially useful strategy in reducing the comorbidity of operation to both lesions.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
7/66. lung cancer resection or aortic graft replacement with simultaneous myocardial revascularization without cardiopulmonary bypass.BACKGROUND: The concomitant occurrence of lung cancer or other thoracic problems requiring surgical treatment in patients with significant coronary artery disease is uncommon. methods: Three patients underwent revascularization of the anterior descending artery, without cardiopulmonary bypass, with simultaneous pulmonary lobectomy (two patients) or replacement of an obstructed descending aortic graft (one patient). RESULTS: Postoperative ventilation time was < 3 h, and no morbidity related to the combined procedure occurred during midterm follow-up. CONCLUSIONS: This one-stage approach allowed the immediate solution of two intrathoracic comorbidities, reducing expenses and suffering to the patients and minimizing the risk of bleeding or tumor dissemination secondary to extracorporeal circulation-induced coagulopathy and immunosuppression.- - - - - - - - - - ranking = 0.25622799453823keywords = coronary, circulation (Clic here for more details about this article) |
8/66. Extensive spinal epidural hematoma: a rare complication of aortic coarctation.Development of collateral circulation belongs among the typical signs of aortic coarctation. Cerebral or spinal artery aneurysm formation with increased risk of subarachnoid hemorrhage represent the most common neurovascular complication of this disease. We report a case of a 20-year-old sportsman who developed acute non-traumatic paraplegia as a result of extensive spinal epidural hemorrhage from collateral vessels accompanying aortic coarctation which was unrecognized up to that time. To the best of our knowledge, acute spinal epidural hematoma as a complication of aortic coarctation has not been previously reported.- - - - - - - - - - ranking = 0.089561327871566keywords = circulation (Clic here for more details about this article) |
9/66. Anomalous origin of left coronary artery from the right pulmonary artery in association with type III aortopulmonary window and interrupted aortic arch.Anomalous origin of the left coronary artery from the pulmonary artery, also known as Garland-Bland-White syndrome, usually occurs as an isolated condition. We report an infant with caudal regression sequence diagnosed with interrupted aortic arch type B and type III aortopulmonary window, who was found to have anomalous origin of the left coronary artery from the right pulmonary artery at surgical repair. Successful repair of the aortopulmonary window and interruption was performed with reimplantation of the left coronary artery into the ascending aorta. This report highlights the importance of closely assessing the coronary ostia in patients undergoing complex aortopulmonary window repair.- - - - - - - - - - ranking = 1.3333333333333keywords = coronary (Clic here for more details about this article) |
10/66. Hypothermic circulatory arrest for the surgical treatment of complicated adult coarctation of the aorta.OBJECTIVES: This study was designed to evaluate the surgical treatment of recurrent coarctation by a new technique. BACKGROUND: Recurrent coarctation either from aneurysm or recurrent constriction is a difficult problem in the adult because of the possible interruption of important collateral circulation. methods: We reviewed four patients who underwent recurrent coarctation surgery with the use of deep hypothermic circulatory arrest (HCA). RESULTS: All four patients survived. Deep HCA facilitated precise surgical resection and there was no postoperative paraplegia, stroke, or myocardial infarction. CONCLUSIONS: Deep HCA and resection and grafting of the coarctation is indicated for complicated adult coarctations, particularly when the collateral circulation is in doubt.- - - - - - - - - - ranking = 0.17912265574313keywords = circulation (Clic here for more details about this article) |
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