Unilateral antegrade cerebral perfusion at 22 degrees C systemic hypothermia appears to be safe and reliable for brain protection. Advantages of this technique are avoidance of deep hypothermia and reduced cardiopulmonary bypass and mechanical ventilation times in patients undergoing aortic surgery.
Primary cardiac tumors are rare. Nearly 25% of primary cardiac tumors are malignant, with rhabdomyosarcoma being the second most common primary sarcoma. Symptoms are variable, and the clinical presentation depends on the location and propagation of the tumor. Transthoracic and transesophageal echocardiography are preliminary tests in diagnosing the disease. Echocardiographic findings should be supported by other imaging methods. In appropriate cases, surgery combined with chemotherapy and radiotherapy is suggested. We present a case of primary cardiac rhabdomyosarcoma with surgical removal and mitral valve repair.
This study aimed to investigate the predictive value of red blood cell distribution width (RDW) for early failure of arteriovenous fistula (AVF) for haemodialysis access. The hospital records of those patients who underwent primary AVF creation procedures for haemodialysis between December 2010 and September 2013 were included for retrospective analysis. Of 313 patients, 195 (62%) were male and 118 (38%) were female. Mean age was 60 (range 17-90) years. Of the 313 AVF procedures performed, 229 (73%) were created at forearm (radial artery-cephalic vein), and 84 (27%) were created upperarm (antecubital, brachiocephalic, or brachiobasilic procedures). Early AVF failure was found in 61 (19%) patients. According to chi-square test, the incidence of early AVF failure was higher in patients with heart failure and peripheral artery disease (P < 0.001). According to Mann-Whitney U test, the RDW (P = 0.001) and C-reactive protein (P = 0.024) values were higher in patients with early AVF. Our data showed that preoperative RDW is a reliable parameter that can be useful in predicting the early failure of AVF.
Patients with the combination of coronary artery disease and peripheral vascular disease have multiple risk factors and manifest widespread vascular disease. Although indications of combined coronary and femoral revascularization are rare, a combined procedure is useful in selected patients. We report a patient who underwent a successful combined coronary and lower extremity revascularization with anterolateral limited thoracotomy.
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