Asunto(s)
Fibrosis Retroperitoneal , Trombosis de la Vena , Abdomen , Humanos , Fibrosis Retroperitoneal/complicaciones , Fibrosis Retroperitoneal/diagnóstico por imagen , Fibrosis Retroperitoneal/cirugía , Vena Cava Inferior/diagnóstico por imagen , Vena Cava Inferior/cirugía , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/etiología , Trombosis de la Vena/cirugíaAsunto(s)
Estenosis de la Válvula Aórtica , Bioprótesis , Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/cirugía , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos , Diseño de Prótesis , Resultado del TratamientoAsunto(s)
Procedimientos Endovasculares , Isquemia Mesentérica , Oclusión Vascular Mesentérica , Enfermedad Crónica , Humanos , Isquemia/cirugía , Isquemia Mesentérica/cirugía , Oclusión Vascular Mesentérica/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Procedimientos Quirúrgicos VascularesRESUMEN
Abstract Introduction: In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery bypass grafting (CABG). Methods: This single-center, retrospective study included a total of 40 patients with a previous CABG who were admitted to our emergency unit for any reason and underwent a contrast-enhanced chest computed tomography (patient group) and 40 patients without previous cardiac surgery (control group) between January 2018 and November 2019. The retrosternal area was compared between the groups using the statistical shape analysis method. The distance between the sternum and the ascending aorta and pulmonary artery was measured and anatomical deformations of the retrosternal area were examined. Results: There was a statistically significant difference in the anatomical structures of the retrosternal area between the patient and control groups (P<0.001). The distance from the midsternal line to the highest point of the pulmonary artery was statistically significantly shorter in the patient group, compared to the control group (P=0.013). The distance from the sternum to the ascending aorta was also shorter in the patient group, although it did not reach statistical significance (P>0.05). Conclusions: Our study results showed narrowing of the retrosternal area following CABG and a shorter distance from the sternum to the pulmonary artery than the ascending aorta. Based on these findings, surgeons should be cautious about possible injuries in patients requiring cardiac surgery with repeated median sternotomy.
Asunto(s)
Humanos , Puente de Arteria Coronaria/efectos adversos , Esternotomía/efectos adversos , Reoperación , Esternón/cirugía , Esternón/diagnóstico por imagen , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
INTRODUCTION: In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery bypass grafting (CABG). METHODS: This single-center, retrospective study included a total of 40 patients with a previous CABG who were admitted to our emergency unit for any reason and underwent a contrast-enhanced chest computed tomography (patient group) and 40 patients without previous cardiac surgery (control group) between January 2018 and November 2019. The retrosternal area was compared between the groups using the statistical shape analysis method. The distance between the sternum and the ascending aorta and pulmonary artery was measured and anatomical deformations of the retrosternal area were examined. RESULTS: There was a statistically significant difference in the anatomical structures of the retrosternal area between the patient and control groups (P<0.001). The distance from the midsternal line to the highest point of the pulmonary artery was statistically significantly shorter in the patient group, compared to the control group (P=0.013). The distance from the sternum to the ascending aorta was also shorter in the patient group, although it did not reach statistical significance (P>0.05). CONCLUSIONS: Our study results showed narrowing of the retrosternal area following CABG and a shorter distance from the sternum to the pulmonary artery than the ascending aorta. Based on these findings, surgeons should be cautious about possible injuries in patients requiring cardiac surgery with repeated median sternotomy.
Asunto(s)
Puente de Arteria Coronaria , Esternotomía , Puente de Arteria Coronaria/efectos adversos , Humanos , Reoperación , Estudios Retrospectivos , Esternotomía/efectos adversos , Esternón/diagnóstico por imagen , Esternón/cirugía , Resultado del TratamientoAsunto(s)
Trombosis , Várices , Cianoacrilatos , Humanos , Incidencia , Factores de Riesgo , Vena Safena , Trombosis/diagnóstico por imagen , Trombosis/etiologíaAsunto(s)
Enfermedad , Vena Ilíaca , Constricción Patológica , Humanos , Vena Ilíaca/diagnóstico por imagen , Rayos Láser , Pacientes , Vena Safena , StentsRESUMEN
Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.
Asunto(s)
Aneurisma Roto/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Arteria Femoral/diagnóstico por imagen , Anciano , Aneurisma Roto/cirugía , Arteria Femoral/cirugía , Oclusión de Injerto Vascular , Humanos , Ligadura , Masculino , Valor Predictivo de las Pruebas , Resultado del TratamientoRESUMEN
OBJECTIVE: To compare the anatomical and physiological scoring systems and the outcomes of surgical management of penetrating cardiovascular trauma at a rural center. METHODS: Seventy-seven patients underwent emergency surgery at our center between January/2012 and October/2018 due to penetrating cardiovascular trauma. Injury Severity Score (ISS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS) were calculated. The validation of these risk scores to predict mortality was assessed by the area under the receiver operating characteristic curve analysis. RESULTS: All trauma scores were correlated with mortality. As ISS, NISS, and TRISS values increased and RTS values decreased, the mortality rate increased. The area under the curve (AUC) in the receiver operating characteristic curve analysis was 0.943 for TRISS, 0.915 for RTS, 0.890 for ISS, and 0.896 for NISS (P<0.001 for each). Logistic regression analysis revealed that scores were correlated with mortality (P<0.001 for each). By investigating cardiac injuries alone, only TRISS and RTS results correlated with mortality for cardiac injuries (Mann-Whitney U test, P=0.003 and P=0.01, respectively). The AUC was only statistically significant for TRISS and RTS (AUC=0.929, P<0.05 for both). For vascular injuries, all the scores were significantly correlated with in-hospital mortality (Mann-Whitney U test, P<0.001 for each). TRISS had the highest AUC (AUC=0.946, P<0.001). CONCLUSION: TRISS has the highest predictivity for in-hospital mortality in patients with penetrating cardiovascular trauma.