Publications (3)0 Total impact
Article: Outcomes after ascending aorta and proximal aortic arch repair using deep hypothermic circulatory arrest with retrograde cerebral perfusion: analysis of 207 patients.[show abstract] [hide abstract]
ABSTRACT: Correction of ascending aorta and proximal aortic arch pathology with numerous surgical techniques having been proposed over the years remains a surgical challenge. This study was undertaken to identify risk factors influencing outcome after aortic arch operations, requiring deep hypothermic circulatory arrest (DHCA). Between 1993 and 2010, 207 consecutive patients were operated for ascending aorta and proximal arch correction with the use of deep hypothermic circulatory arrest with retrograde cerebral perfusion. All patients were followed up with regular out-patient clinics, transthoracic echocardiography and, when required, chest computed tomography. There were 102 (49.3%) emergencies (acute type A dissection) and 105 (50.7%) elective cases. Mean age: 63.5 ± 12 years. Mean circulatory arrest time was 25.4 ± 13 min. Unadjusted analysis of factors associated with 30-day mortality revealed emergency status, preoperative hemodynamic instability, acute dissection, reoperation, increased circulatory arrest time, postoperative bleeding, postoperative creatinine levels and presence of neurological dysfunction. Multi-adjusted analysis revealed duration of circulatory arrest as the only and main factor related to death. Thirty-day mortality was 2.4% for the elective and 7.2% for emergencies cases. Survival during long-term follow-up was 93, 82 and 53% at 1, 5 and 10 years, respectively. Ascending aorta and proximal aortic arch replacement with brief duration of deep hypothermic circulatory arrest combined with retrograde cerebral perfusion is a safe method with acceptable short- and long-tem results.Interactive cardiovascular and thoracic surgery 06/2012; 15(3):456-61.
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ABSTRACT: We are reporting the successful surgical treatment of a 23-year-old female with a giant right coronary artery to coronary sinus fistula. This woman had complaints of chest pain and dyspnea on exertion for few months. Transthoracic echocardiography (TTE) showed a large tortuous right coronary artery and a dilated coronary sinus. Preoperative multi-detector computed tomography (MDCT) coronary angiography and cardiac catheterization confirmed the diagnosis of a right coronary artery to coronary sinus fistula. The patient underwent surgical closure of the fistula and division of the communication between the right coronary artery and the coronary sinus with the use of cardiopulmonary bypass. The patient was discharged home on postoperative day 5 and at one-year follow-up is symptom-free.Interactive cardiovascular and thoracic surgery 09/2011; 13(6):672-4.
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ABSTRACT: Cardiac myxoma is the most common benign tumor of the heart. It presents with a variety of clinical signs and symptomatology making diagnosis frequently quite a challenge. We review our experience with 41 patients who underwent surgical intervention for cardiac myxoma between 1994 and 2011. All patients' preoperative, intraoperative and postoperative characteristics were recorded. They all had a standard sternotomy and cardiopulmonary bypass with cardioplegic cardiac arrest and were followed up with clinical examination and echocardiography. The surgical goal was to remove not only the tumor but the whole area of attachment to prevent recurrence. Biatrial approach facilitated the complete excision of the tumor. Surgical excision of cardiac myxoma carries a low-operative risk and gives excellent short- and long-term results.Interactive cardiovascular and thoracic surgery 09/2011; 13(6):597-600.