RESUMEN
A 22-year-old man underwent palliative surgery for superior vena cava syndrome due to a benign obstructive process compatible with fibrosing mediastinitis. By using a spiral vein constructed from autologous saphenous vein, an innominate vein to the right atrial appendage shunt was created. This technique, which was first described experimentally in 1974 and performed clinically in 1976, may warrant more liberal application in patients with superior vena cava syndrome caused by malignant and benign diseases.
RESUMEN
Violent injury currently accounts for the majority of deaths among young people. Cardiac trauma is responsible for 15% of deaths from thoracic injury, and the incidence of cardiac injury in blunt chest trauma is as high as 76% in some clinical series. Many of these cardiac injuries consist of myocardial contusions. Recently, however, there has been increasing recognition of chamber disruption caused by blunt chest trauma. Cardiac injury is usually the result of direct compression of the heart between the sternum and the dorsal spine. These patients are frequently in extremis, with signs of pericardial tamponade, hypotension, and/or massive hemothorax. Successful management is dependent upon prompt diagnosis and surgical repair. To date there have been only 28 survivors (including the three patients in this report) of this catastrophic and frequently unrecognized injury.
Asunto(s)
Lesiones Cardíacas/etiología , Traumatismos Torácicos/complicaciones , Heridas no Penetrantes/complicaciones , Accidentes de Tránsito , Adulto , Atrios Cardíacos/lesiones , Atrios Cardíacos/cirugía , Lesiones Cardíacas/diagnóstico , Lesiones Cardíacas/cirugía , Humanos , Masculino , Mediastino/diagnóstico por imagen , RadiografíaRESUMEN
Thrombosis of the Björk-Shiley prosthesis has been a recognized problem for many years. Review of 172 patients at the University of Kentucky Medical Center who had one or more Björk-Shiley valves inserted between January, 1975, and July, 1980, revealed special problems in those patients with multiple prostheses. Diagnosis and therapy prove more difficult, and the cumulative incidence of thrombosis in the patients with multiple prostheses is 26.8% at six years. Projected long-term use of multiple Björk-Shiley prostheses is discouraged.
Asunto(s)
Prótesis Valvulares Cardíacas/efectos adversos , Trombosis/etiología , Válvula Aórtica/cirugía , Trastornos Cerebrovasculares/etiología , Femenino , Prótesis Valvulares Cardíacas/mortalidad , Hemorragia/etiología , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/cirugía , Complicaciones PosoperatoriasRESUMEN
A growing number of patients have prolonged survival after cardiac valve replacement. Longer life-spans increase the eventual risk of development of general surgical problems in these patients. Additionally, prosthetic dysfunction such as thrombosis, endocarditis, or dehiscence may lead to abdominal symptoms, systemic illness, or thromboembolic phenomena. a team approach, including the general surgeon, cardiologist, and thoracic surgeon, should be sought in the care of such patients.
Asunto(s)
Prótesis Valvulares Cardíacas/efectos adversos , Adulto , Anciano , Endocarditis/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Trombosis/etiología , Factores de TiempoRESUMEN
A patient with diabetes mellitus who sustained an iatrogenic perforation of the cervical esophagus subsequently had osteomyelitis of the cervical spine involving the bodies of C-6 and C-7. This occurred despite early and aggressive surgical treatment of the perforation. Roentgenograms of the cervical spine should be included in the follow-up of selected patients treated for perforation of the esophagus.
Asunto(s)
Esófago/lesiones , Osteomielitis/etiología , Vértebras Cervicales/diagnóstico por imagen , Complicaciones de la Diabetes , Endoscopía/efectos adversos , Femenino , Humanos , Enfermedad Iatrogénica , Persona de Mediana Edad , RadiografíaAsunto(s)
Estenosis Traqueal/congénito , Traqueotomía/métodos , Humanos , Lactante , Masculino , Estenosis Traqueal/cirugíaRESUMEN
A method employing an 8-F Fogarty balloon catheter to provide temporary occlusion of a pseudoaneurysm of the ascending aorta prior to surgery is presented. The technique of occlusion and its benefits are discussed.