A patient who underwent previous implantation of a mitral valve replacement with a Björk-Shiley Delrin (BSD) mitral valve prosthesis during infancy was admitted to our institution 43 years later ...after an episode of syncope and cardiac arrest. Under extreme hemodynamic instability, a mitral valve prosthetic dysfunction causing massive mitral regurgitation was identified. The patient underwent an emergent cardiac operation, and a complete disc fracture with partial disc migration was found. Exceptional cases of mechanical prosthetic heart valve fracture exist. We report the first case of complete transversal disc rupture of a BSD mitral valve prosthesis after the longest period of implantation ever reported in that position.
Pericardial Agenesis Arnáiz-García, Mª Elena; Dalmau-Sorlí, María José; González-Santos, José María ...
Journal of cardiac surgery,
November 2014, Letnik:
29, Številka:
6
Journal Article
Diabetes remission after malabsorptive bariatric surgery González Arnáiz, Elena; Ballesteros Pomar, María D; Pintor de la Maza, Begoña ...
Endocrinología, diabetes y nutrición.,
04/2021, Letnik:
68, Številka:
4
Journal Article
A patient with advanced rheumatic heart valve disease underwent aortic and mitral valve replacement with tricuspid ring annuloplasty. There was an anomalous left circumflex coronary artery (LCCA) ...arising from the right coronary artery (RCA) running along the anterior surface of an enlarged right ventricle (RV). During the immediate postoperative course, signs of inferior and lateral myocardial ischemia developed. An emergent coronary angiography revealed LCCA entrapment. An additional suture placed in the RV outflow tract used to optimize exposition of the aortic root during the aortotomy was determined to be the origin of the coronary entrapment. No similar case of LCCA occlusion has previously been reported. This is a description of successful management of this complication.
Background
Bariatric surgery (BS) is a very effective treatment regarding body weight loss but might affect food tolerance and energy and protein intake. The aim of this study was to compare three BS ...techniques (biliopancreactic diversion (BPD), gastric bypass (GB), and sleeve gastrectomy (SG)) and their effect on food tolerance.
Methods
Prospective study conducted between April 2016 and April 2019. Visits included were 1 before and 6, 12, and 24 months after BS. Food tolerance test (FTT), 24-h recall, and bioelectrical impedance (TANITA MC780) were performed at all visits.
Results
Sixty-six patients were included (74.2% women). FTT showed a better self-perception of the intake after surgery in BPD at 6 months (
p
= 0.013), and at 12 months (
p
= 0.006). BPD had a better tolerance of 8 food groups at 6 months (red meat
p
= 0.017, white meat
p
= 0.026, salad
p
= 0.017, bread
p
< 0.001, rice
p
= 0.047, pasta
p
= 0.014, fish
p
= 0.027) and at 12 months, but only red meat (
p
= 0.002), bread (
p
< 0.001), rice (
p
= 0.025), and pasta (
p
= 0.025) remained statistically different. Twenty-four months after surgery, only the red meat food group (
p
= 0.007) showed differences. BPD had the lowest incidence of vomiting at 6 months (
p
< 0.001), 12 months (
p
= 0.008), and 24 months (
p
= 0.002). The total score of FTT was better in BPD at 6 months 25.6 (SD 1.5),
p
< 0.001, 12 months 25.6 (SD 2.4),
p
< 0.001, and 24 months 25.7 (SD 1.3),
p
= 0.001. BPD showed the best intake in energy and proteins at 6 months 1214.8 (SD 342.4) kcal and 67.1 (SD 18.4) g and 12 months 1199.6 (SD 289.7) kcal and 73.5 (SD 24.3) g. % FML was higher in GB both at 6 and 12 months being statistically different (
p
< 0.050).
Conclusion
Biliopancreatic diversion appears to be the technique with a better food tolerance and protein and energy intake in the first year of follow-up after BS.
Graphical Abstract
We present the case of how a massive proximal deep vein thrombosis result of an unknown recurrence of a previously colonic malignancy treated, classically known Trousseau´s Syndrome, can mimic ...symptoms of severe peripheral arterial disease in a patient affected of peripheral chronic arterial disease surgically treated. Trousseau´s Syndrome is commonly associated with serious and chronic diseases and a variety of paraneoplastic thromboembolic disorders. Thrombotic episodes may precede the diagnosis of cancer and be the potential marker for an unknown and occult malignancy. We highlight the key points of the Trousseau´Syndrome and those paraneoplastic vasculopathies related that can mimic a vascular disease or complication.
Huge aortic root aneurysm as cause of recent-onset dyspnea Arnaiz-Garcia, María Elena; López-Rodríguez, Francisco Javıer; Merchán-Gómez, Soraya ...
Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir,
12/2020, Letnik:
48, Številka:
8
Journal Article
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. ...However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology. Conservative treatment of aneurysms of the AA via wrapping with different synthetic materials has been implemented for many years. The most commonly used technical variant is wrapping the dilated aorta with a vascular prosthesis with a predetermined diameter. When this technique is adequately applied, it immediately reduces the diameter of the AA and, to a lesser degree, the diameter of the aortic root and arch, while at the same time it reinforces the weak aortic wall. These effects lead to a drop-in wall shear stress and in the risk of aortic dissection and rupture, and persist over time. Although the low elasticity of the external support causes significant changes in the histologic structure of the aortic wall, mainly atrophy and alterations typical of a foreign body-induced reaction, this does not seem to involve a higher risk of complications. In some selected patients, this technique may be used in cases other than post-stenotic aortopathy, and also in aortas with a larger diameter.
Postoperative bleeding with its important socioeconomic cost is associated with an increased morbidity and mortality. It causes hemodynamic instability, increases blood loss, and multiplies the ...number of transfusions required. Especially in vascular or aortic surgery, postoperative bleeding can become a life-threatening complication due to anticoagulant or antiaggregation preoperative status or postoperative coagulation dysfunction after a high level of heparinization. Presently described is the case of a patient who underwent an aortic valve and ascending aorta replacement. A simple but effective method to achieve hemostasis, designed particularly for aortic surgery and the use of Dacron grafts, is presented. No residual adherence or contraindications exist, and it can potentially be applied to any kind of surgical process. This method offers a cheap, biocompatible, and highly effective means to achieve complete hemostasis without the use of extra sutures, or expensive synthetic or allogeneic hemostatic agents or sealants.
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