- Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps. [Journal Article]
- EAEur Arch Otorhinolaryngol 2018 Nov 07
- CONCLUSIONS: Microscopic approach of septal perforation closure using bilateral advancement flaps can be an affordable technique with a high percent of success and low rate of complications.
- Endoscopic Full-Thickness Defects and Closure Techniques. [Review]
- CTCurr Treat Options Gastroenterol 2018 Oct 31
- Gastrointestinal transmural defects are defined as total rupture of the gastrointestinal wall and can be divided into three main categories: perforations, leaks, and fistulas. Due to an increase in t...
Gastrointestinal transmural defects are defined as total rupture of the gastrointestinal wall and can be divided into three main categories: perforations, leaks, and fistulas. Due to an increase in the number of therapeutic endoscopic procedures including full-thickness resections and the increase incidence of complications related to bariatric surgeries, there has been an increase in the number of transmural defects seen in clinical practice and the number of non-invasive endoscopic treatment procedures used to treat these defects.
- Preference and Perception of Enhanced Images During Endonasal Endoscopic Surgery. [Journal Article]
- JCJ Craniofac Surg 2018; 29(8):2296-2298
- Image enhancement is used widely in endoscopic sinonasal surgery. It is yet to be established whether image enhancement has advantages over white-light endoscopy. The authors aimed to evaluate the pr...
Image enhancement is used widely in endoscopic sinonasal surgery. It is yet to be established whether image enhancement has advantages over white-light endoscopy. The authors aimed to evaluate the preferences and subjective visual perception of image enhancement in diagnostic images acquired at the beginning of endonasal endoscopic surgeries. An online survey consisting of 12 endoscopic images, 4 enhanced with Clara mode, 4 enhanced with Chroma mode, and 4 enhanced with Clara+Chroma mode, was distributed. The enhanced images were randomly presented with nonenhanced white-light images. These images were captured at the beginning of endonasal endoscopic surgeries for septal perforation, septal deviation, and chronic rhinosinusitis. Survey respondents (n = 205) included 81 otorhinolaryngologists, 94 other specialty physicians (35 endoscopy/laparoscopy users and 59 nonusers), and 30 nonmedical image experts. They were asked to choose superior images according to brightness, contrast and sharpness, depth of field, and overall preference. A quantitative study was also conducted to evaluate different enhancement modes. The authors found that Clara enhanced brightness and Chroma enhanced contrast and sharpness significantly (P < 0.001). Overall, 91.8% chose Clara and 91.7% chose Clara+Chroma-enhanced images for brightness enhancement. For contrast and sharpness, 87% chose Clara+Chroma and 86.7% chose Chroma. There was no significant difference between perception scores among the groups. Our survey group showed a significantly high overall preference for enhanced images. This preference was independent of profession or experience, but closely related to the quantitative enhancement of the specific mode. Continuous use of image enhancement in endonasal surgery may have advantages over white-light endoscopy.
- Spontaneous rupture of right aortic sinus of Valsalva leading to massive cystic dissection of interventricular septum and complete heart block. [Case Reports]
- EEchocardiography 2018 Oct 18
- The interventricular septal dissection is an uncommon, and is occasionally associated with sinus of Valsalva aneurysm. A spontaneous dissection with a normal sinus of Valsalva is extremely rare and i...
The interventricular septal dissection is an uncommon, and is occasionally associated with sinus of Valsalva aneurysm. A spontaneous dissection with a normal sinus of Valsalva is extremely rare and is mostly a result of a congenital defect. We report the case of a 23-year-old male admitted for complete heart block and presenting as an incidental finding during the TTE multiple and huge cystic-like mass in the interventricular septum (IVS) which is the TTE characteristic of IVS dissection. Most patients remain asymptomatic until the anatomical and hemodynamic changes lead to complications like: severe aortic regurgitation with heart failure and conduction abnormalities. Although transthoracic echocardiogram (TTE) has been the first-line imaging modality for such findings, cardiac computed tomography (CT) and magnetic resonance imaging have been increasingly used as supplemental or confirmatory tests. The imaging modalities showed a perforation of right sinus of Valsalva causing the expansion of the dissection to the apex. The patient underwent surgical repair with satisfying results. In conclusion, we report an extremely rare clinical case of spontaneous dissection of the interventricular septum using multiple imaging techniques and with a successful surgery.
- Characteristics and outcome of impacted button batteries among young children less than 7 years of age in China: a retrospective analysis of 116 cases. [Journal Article]
- WJWorld J Pediatr 2018; 14(6):570-575
- CONCLUSIONS: Inhalation or ingestion may occur in the nasal cavities, the esophagus and GI tract and the auditory tract. Prompt diagnosis and treatment are required for a satisfactory outcome and ingested or inhaled button batteries require different treatment protocols.
- [Modified David-Komeda Repair for Ventricular Septal Perforation Complicated with Severe Postoperative Acute Respiratory Distress Syndrome;Report of a Case]. [Journal Article]
- KGKyobu Geka 2018; 71(11):953-956
- A 61-year-old man presented by ambulance with dyspnea. He was diagnosed with myocardial infarction complicated with ventricular septal perforation (VSP), and intraaortic balloon pumping support and i...
A 61-year-old man presented by ambulance with dyspnea. He was diagnosed with myocardial infarction complicated with ventricular septal perforation (VSP), and intraaortic balloon pumping support and intensive care were started. Because of instability of hemodynamic status, modified David-Komeda operation with double patch was performed in the subacute phase of VSP. Although he developed acute respiratory distress syndrome( ARDS) on the 21st day after operation, he was successfully treated with corticosteroid pulse therapy and artificial ventilation. He was transferred to a rehabilitation hospital on the 141st postoperative day.
- [Surgical Treatment of Acute Infective Endocarditis after Transcatheter Aortic Valve Replacement]. [Journal Article]
- KGKyobu Geka 2018; 71(11):929-931
- Infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) is a rare complication, but has a high mortality. An 86-year-old female with symptomatic severe aortic stenosis underwe...
Infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) is a rare complication, but has a high mortality. An 86-year-old female with symptomatic severe aortic stenosis underwent TAVR at our hospital and she was discharged without complication after 10 days. She was readmitted with high fever and acute heart failure 1 month later. Blood culture revealed Staphylococcus, and echocardiography showed vegetation on the septal cusp of the tricuspid valve and perforation at the membranous ventricular septum. We decided to perform emergency operation due to active infection and intracardiac complication despite appropriate antibiotic treatment. The infected valve was replaced with a bioprosthetic valve and the right ventricular (RV)-left ventricular (LV) communication was closed with a bovine pericardial patch. The patient received the antibiotics for 6 week and was transferred to the previous facility.
- Bail-out use of the Amplatzer Septal Occluder for treatment of acute iatrogenic leaflet perforation during the MitraClip procedure in a patient with functional mitral regurgitation. [Journal Article]
- PKPostepy Kardiol Interwencyjnej 2018; 14(3):304-308
- Left ventricle pseudoaneurysm: Diagnosis by a new murmur. [Journal Article]
- JCJ Cardiol Cases 2018; 18(1):20-24
- Incomplete rupture of the ventricle free wall can occur after myocardial infarction. This occurs when an organized thrombus and the pericardium seal the ventricular perforation. This can progress to ...
Incomplete rupture of the ventricle free wall can occur after myocardial infarction. This occurs when an organized thrombus and the pericardium seal the ventricular perforation. This can progress to the formation of a left ventricle pseudoaneurysm (LVPA). A 70-year-old male with an antero-septal ST-elevation myocardial infarction (STEMI) underwent an emergent left heart catheterization which revealed severe three-vessel disease with occluded grafts, non-amenable to re-vascularization, and an apical thrombus. As he was high-risk for repeat coronary artery bypass graft, he was medically managed. Transthoracic echocardiogram (TTE) showed a normal left ventricle ejection fraction (LVEF), apical anterior and inferior wall akinesis, moderate sized apical thrombus, and pericardial thickening. On hospital day 7, examination revealed a new 3/6 to-and-fro murmur that was loudest at the apex. The patient was asymptomatic with normal vital signs. A repeat TTE revealed an apical wall rupture with flow into the pericardial cavity and absence of the apical thrombus. A LVPA was diagnosed and the patient was immediately referred for surgical repair. This case illustrates the potential for developing LVPA in STEMI patients and the importance of physical examination. If identified early a potential emergent situation in a previously asymptomatic patient can be averted, thereby preventing fatal consequences. <Learning objective: With the growing use of diagnostic testing the importance of physical examination is being lost. However, with an astute cardiac examination, potential complications such as a left ventricular pseudoaneurysm can be identified and promptly managed. In addition, a ventricular pseudoaneurysm must be considered in the differential as a rare complication in post ST-elevation myocardial infarction patients with a new murmur.>.
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- Intracorporeal Septorhinoplasty: Technique and Outcome. [Journal Article]
- JCJ Craniofac Surg 2018; 29(8):2055-2057
- CONCLUSIONS: Intracorporeal correction of septal deformities in open rhinoplasty technique is still found to be effective and less invasive option even with sever septal deviation.