ANZ JOURNAL OF SURGERY, Issue 8 2008
John Y. S. Choi
Abdominal Compartment Syndrome (ACS) is an increasingly recognized syndrome of intra-abdominal hypertension and generalized physiological dysfunction in critically ill patients. Patients suffering a ruptured abdominal aortic aneurysm (rAAA) are at risk of developing ACS. The objective of the study was to compare the current views on the importance, prevalence and management of ACS after rAAA among Australian vascular surgeons and intensivists. A questionnaire was mailed to 116 registered vascular fellows from the Royal Australasian College of Surgeons and 314 registered fellows of the Joint Faculty of Intensive Care Medicine. Data were collected on the prevalence and importance of ACS after rAAA and whether prophylactic measures were or should be taken to prevent ACS. Hypothetical clinical scenarios representing a range of ACS after rAAA were also presented. The responses were compared using ,2 -test and t -test. Sixty-seven per cent (78 of 116) of surgeons and 39% (122 of 314) of intensivists responded. Both groups estimated the prevalence of ACS after rAAA as between 10 and 30% and considered it an important entity. Only 30% of surgeons and 50% of intensivists suggested routine intra-abdominal pressure (IAP) monitoring. In patients with borderline IAP (18 mmHg), both groups believed that surgical intervention was unnecessary. Intensivists were more inclined to suggest surgical intervention for clinically deteriorating patients with an increased IAP (30 mmHg) compared with surgeons. Forty-three per cent of intensivists and 17% of surgeons suggested prophylactic (leaving the abdomen open) measures to prevent ACS in high-risk patients. Surgeons and intensivists have similar views on the prevalence and clinical importance of ACS after rAAA. Intensivists more frequently monitored IAP and suggested both early prophylactic and therapeutic intervention for ACS based on physiological and IAP findings. [source]

COMBINED ARTERIOVENOUS FISTULA AND VENOUS ANEURYSM FOLLOWING KNEE ARTHRODESIS

ANZ JOURNAL OF SURGERY, Issue 11 2006
Robert Coleman
We study a case of a 65-year-old woman who developed popliteal arteriovenous fistula (AVF) and venous aneurysm following left knee arthrodesis. Presenting features included left popliteal and calf pain, a tender pulsatile mass posterior to her left knee, popliteal bruit and a thrill at the popliteal fossa and ankle. Left femoral angiography showed an AVF arising from the right tibioperoneal trunk and an aneurysm at the level of the AVF. Findings at open investigation included AVF between the tibioperoneal trunk and the popliteal vein, and a venous aneurysm arising from the popliteal vein opposite the neck of the arteriovenous communication. The aneurysm and fistula were repaired using prolene suture. [source]

Huge Left Ventricular Aneurysm in a Minimally Symptomatic 11-Year-Old Boy

CONGENITAL HEART DISEASE, Issue 1 2009
Stéphane Moniotte MD
ABSTRACT An 11-year-old boy presented with mild shortness of breath and tachycardia and was diagnosed with a huge left ventricular aneurysm ruptured in a secondary pseudoaneurysm. This report highlights the complementary use of echocardiography and cardiac magnetic resonance imaging in the preoperative assessment of this anomaly. [source]

Surgery for Ruptured Sinus of Valsalva Aneurysm into Right Ventricular Outflow Tract: Role of Intraoperative 2D and Real Time 3D Transesophageal Echocardiography

ECHOCARDIOGRAPHY, Issue 7 2010
Shrinivas Gadhinglajkar M.D.
A major limitation of the 2D echocardiography during surgery for a complex cardiac lesion is its inability to provide an accurate spatial orientation of the structure. The real time 3D transesophageal echocardiography (RT-3D-TEE) technology available in Philips IE 33 ultrasound machine is relatively new to an operation suite. We evaluated its intraoperative utility in a patient, who was operated for repair of a ruptured sinus of Valsalva aneurysm (RSOVA) and closure of a supracristal ventricular septal defect. The VSD and RSOVA were visualized through different virtual windows in a more promising way on intraoperative RT-3D-TEE than on the 2D echocardiography. The acquired images could be virtually cropped and displayed in anatomical views to the operating surgeon for a clear orientation to the anatomy of the lesion. RT-3D-TEE is a potential intraoperative monitoring tool in surgeries for complex cardiac lesions. (Echocardiography 2010;27:E65-E69) [source]

Severe Right Ventricular Outflow Obstruction by Right Sinus of Valsalva Aneurysm

ECHOCARDIOGRAPHY, Issue 3 2010
Anil Avci M.D.
Aneurysms of the sinus of Valsalva are rarely diagnosed cardiac anomalies, occurring in 0.14%,0.96% of patients who have undergone open heart surgical procedures. The most common congenital anomalies accompanying sinus of Valsalva aneurysm (SVA) are ventricular septal defect, bicuspid aortic valve, atrial septal defect, and coarctation of aorta. We report a patient with an unruptured right SVA presenting with severe right ventricular outflow tract (RVOT) obstruction, and coexisting patent foramen ovale (PFO) with a right to left shunt. It could be assumed that the increase in right atrial pressure due to RVOT obstruction had led to a right to left shunt across the patent foramen ovale. (Echocardiography 2010;27:341-343) [source]

Dense Smoke in the Operating Room: Epivascular Ultrasonography in a Large Right Coronary Artery Aneurysm

ECHOCARDIOGRAPHY, Issue 5 2008
Andreas P. Kalogeropoulos M.D.
First page of article [source]

Sinus of Valsalva Aneurysm with Dissection into the Interventricular Septum

ECHOCARDIOGRAPHY, Issue 1 2008
Maria do Carmo P. Nunes M.D., Ph.D.
No abstract is available for this article. [source]

Echocardiographic Diagnosis of a Case with Giant Right Atrial Aneurysm

ECHOCARDIOGRAPHY, Issue 2 2006
Nesligül Yildirim M.D.
Right atrial aneurysm (RAA) is a very rare anomaly. Rarer still is its association with atrial septal defect (ASD). We reported a case of a 42-year-old woman with giant RRA and secundum type ASD detected by means of transthoracic echocardiography. (ECHOCARDIOGRAPHY, Volume 23, February 2006) [source]

Rupture of a Right Sinus of Valsalva Aneurysm into the Right Ventricle During Vaginal Delivery: A Case Report

ECHOCARDIOGRAPHY, Issue 10 2005
F.E.S.C., Josip Vincelj M.D., Ph.D.
A case is reported of a right sinus of Valsalva aneurysm rupture into the right ventricle during vaginal delivery in a 34-year-old healthy woman in her third pregnancy. Pregnancy was carried to term and a healthy baby was delivered vaginally. On day 7 following vaginal delivery she was admitted to hospital for dyspnea and cough, with clinical signs of severe heart failure. The diagnosis of the right sinus of Valsalva aneurysm rupture into the right ventricle was established by transthoracic and transesophageal echocardiography. Clinical recognition and early echocardiographic diagnosis followed by immediate surgical repair proved lifesaving in our patient. (ECHOCARDIOGRAPHY, Volume 22, November 2005) [source]

A Giant Dissecting Aneurysm of Ascending Aorta

ECHOCARDIOGRAPHY, Issue 3 2005
Oben Baysan M.D.
Aortic aneurysm is a serious clinical challenge for the cardiologist. Aneurysm expansion frequently associated with significant dissection and rupture risk. Currently available diagnostic modalities make earlier diagnosis and therapy possible hence giant aneurysm with dissection is relatively rare. In this case report, we present a patient with giant aortic aneurysm with dissection. [source]

The Rupture of Periaortic Infective Aneurysm into the Left Atrium and the Left Ventricular Outflow Tract: Preoperative Diagnosis by Transthoracic Echocardiography

ECHOCARDIOGRAPHY, Issue 3 2002
Ewa Lastowiecka M.D.
We present a rare complication of infective endocarditis, perforated periaortic abscess with fistulous communication between the aortic root, the left atrium, and the left ventricular outflow tract. Preoperative transthoracic echocardiographic diagnosis was confirmed intraoperatively. The patient was treated successfully by aortic homograft implantation. [source]

Prospective Study of Accuracy and Outcome of Emergency Ultrasound for Abdominal Aortic Aneurysm over Two Years

ACADEMIC EMERGENCY MEDICINE, Issue 8 2003
Vivek S. Tayal MD
Abstract Determination of the presence of an abdominal aortic aneurysm (AAA) is essential in the management of the symptomatic emergency department (ED) patient. Objectives: To identify whether emergency ultrasound of the abdominal aorta (EUS-AA) by emergency physicians could accurately determine the presence of AAA and guide ED disposition. Methods: This was a prospective, observational study at an urban ED with more than 100,000 annual patient visits with consecutive patients enrolled over a two-year period. All patients suspected to have AAA underwent standard ED evaluation consisting of EUS-AA, followed by a confirmatory imaging study or laparotomy. AAA was defined as any measured diameter greater than 3 cm. Demographic data, results of confirmatory testing, and patient outcome were collected by retrospective review. Results: A total of 125 patients had EUS-AA performed over a two-year period. The patient population had the following characteristics: average age 66 years, male 54%, hypertension 56%, coronary artery disease 39%, diabetes 22%, and peripheral vascular disease 14%. Confirmatory tests included radiology ultrasound, 28/125 (22%); abdominal computed tomography, 95/125 (76%); abdominal magnetic resonance imaging, 1/125 (1%); and laparotomy, 1/125 (1%). AAA was diagnosed in 29/125 (23%); of those, 27/29 patients had AAA on confirmatory testing. EUS-AA had 100% sensitivity (95% CI = 89.5 to 100), 98% specificity (95% CI = 92.8 to 99.8), 93% positive predictive value (27/29), and 100% negative predictive value (96/96). Admission rate for the study group overall was 70%. Immediate operative management was considered in 17 of 27 (63%) patients with AAA; ten patients were taken to the operating room. Conclusions: EUS-AA in a symptomatic population for AAA is sensitive and specific. These data suggest that the presence of AAA on EUS-AA should guide urgent consultation. Emergency physicians were able to exclude AAA regardless of disposition from the ED. [source]

Mycotic aneurysm of the superior mesenteric artery in a young woman

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2005
P-H Chu
Summary Aneurysm of the superior mesenteric artery (SMA) is rare. We, in this study, present the case of a 21-year-old woman with a history of heroin abuse who was admitted to our hospital for infective endocarditis complicated by floating vegetation at the posterior mitral valve. After receiving 2-week antibiotic treatment, the patient had acute abdominal pain. Computed tomography demonstrated an aneurysm at the SMA. The mycotic aneurysm was resected and the mitral valve was repaired successfully. This report reviews the pathophysiology of mycotic aneurysms of the SMA and role of computed tomography in the differential diagnosis of this condition from acute mesenteric ischaemia. [source]

Total Arch Replacement with Open Stent-Grafting for Aneurysm of Ductus Arteriosus After Surgery for Patent Ductus Arteriosus

JOURNAL OF CARDIAC SURGERY, Issue 5 2010
Kosaku Nishigawa M.D.
An enhanced computed tomography of the chest revealed a saccular aneurysm measuring a maximum diameter of 28 mm in the lesser curvature of the distal aortic arch; she was diagnosed with an aneurysm of ductus arteriosus after surgery for PDA. We performed total aortic arch replacement with open stent-grafting through median sternotomy. This approach enabled us to avoid the risk of dissecting adhesions around the aneurysm and clamping the aorta distal to the aneurysm.,(J Card Surg 2010;25:557-559) [source]

Giant Aneurysm After Aortic Coarctation: Repair without Circulatory Arrest

JOURNAL OF CARDIAC SURGERY, Issue 5 2010
D.E.S.A., Gabor Erdoes M.D.
Using the hemi-clamshell approach, the entire aortic arch was replaced and the supraaortic branches were reimplanted. The applied surgical technique using hypothermic extracorporeal circulation without cardiac arrest allowed an uninterrupted cerebral and spinal cord perfusion due to stepwise clamping of the aortic arch during reconstruction and resulted in an excellent neurologic outcome at six-month follow-up.,(J Card Surg 2010;25:560-562) [source]

Congenital Left Ventricular Aneurysm

JOURNAL OF CARDIAC SURGERY, Issue 3 2010
Jian-ying Deng M.D.
(J Card Surg 2010;25:351) [source]

Mycotic Aneurysm of the Descending Thoracic Aorta Caused by Haemophilus Influenzae

JOURNAL OF CARDIAC SURGERY, Issue 2 2010
Ph.D., Yosuke Takahashi M.D.
Because of suspected infectious or inflammatory etiology, he was managed with a combination of emergency aortic repair using prosthetic graft with omental flap and antibiotic chemotherapy. Haemophilus influenzae was identified from perioperative specimens and the postoperative course was uneventful.,(J Card Surg 2010;25:218-220) [source]

Congenital Aneurysm of Left Atrial Appendage: A Case Report

JOURNAL OF CARDIAC SURGERY, Issue 1 2010
Sanjeev Gupta M.S.
We report a case of a two-year-old child with congenital aneurysm of the LAA with a large thrombus in it. He presented with an episode of seizures with left-sided hemiparesis. Diagnosis was based on transthoracic echocardiography and magnetic resonance imaging. The patient was successfully treated by surgical resection of the aneurysm and removal of the thrombus.(J Card Surg 2010;25:37-40) [source]

64-Row MDCT Demonstration of an Unruptured Aneurysm of the Sinus of Valsalva

JOURNAL OF CARDIAC SURGERY, Issue 1 2010
Guangyu Tang M.D.
(J Card Surg 2010;25:70-71) [source]

Aortic Arch Aneurysm Associated with Arch Vessel Anomalies: Truncus Bicaroticus and Retroesophageal Right Subclavian Artery

JOURNAL OF CARDIAC SURGERY, Issue 4 2009
Namhee Park M.D.
An aberrant right subclavian artery is just as rare, especially with a retroesophageal course. A combination of these two conditions, we believe, has never been reported. [source]

Autologous Pericardium Patch Aneurysm after Ventricular Septal Defect Closure and Arterial Switch Operation

JOURNAL OF CARDIAC SURGERY, Issue 4 2009
Fernando A. Atik M.D.
Four months later, the child came back with right ventricular inflow obstruction related to aneurysmal pericardial patch, severe tricuspid regurgitation, and severe supra-valvular pulmonic stenosis. At reoperation, there was a redundant, aneurysmal pericardial patch densely adherent to the septal and posterior leaflets of the tricuspid valve, which was damaged. The pericardial patch was replaced, the pulmonary artery enlarged, and tricuspid valve repaired. Postoperative course was uneventful, but residual moderate tricuspid regurgitation required intensive medical treatment. [source]

Giant Unruptured Noncoronary Sinus of Valsalva Aneurysm

JOURNAL OF CARDIAC SURGERY, Issue 3 2009
Sirous Darabian M.D.
We report a 32-year-old woman presenting with exertional dyspnea in which a giant unruptured noncoronary sinus of Valsalva aneurysm was detected after echocardiography. The aneurysm was surgically repaired and the aortic and mitral valves were replaced. [source]

Surgical Repair of a Congenital Left Ventricular Aneurysm

JOURNAL OF CARDIAC SURGERY, Issue 1 2007
Mustafa Cikirikcioglu M.D., Ph.D.
A 9-year-old boy with complaints of dyspnea and palpitation was diagnosed with a left ventricular aneurysm originating from the left ventricle free wall. Aneurysm resection and endoventricular patch repair was performed. Postoperative follow-up was uncomplicated and follow-up echocardiographs showed normal left ventricular contractility. [source]

Combined DOR Ventriculoplasty and Aortic Valve Replacement in the Treatment of Post Infarction Ventricular Aneurysm and Aortic Regurgitation

JOURNAL OF CARDIAC SURGERY, Issue 5 2006
Erik E. Suarez M.D.
We present the unique case of a patient suffering from congestive heart failure due to both post-infarct aortic regurgitation and ventricular aneurysm along with his successful surgical treatment. [source]

Giant Aneurysm of Aortocoronary Saphenous Vein Graft Compressing the Left Pulmonary Artery

JOURNAL OF CARDIAC SURGERY, Issue 4 2006
Bruno Chiappini M.D.
CT scan displayed a mass with an internal lumen compressing the left atrium as well as the left pulmonary artery. [source]

On "Onlay Patch for Complete Intercostals Artery Preservation During Thoracic and Thoracoabdominal Aortic Aneurysm Repair"

JOURNAL OF CARDIAC SURGERY, Issue 6 2005
Irving L. Kron M.D.
No abstract is available for this article. [source]

Ductus Arteriosus Aneurysm in an Adult Patient Presenting with Hoarseness

JOURNAL OF CARDIAC SURGERY, Issue 4 2005
Peter Pastuszko M.D.
The unusual adult cases reported in the literature have been associated with high morbidity and a surgical repair has been recommended. We report a case of a 60-year-old man who presented with hoarseness secondary to a ductus arteriosus aneurysm and underwent a repair of this abnormality via a left posterolateral thoracotomy utilizing partial cardiopulmonary bypass. [source]

Minimized Mortality and Neurological Complications in Surgery for Chronic Arch Aneurysm:

JOURNAL OF CARDIAC SURGERY, Issue 4 2004
Axillary Artery Cannulation, Replacement of the Ascending, Selective Cerebral Perfusion, Total Arch Aorta
For preventing this complication, axillary artery cannulation, selective cerebral perfusion, and replacement of the ascending and arch aorta were applied to thoracic aortic aneurysm involving aortic arch. Method: From May 1999 to July 2002, consecutive 39 patients with true aneurysm (29 patients) or chronic aortic dissection (10 patients) involving aortic arch underwent replacement of the ascending and arch aorta with an elephant trunk under hypothermic cardiopulmonary bypass through the axillary artery cannulation and selective cerebral perfusion. The brain was continuously perfused without any intermission through the axillary artery. Concomitant operation included coronary artery bypass grafting (CABG) in two patients, aortic valve replacement (AVR) in one, Bentall operation in two, mitral valve replacement (MVR) in one, and aortic valve sparing operation in one. Patient age at operation was 40,84 (72 + 9) years and 24 of them were older than 70 years of age. Results: There was one operative death (2.5%) due to bleeding from the left lung, and one hospital death due to respiratory failure. Postoperative permanent neurological dysfunction was found in one patient (2.5%). Two patients presented temporary neurological dysfunction (5%). Thirty-six of the 39 patients were discharged from hospital on foot. Conclusion: Continuous perfusion through the axillary artery with selective cerebral perfusion and replacement of the ascending and arch aorta may minimize cerebral complication leading to satisfactory results in patients with chronic aortic aneurysm involving aortic arch. [source]

Dor Operation for a Young Male with Left Ventricular Aneurysm due to Spontaneous Left Anterior Descending Coronary Artery Dissection

JOURNAL OF CARDIAC SURGERY, Issue 1 2004
Masato Nakajima M.D.
We describe a young male who had a myocardial infarction with left ventricular aneurysm due to spontaneous left anterior descending coronary artery dissection. He was successfully treated with Dor's left ventriculoplasty without coronary artery revascularization. The Dor procedure was a simple and effective treatment. To our knowledge, this is the first report in which the Dor procedure was used to treat spontaneous coronary artery dissection with left ventricular aneurysm. (J Card Surg 2004;19:54-56) [source]