RESUMEN
The recently introduced pumpless extracorporeal lung assist (PECLA) is a remarkable alternative to the conventional extracorporeal membrane oxygenation in case of severe lung failure. By establishing a shunt between femoral artery and vein using the arterio-venous pressure gradient as a driving force through a low-resistance membrane oxygenator, PECLA provides highly effective gas-exchange by preserved cardiac function. Due to its closed system, reduced priming volume and low heparin demand, the unfavourable effects of extracorporeal membrane oxygenation can be effectively diminished. Hence the small technical, financial and personal input, the PECLA can be ideally used in district hospitals and during transport as well. Our short summary demonstrates the advantages and safety of the system proven over 123 cases.
Asunto(s)
Derivación Arteriovenosa Quirúrgica , Oxigenación por Membrana Extracorpórea , Insuficiencia Respiratoria/terapia , Adulto , Anciano , Oxigenación por Membrana Extracorpórea/instrumentación , Oxigenación por Membrana Extracorpórea/métodos , Femenino , Arteria Femoral/cirugía , Vena Femoral/cirugía , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Respiratoria/etiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Percutaneous device closure of atrial septal defect (ASD) has merged as an alternative to traditional surgical closure. The authors are presenting the case of a 55-year-old female patient with chest complaints following Amplatzer occluder implantation for closure of secundum type ASD. She had been presented ambulatory at her cardiologist's office 3 days after the discharge from the hospital. Echocardiography revealed persisting ASD and displacement of the device. She had been referred to the Heart Institute of Pécs, where chest X-ray and CT examination were done. The dislocated occluder device was found wedged in the bifurcation of aorta and brachiocephalic trunk. Open heart surgery was indicated and the device was removed, after that the ASD was directly closed. The patient had been discharged in good health at the 5th postoperative day.
Asunto(s)
Aorta Torácica , Oclusión con Balón/efectos adversos , Oclusión con Balón/instrumentación , Migración de Cuerpo Extraño/diagnóstico , Migración de Cuerpo Extraño/etiología , Defectos del Tabique Interatrial/cirugía , Tronco Braquiocefálico , Procedimientos Quirúrgicos Cardíacos/métodos , Ecocardiografía , Femenino , Migración de Cuerpo Extraño/cirugía , Humanos , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
One of the rare reasons of the non malignant superior vena cava syndrome is the thrombosis of superior vena cava. Obstruction or occlusion of central veins is one of the many complications of the more and more frequently used central venous catheters and pacemaker electrodes. The authors report a case of superior vena cava thrombosis resulting in dialysis catheter insufficiency in case of a young, uraemic, female patient wit Tesio catheter and the surgical treatment of it with the use of cardiopulmonary bypass during the operation. Apropos of this case, the authors outline the causes of malignant, non-malignant and iatrogenic superior vena cava syndrome, furthermore the conservative, surgical and catheter therapy of the syndrome.
Asunto(s)
Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/instrumentación , Catéteres de Permanencia/efectos adversos , Diálisis Renal/instrumentación , Síndrome de la Vena Cava Superior/etiología , Síndrome de la Vena Cava Superior/terapia , Adulto , Falla de Equipo , Femenino , Humanos , Radiografía , Síndrome de la Vena Cava Superior/diagnóstico por imagen , Síndrome de la Vena Cava Superior/cirugía , Trombectomía , Terapia Trombolítica , Resultado del TratamientoRESUMEN
The recently introduced minimal extracorporeal circulation system is a remarkable alternative to the conventional heart-lung machine in several cardiosurgical indications. It consists of a centrifugal pump, an oxygenator, a tip-to-tip heparin coated line set and a modified cell saver application. Due to its closed blood-air interaction-free construction and reduced priming volume, the unfavourable effects of perfusion as haemodilution, inflammatory response, locoregional malperfusion, transfusion needs, can be effectively reduced. Our short summary demonstrates the advantages and safety of the system proven over 2000 cases. The potential applications are aortocoronary bypass operations with or without arrest, left heart bypass at thoracal aneurysms, "bridge to recovery" in heart failure or subsequent to reanimation, extracorporeal membrane oxygenation and many more.
Asunto(s)
Circulación Extracorporea , Animales , Anticoagulantes/uso terapéutico , Transfusión de Sangre Autóloga , Puente Cardiopulmonar , Circulación Extracorporea/instrumentación , Circulación Extracorporea/métodos , Hemodilución , Heparina/uso terapéutico , HumanosRESUMEN
Atrial fibrillation is the most frequent chronic arrhythmia, with significant cardiovascular morbidity and mortality risk. Poor remission rate with medical treatment and the outstanding efficacy of Cox-maze procedure inspired the less invasive intraoperative radiofrequency ablation therapy in patients undergoing open heart surgery. In June 2003 the first maze procedure in Hungary with the Medtronic Cardioblate surgical ablation system, with mitral and tricuspid valvuloplasty in a patient suffering from mitral and tricuspid insufficiency with paroxysmal atrial fibrillation, was performed in our institution. After 8 months the patient is in sinus rhythm and is free of complaints.