With the growing number of patients with degenerative aortic valve pathology, mainly an older population, sometimes with calcified and fragile aortic wall, the issue of dealing with an SAR poses the dilemma of whether to implant a smaller prosthesis and admit some degree of PPM, or to enlarge the aortic root. This study demonstrates that the latter can be done in a safe and reproducible manner.
The chest wall chondrosarcoma (CWC) is a rare slowly growing primary tumor of the chest wall with an incidence of <0.5 per million person-years. We present the case of a giant CWC that caused a mass effect on the mediastinum, heart, and lung. Large tumors with thoracic structures compression may be life threatening, and its resection and subsequent chest wall reconstruction represent a significant multidisciplinary surgical challenge. In this case, despite the large tumor dimensions, the preoperative planning-sparing key reconstructive options without compromising the tumor resection-allowed a complete en bloc tumor excision of a grade III chondrosarcoma with negative histologic margins. Successful reconstruction of the large full-thickness chest wall defect, with a latissimus dorsi muscle flap and methyl methacrylate incorporated into a polypropylene mesh in a sandwich fashion, was accomplished. Patient recovery was uneventful with good functional and aesthetic outcomes, and no evidence of recurrence at 1.5 years follow-up. This case report illustrates the main clinical, radiological, and histologic features of a CWC while discussing the surgical goals and highlighting the principles for chest wall reconstruction following extensive resection of a large and rare entity.
Redo AVS performed in patients submitted to CABG previously results in mortality and morbidity rates that are much lower than what is expected, bringing clear benefits to the patients.
The hospital-stay duration after first surgery was 30 (12-99) days. There were no postoperative mortalities. Conclusion: Diabetes mellitus, preoperative chemotherapy, and COPD could be significant risk factors for postoperative empyema. Infecting organisms associated with postoperative empyema were related to preceding postoperative complications. Therefore, emphasis on controlling factors that contribute to pulmonary and surgical-site infection and pulmonary air leak is important to prevent postoperative empyema.
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