Portuguese Journal of Cardiac Thoracic and Vascular Surgery

Successful Radical Resection Of Masaoka Iii Squamous Cell Thymic Carcinoma Invading Superior Vena Cava And Right Atrium – Case Report

2024-06-11T08:12:36-07:00

Introduction: Complete radical resection is crucial for successfully treating thymic carcinomas. However, when the invasion of the great vessels or the heart in Masaoka III and IV stages occurs, the management poses more challenges. The R0 resection often requires neoadjuvant treatment. We present an example of a debatable case in which a treatment decision was guided by an imminent risk to the patient's life.

Case description: We report the case of a 74-year-old female with a mediastinal mass invading the superior vena cava (SVC) and the right atrium (RA), which was successfully treated with radical resection. The procedure under the femoro-femoral CardioPulmonary Bypass (CPB) included resection of the right intra-auricular mass and the SVC followed by the interposition of a Gore-Tex conduit between the left innominate vein and RA and also wedge resection of the upper left (LUL) and right lobes (RUL). A final histopathological examination confirmed the diagnosis of squamous cell carcinoma.

Conclusions: Complete radical resection is essential for successful treatment and represents the most significant prognostic factor.

Mini Atrial Septal Defect Closure In Dextrocardia With Situs Inversus By Left Anterolateral Thoracotomy(Lalt) Approach - A Surgical Challenge

2024-10-09T09:49:54-07:00

Background: Atrial septal defect (ASD) is a relatively rare among patients with situs inversus dextrocardia with concordant atrioventricular (AV) connection and a minimally invasive approach in dextrocardia has yet to be standardized. The present case describes surgical closure of ostium secundum ASD by left mini-thoracotomy approach in patient with dextrocardia and situs inversus.

Case presentation: The present case describes a 44-year female diagnosed with ostium secundum ASD in dextrocardia with situs inversus. The patient underwent minimal invasive ASD closure by left anterolateral thoracotomy approach (LALT). The procedure has achieved good clinical and cosmetic results

Conclusion: This article describes surgical techniques to overcome the challenges in subset of dextrocardia with situs inversus patients.

“Deviceless” Video-Assisted Thoracoscopic Lobectomy: Is It Feasible?

2024-05-05T10:01:23-07:00

We demonstrate that performing anatomical pulmonary resection by video-assisted thoracoscopic surgery without staplers or energy devices is feasible. This technique is an alternative for surgeons with limited access to expensive technologies.

Jejunal Artery Aneurysm Exclusion With Immediate Vascular Reconstruction: A Case Report

2024-06-07T09:29:00-07:00

A 44 year-old previously healthy woman presented a persistent epigastric pain. Computed tomography revealed a saccular aneurysm with a diameter of 25x20 mm in the first jejunal artery and also a stenosis in the celiac trunk associated with median arcuate ligament syndrome, turning the hepatic perfusion dependent of the gastroduodenal artery flow. Through a midline laparotomy, celiac axis was exposed, and median arcuate ligament released for median arcuate ligament syndrome treatment. A tangential resection of the aneurysm was done, preserving the flow in the jejunal artery. Arterial closure was achieved through an anastomosis between the jejunal artery and the bevelled pancreatoduodenal artery. One of the duodenal branches was also re-implanted in the jejunal artery. The patient's post-operative course was uneventful. At 1 year after the surgery, patient is asymptomatic and with patency of the reconstructed arteries.

Catheter-Based Aspiration of A Large Superior Vena Cava Mass In A Patient With Endocarditis

2024-11-11T07:46:03-08:00

Infective endocarditis carries a high risk of morbidity and mortality with recurrent infections and non-compliance. In the case of right-sided endocarditis, the indications for intervention are less clear. The Angiovac procedure provides a treatment for right-sided endocarditis that is a less-invasive and ideal for a complicated patient population.

Imaging Red Flags In A Symptomatic Abdominal Aortic Aneurysm

2024-09-10T07:36:31-07:00

Unusual Location of a Bronchogenic Cyst

2024-09-04T11:28:36-07:00

Symptomatic Carotid Web: a Rare Cause of Stroke

2024-09-16T08:26:04-07:00

Abstracts of the SPCCTV 4D VISIONS 2024 - Cardiac Surgery

2025-01-25T14:12:19-08:00

Abstracts of the SPCCTV 4D VISIONS 2024 - Thoracic Surgery

2025-01-25T14:14:48-08:00

Abstracts of the SPCCTV 4D VISIONS 2024 - Vascular Surgery

2025-01-25T14:29:04-08:00

Abstracts of the SPCCTV 4D VISIONS 2024 - Intensive Care

2025-01-25T14:31:18-08:00

Abstracts of the SPCCTV 4D VISIONS 2024 - Nursing

2025-01-25T14:43:18-08:00

Acknowledging Our Reviewers

2024-12-30T11:53:48-08:00

Aortic Valve-Sparing operations

2024-12-15T11:11:41-08:00

Otherwise, inoperable. The role of ECMO in thoracic surgery – focus on the mediastinum

2024-12-14T16:36:56-08:00

The use of extracorporeal membrane oxygenation (ECMO) in surgery is expanding as the medical community started adopting it, with good results, for procedures with high risk of respiratory and hemodynamic instability. This technique provided the possibility to reduce the number of patients previously considered inoperable because of these limitations.

Thymic epithelial tumors (TETs) are rare neoplastic mediastinal lesions, with a reported incidence of 0.3 per million. They are indolent and associated with a delayed diagnosis, as symptoms arise late. Some can reach such dimensions that surgery without ECMO support would render these patients at risk of heart/great vessels or/and respiratory compression of prohibitive surgical risk or even inoperable.

This report aims to update information on ECMO support in surgery for prevascular mediastinal masses, focusing on pre-operatory assessment, ECMO implantation, patient selection and surgical results.

Advances in Diagnosis, Treatment and Prognostic in Aortoiliac Occlusive Disease - A Narrative Review

2024-11-27T14:31:15-08:00

Background: Aortoiliac disease (AID) is a variant of peripheral artery disease involving the infrarenal aorta and iliac arteries. Similar to other arterial diseases, aortoiliac disease obstructs blood flow through narrowed lumens or by embolization of plaques. AID, when symptomatic, may present with a triad of claudication, impotence, and absence of femoral pulses, a triad also referred as Leriche Syndrome (LS).

Objective: The authors aim to review the available evidence on the management of the aortoiliac occlusive disease and describe its clinical characteristics, diagnosis and treatment management.

Methods: A comprehensive review of the literature was carried out to collect data from relevant studies concerning patients with moderate to severe symptomatic aortic occlusive disease. The data was identified by a search using PubMed and Google Scholar with the keywords / MESH terms "aortoiliac occlusive disease". For this study, the authors included papers published in the past two decades, written in English.

Results: The diagnosis and evaluation of extensive aortoiliac disease involves several important considerations: vascular imaging plays a fundamental role in confirming the diagnosis of peripheral artery disease (PAD), evaluating the severity and extent of the disease and directing the planning of revascularization procedures. It provides essential information to select the most appropriate treatment modality.

Conclusion: Despite successful revascularization, patients are at high risk of mortality and numerous life-threatening complications. Clinical and imagiologic factors may be used for risk stratification in order to select appropriate patients for revascularization and to better counsel patients about expected postoperative outcomes.

Surgical Challenges In Managing Haemodialysis Arteriovenous Fistula Complications In Tertiary Care Centre: Our Approach

2024-09-16T08:30:02-07:00

Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture. While some patients undergo elective AV fistula takedown post renal transplantation or for cosmesis, majority of patients presenting with life-threatening rupture require emergency surgery for AV fistula takedown with or without maintaining arterial continuity. This study aims to compile our experience with surgical management of various AV fistula complications.

Methods: This is a retrospective study of 29 patients who underwent Arteriovenous Fistula takedown in our institute over a period of 3years from May 2021 to May 2024.

Results: The most common cause of fistula takedown in our setup was rupture (n=25, 86.21%). AV fistula takedown was done in all cases (n=29, 100%). Arterial ligation was done in all infected cases (n=22, 75.86%) whereas in non-infected cases arterial continuity was maintained by repair or interposition venous graft. There was no aneurysm or psedoaneurysm formation or limb ischaemia in a follow up period ranging from 1month to 3 years.

Conclusion: Erroneous ways of cannulation and lack of awareness of fistula care were the prime cause of AV fistula complications. Early detection and presentation to healthcare setup could offer a better prognosis for limb salvage in the long term and decrease the incidence of morbidity and mortality.