Filter by keywords:



Filtering documents. Please wait...

1/105. Revision hip arthroplasty in patients with a history of previous malignancy.

    BACKGROUND AND OBJECTIVES: The potential association between implants and malignancy has been discussed in the literature, but never as a cause of loosening of joint arthroplasty. methods: The records of all patients who underwent revision arthroplasty at our institution between 1992 and 1995 were reviewed. RESULTS: Among 93 patients who underwent revision hip arthroplasties, 11 (11.8%) had a history of previous malignancy. At surgery, in 2 of these patients, metastasis was found to be the cause of loosening in the affected hip. CONCLUSIONS: When revision hip arthroplasty is considered, patients with a history of malignancy require attenuated pre-, intra-, and postoperative workup. Management algorithm in such cases is proposed.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/105. Conservative management of a methicillin-resistant staphylococcus aureus (MRSA)-infected aortobifemoral graft: report of a case.

    A 63-year-old man was referred to our department for treatment of intermittent claudication in the right lower limb. The preoperative angiogram showed severe stenosis extending from the terminal aorta to the bilateral common femoral arteries, with occlusion of the right superficial femoral artery and the left popliteal artery. He underwent aortobifemoral bypass with thromboendarterectomy of the left common femoral artery, and right graft-popliteal artery bypass. The patient had an uneventful postoperative course; however, 14 days after the operation, a pulsatile mass suddenly appeared in the left groin. Emergency surgery revealed disruption of the left distal anastomosis of the aortobifemoral bypass and therefore, revision, in the form of graft-profunda femoris artery interposition with graft-superficial femoral artery bypass, was performed. Microscopic examination showed colonies of bacteria in the host artery adventitia adjacent to the anastomosis. culture of the discharge from the right groin operative scar revealed methicillin-resistant staphylococcus aureus (MRSA). The discharge resolved following the intravenous administration of vancomycin and the local application of vancomycin ointment. There were no operative complications other than the MRSA infection, and the patient was discharged 20 days after revision surgery. In the 14 months since the revision, all grafts have remained patent and there have been no further symptoms of graft infection.
- - - - - - - - - -
ranking = 4
keywords = operative
(Clic here for more details about this article)

3/105. Three ventriculoplasty techniques applied to three left-ventricular pseudoaneurysms in the same patient.

    A 59-year-old male patient underwent surgery for triple-vessel coronary artery disease and left-ventricular aneurysm in 1994. Four months after coronary artery bypass grafting and classical left-ventricular aneurysmectomy (with Teflon felt strips), a left-ventricular pseudoaneurysm developed due to infection, and this was treated surgically with an autologous glutaraldehyde-treated pericardium patch over which an omental pedicle graft was placed. Two months later, under emergent conditions, re-repair was performed with a diaphragmatic pericardial pedicle graft due to pseudoaneurysm reformation and rupture. A 3rd repair was required in a 3rd episode 8 months later. Sternocostal resection enabled implantation of the left pectoralis major muscle into the ventricular defect. Six months after the last surgical intervention, the patient died of cerebral malignancy. Pseudoaneurysm reformation, however, had not been observed. To our knowledge, our case is the 1st reported in the literature in which there have been 3 or more different operative techniques applied to 3 or more distinct episodes of pseudoaneurysm formation secondary to post-aneurysmectomy infection. We propose that pectoral muscle flaps be strongly considered as a material for re-repair of left-ventricular aneurysms.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

4/105. Recurrent endocarditis in silver-coated heart valve prosthesis.

    BACKGROUND AND AIM OF THE STUDY: In order to prevent prosthetic valve endocarditis (PVE), the implantation of a new silver-coated sewing ring has been introduced to provide peri- and postoperative protection against microbial infection. methods: A 56-year-old woman with aortic stenosis had elective replacement with a St. Jude Medical mechanical valve fitted with a silver-coated sewing ring (Silzone). The patient developed early PVE, which necessitated reoperation after one month. Despite a second Silzone prosthesis being implanted, the endocarditis recurred. During a third operation an aortic homograft was implanted, and after six months a fourth operation was performed for a pseudoaneurysm at the base of the homograft, in proximity to the anterior mitral valve leaflet. RESULTS: The diagnosis of PVE was confirmed by the presence of continuous fever, transesophageal echocardiography and growth of penicillin-resistant staphylococcus epidermidis from the valve prosthesis. CONCLUSION: The implantation of all prosthetic valves is encumbered with a risk of endocarditis. Although silver has bacteriostatic actions, the advantages of silver-coated prostheses in the treatment of this condition have yet to be assessed in clinical trials.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

5/105. infection of a knee prosthesis with Tsukamurella species.

    A 69-year-old woman with a history of multiple infections of a postoperative wound from a knee replacement was diagnosed with an infection with Tsukamurella sp. The infection was treated with a course of vancomycin and pipercillin/tazobactam, followed by a course of clarithromycin, ciprofloxacin, and ethambutol. The patient responded well. This represents the first report of a Tsukamurella infection of an artificial joint.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

6/105. Video-assisted tricuspid valve surgery: a new surgical option in endocarditis on pacemaker.

    A patient presenting with a pacemaker lead infection and tricuspid regurgitation underwent a minimally invasive video-assisted tricuspid valve replacement. The valve was approached through a right anterior mini thoracotomy. Under thoracoscopic vision and peripheral cardiopulmonary bypass, a catheter was placed on the ascending aorta for antegrade cardioplegia delivery. A transthoracic aortic cross-clamp was introduced through the third right intercostal space. tricuspid valve replacement added to the pacemaker leads ablation was exclusively performed under thoracoscopic vision, providing an excellent video-image in this reduced operative field. After 22 months of follow up, the patient is asymptomatic, the echocardiography showing a normally functioning valve.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

7/105. Postoperative inflammatory reactions of impregnated Dacron grafts.

    The clinical efficacy of Dacron grafts that are impregnated with collagen or gelatin has been well demonstrated, but inflammatory reactions during the first few postoperative weeks have been reported. We experienced two patients, an 87-year-old man with a reconstruction of an abdominal aorta and a 7-year-old boy with a reconstruction of aortic arch with a collagen-impregnated graft (Hemashield), who continued to demonstrate a high fever with a high serum level of c-reactive protein (CRP) and immunoglobin for more than 5 months. The body temperature, the white blood cell (WBC) counts, and the serum level of CRP were compared on the seventh and 14th postoperative day among the 37 patients who underwent a reconstruction of either a thoracic or abdominal aorta using the Hemashield graft (Hemashield group) and a nonimpregnated graft (control group) in our hospital. An elevation of body temperature above 38 degrees C was seen 29% of the patients in the Hemashield group and 0% in the control group. No significant differences were seen in the WBC counts, but the serum level of CRP was significantly higher on the 14th postoperative day in the Hemashield group. We should therefore pay careful attention to inflammatory reactions after the implantation of the impregnated grafts.
- - - - - - - - - -
ranking = 7
keywords = operative
(Clic here for more details about this article)

8/105. saphenous vein graft infection: a fatal complication of postoperative mediastinitis.

    infection and erosion of the saphenous vein graft with mediastinal hemorrhage is a rare but highly lethal complication of cardiac surgery. This is associated with a mortality rate of 50%. We present a patient who died during the postoperative period due to this complication.
- - - - - - - - - -
ranking = 5
keywords = operative
(Clic here for more details about this article)

9/105. Video-assisted endoscopic removal of infected endocardial pacemaker lead with large floating vegetation.

    The best management of pacemaker lead related endocarditis is complete surgical or percutaneous removal of the pacemaker system. Although the traditional surgical approach is via median sternotomy, we present two cases in which the lead and vegetations were removed using a video-assisted endoscopic technique through a limited right submammary incision. In each case the patient was supported by partial extracorporeal perfusion. Additional tricuspid valve repair and atrial septal defect closure was performed in one case. The postoperative courses were uneventful, illustrating that, when compared to the conventional open heart surgical approach, the less invasive approach can be a safe and effective way to remove an infected foreign body from the right heart with increased comfort, fast recovery, and a better cosmetic result.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

10/105. A prosthetic breast implant infected with mycobacterium fortuitum.

    Augmentation mammaplasty is a common operation performed in the united states. Postoperative wound infections are rare, but can be devastating. Most often, bacteria from the normal skin flora cause these infections, but more atypical organisms can lead to similar situations. The authors present a case of a prosthetic breast implant infected with mycobacterium fortuitum after augmentation mammaplasty. The patient, diagnosis, and treatment are discussed so that others may recognize and treat this entity successfully before encountering major complications. Although it is an infrequent occurrence, plastic surgeons, infectious disease specialists, and primary care doctors who may see postoperative wound infections should be aware of this potential pathogen. It is important in any postimplant infection and especially crucial in cases of unresolving or recurrent infections with unusual or even clear drainage. With proper identification through acid-fast smear and culture, multiagent therapy can be initiated early. Additional complications, including implant removal, may thus be avoided.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Prosthesis-Related Infections'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.