Abstract：
:Since the adoption of off-pump coronary artery bypass surgery (OPCAB), numerous investigators have compared its short- and long-term results with those of on-pump coronary bypass surgery. Some reports of OPCAB were quite favorable, whereas others were critical, claiming that it resulted in incomplete revascularization and reduced venous graft patency. A potentially serious complication of OPCAB, not heretofore sufficiently confronted, is the increased incidence of early postoperative acute aortic dissection, in comparison with the more familiar intraoperative and late-occurring aortic dissection after conventional on-pump bypass surgery.Early postoperative acute aortic dissection after OPCAB appears to be more frequent than was initially thought. Its clinical manifestations can be unusual and often neurologic in nature-rendering diagnosis difficult, causing delays in surgical intervention, and resulting in a high mortality rate.When the physician notes unusual developments in patients after OPCAB that lead to the suspicion of aortic dissection, immediate computed tomography of the chest and surgery should occur if dissection is confirmed. If not detected early, this sequela almost certainly leads to rapid death from aortic rupture. Prevention lies in the strict control of systolic blood pressure during the performance of proximal anastomoses; avoidance of aortic clamping through the use of sequential all-arterial grafts or new-generation mechanical connectors; and, at times, aggressive replacement of the aorta with a prosthetic graft.Herein, we present the cases of 4 patients who sustained acute aortic dissection early after OPCAB. We review the pertinent medical literature.
journal_name
Tex Heart Inst Jjournal_title
Texas Heart Institute journalauthors
Tabry IF,Costantini EMsubject
Has Abstractpub_date
2009-01-01 00:00:00pages
462-7issue
5eissn
0730-2347issn
1526-6702journal_volume
36pub_type
杂志文章abstract：:Unruptured aneurysms of the left sinus of Valsalva are extremely rare, and their clinical features are not well-documented in the literature. We describe an unusual case in which an unruptured aneurysm of the left sinus of Valsalva associated with previously undiagnosed Marfan syndrome caused extrinsic compression of ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:Acute massive pulmonary embolism after cardiac surgery is very rare. Although accurate diagnosis and rapid treatment are crucial to a successful outcome, there is no standard treatment option. Thrombolytic therapy and catheter embolectomy are the usual treatment options, but they are associated with risks, especially ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：:There is mounting evidence in support of a significant role for influenza infection in the development of atherosclerosis and the triggering of its complications. Here we review the biologic basis of this relationship, with special emphasis on the pro-inflammatory and pro-thrombotic effects of influenza infection. We ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2004-01-01 00:00:00
abstract：:Nephrogenic systemic fibrosis is a recently recognized disease entity that is potentially debilitating. The exact pathogenesis of nephrogenic systemic fibrosis is unclear, but the disease has been linked with the use of gadolinium-based contrast agents, predominantly in patients with acute renal failure or end-stage r...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2010-01-01 00:00:00
abstract：:Pseudoaneurysm of the left ventricle is rare, and recurrence is extremely rare. We report the case of a 62-year-old man who presented at our hospital with a painless pulsatile swelling in the left breast. He had undergone coronary artery bypass grafting and left-ventricular aneurysmectomy 14 years earlier. On investig...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:We report the case of a 65-year-old man with a 6-year history of hypertension who presented with dilated cardiomyopathy, a transient cerebrovascular event, paroxysmal sweating, and intractable hypertension. Coronary angiography revealed no abnormality, but diagnostic testing was pursued because of the severe sweating ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2007-01-01 00:00:00
abstract：:The levels of brain natriuretic peptide (BNP) and monocyte chemoattractant protein-1 (MCP-1) are known to be increased in the sera of subjects with heart failure. Existing models do not account for the biomass of thrombus that occurs in patients undergoing myocardial infarction. In this study, we compared the expressi...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：:Disease or dysfunction of the aortic valve in pediatric patients presents a substantial challenge. Valve preservation, even if not the definitive solution, is always optimal. Successful repair will enable somatic growth and avoid repeated valve replacement and the need for systemic anticoagulation. When repair of the ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：:A conservative nonoperative method of management was utilized in an atypical case of blunt traumatic rupture of the thoracic aorta. In unusual or complicated tears of the aortic arch, as described here, a delayed or expectant method of management may be justified. ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:Aortoiliac occlusive disease is a frequently encountered occlusive arterial disease. Different surgical approaches to the infrarenal abdominal aorta have been reported. We retrospectively studied the postoperative outcomes of patients who were treated for aortoiliac occlusive disease via a retroperitoneal versus a tra...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：:The number of cancer survivors in the United States has exceeded 12 million and is increasing. After secondary malignancies, cardiovascular disease is the leading cause of late morbidity and death among cancer survivors. The cardiovascular needs of cancer survivors have not been described. We describe the clinical cha...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:After heart surgery, complications affecting the brachial plexus have been reported in 2% to 38% of cases. The long thoracic nerve is vulnerable to damage at various levels, due to its long and superficial course. This nerve supplies the serratus anterior muscle, which has an important role in the abduction and elevat...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：:Lesions of the ascending aorta associated with aortic valve disease are usually treated by implanting a prosthetic valved conduit (Bentall procedure). In this report, we present our experience in which a valved homograft conduit was used for the procedure. Six patients underwent a Bentall procedure with the use of a c...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：:In this case report, we describe direct percutaneous delivery of a muscular-ventricular-septal-defect occluder device to close a left ventricular pseudoaneurysm. The occluder was positioned and deployed with the aid of concurrent transthoracic ultrasonography, transesophageal echocardiography, and fluoroscopy. In cont...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4243
更新日期：2015-08-01 00:00:00
abstract：:A successful cardiac transplant starts with the selection of an appropriate donor. Once consent to organ donation has been obtained, the donor should be managed aggressively in order to maintain optimal organ function. In the case of multi-organ donation, the heart is the first organ to be prepared, as well as the fir...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：:Bilateral recurrence of atrial myxoma has been reported only a few times. We describe the case of a 41-year-old woman who had undergone left atrial myxoma resection and presented 9 years later with myxomas in both atria. The patient underwent successful resection of both masses with resolution of symptoms. We discuss ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-16-6017
更新日期：2017-12-19 00:00:00
abstract：:Advances in ultrasound technology will continue to expand the utility of echocardiography in the assessment of structural and functional cardiac disease in children. Tissue Doppler imaging and dobutamine stress echocardiography are 2 promising clinical applications that are expected to become increasingly used with ti...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：1997-01-01 00:00:00
abstract：:We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4407
更新日期：2016-02-01 00:00:00
abstract：:We compared the diagnostic accuracy of N-terminal prohormone brain natriuretic peptide (NT-proBNP) with that of echocardiography in the evaluation of left ventricular diastolic dysfunction after coronary artery bypass grafting. Thirty patients were studied prospectively. Patients who had recent myocardial infarction, ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2008-01-01 00:00:00
abstract：:Despite recent diagnostic and therapeutic advances, infective endocarditis continues to be a very serious illness, with high patient morbidity and mortality rates. The diagnosis of infective endocarditis has been based primarily on clinical signs and positive blood cultures. Echocardiography is currently recognized as...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：1996-01-01 00:00:00
abstract：:Three patients with ventricular septal defect and coarctation of the aorta were treated successfully by simultaneous correction of both anomalies through a single incision via a left transsternal anterolateral thoracotomy. (Texas Heart Institute Journal 1994; 21:158-60) ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：:In this report, 24 patients with partial anomalous pulmonary venous return were reviewed. Six of the eight patients with left-sided drainage were repaired without extracorporeal circulation by anastomosing the left-sided vein to the left atrium. Symptoms resolved in five of the six. Two of the eight were surgically re...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1985-09-01 00:00:00
abstract：:Structural failure of a Model 2400 Starr-Edwards aortic track valve occurred suddenly, 4 years after implantation. At operation, the valve cage was removed from the descending aorta. Examination of the excised prosthesis disclosed minimal cloth wear and no evidence of infective growth; however, three struts were fract...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1983-03-01 00:00:00
abstract：:We describe a technique for transapical cannulation in cases of acute aortic dissection. This method entails aortic cannulation via the apex of the left ventricle and the aortic valve. When this technique is used, retrograde perfusion prevents such fatal complications as malperfusion or cerebral embolism that can occu...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：:We sought to compare outcomes in patients > or = 60 years of age with those of their younger counterparts who underwent ventricular assist device implantation intended as a bridge to cardiac transplantation and also to identify retrospectively additional pre- and postoperative factors that might portend adverse outcom...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:Right ventricular failure secondary to pulmonary embolism is associated with morbidity and death. The Impella RP System has often been used for percutaneous mechanical circulatory support in patients with right ventricular failure from other causes, including myocardial infarction, cardiac surgery, and left ventricula...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-17-6316
更新日期：2018-06-01 00:00:00
abstract：:The detection and correction of ventricular fibrillation at the earliest time after its onset is essential to ensure long-term survival. During successive cardiac arrests the rhythms occurring were sensed by using disposable pre-gelled ECG defibrillator pads placed in the anterior-anterior position. Simultaneously wit...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1986-12-01 00:00:00
abstract：:Left ventricular assist device (LVAD)-supported patients are evaluated routinely with use of transthoracic echocardiography. Values of left ventricular unloading in this unique patient population are needed to evaluate LVAD function and assist in patient follow-up. We introduce a new M-mode measurement, the slope of t...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-13-3604
更新日期：2014-06-01 00:00:00
abstract：:We describe the single-stage surgical management of aortic coarctation and coronary artery disease in a 48-year-old man. Through a left thoracotomy, patch aortoplasty with a preserved bovine pericardial patch, and off-pump grafting of the circumflex and left anterior descending coronary arteries with a saphenous vein ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
abstract：:During reoperation for replacement of a regurgitant aortic bioprosthesis (a 23-mm bovine pericardial valve), it was judged that total removal of the valve would be difficult, and hazardous to the patient. Therefore, its leaflets were excised and its sewing ring left in situ. A 21-mm Carbomedics bileaflet mechanical va...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
