IABP-related vascular complications: Who is responsible - the patient, the surgeon or the sheath? Part I: Sheath-related complications

Introduction: An intra-aortic balloon pump (IABP) is frequently used as a mechanical support during the treatment of low cardiac output syndrome. The use of a sheath during IABP treatment can be associated with ischaemic complications in the extremities. The aim of our study was to determine the isolated role of sheaths in the development of vascular complications following IABP catheterisation

Influence of intracoronary shunt on myocardial damage: a prospective randomized study

Objective: We aimed to evaluate whether surgical intracoronary shunt protects myocardium in patients with moderate left ventricular dysfunction (MLVD). Methods: Thirty-nine patients consisted the shunt group and 43 patients consisted the shuntless group. Troponin I, CK, and CK-MB were measured preoperatively, and at 6 and 24 h postoperatively. Cardiac enzymes, rate of postoperative atrial fibrillation (AF) and third month ejection fraction (EF) were compared between the groups. Results: There were no significant differences between the groups for preoperative troponin I, CK, CK-MB, and postoperative CK levels (at 6 and 24 h). Postoperative troponin I and CK-MB levels were significantly lower in the shunt group (p < 0.001). Although preoperative EF of the patients were not significantly different between groups, the third month EF were significantly increased in both groups, and this increment was significantly higher in the shunt group than the shuntless group. One patient (2.3%) died in the shuntless group whereas there was no death in the shunt group. Conclusion: Intracoronary shunt has protective effects on myocardium in patients with moderate left ventricular dysfunction. (c) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Repair of the Inferior Vena Cava With Autogenous Peritoneo-Fascial Patch Graft Following Abdominal Trauma: A Case Report

Abdominal vascular injuries are among the most challenging and lethal injuries in traumatized patients. Inferior vena cava is the most frequently injured vein during the blunt or penetrating trauma. The primary repair, end to end anastomosis, endovascular stenting, or graft interposition with autogenous or synthetic materials should be considered in selected cases. However, in cases the synthetic graft was preferred, intestinal contaminations due to small or large bowel perforation accompanying the trauma have been cited as a limiting factor for the use of such grafts as in the current case. However, a previous history of lower leg variceal surgery prevents the use of great saphenous vein as a graft. So in the present case, the authors report a patient with inferior vena cava injury repaired with autogenous peritoneo-fascial graft. The authors have used APF graft in traumatic inferior vena cava injury for the first time

Dog bite causing ischemia and neurological deficit at the upper extremity: A case report

We present a case with median and radial nerve injuries together with brachial artery occlusion after a dog bite that is seen rarely in the literature. A 26 year-old man was admitted to our emergency department with a complaint of dog bite and weakness of fingers at the left upper extremity. There were bite impressions at the left arm. The physical examination of the patient revealed no brachial and radial artery pulse. The neurological examination revealed radial and median nerve deficits. The patient underwent a thromboembolectomy operation following laboratory and radiological evaluations. The nerve injuries were evaluated as partial and medical treatment was administered