China
Africa
Explore chapters and articles related to this topic
Deaths Following Cardiac Surgery and Invasive Interventions
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Almost all operations on the heart using cardiopulmonary bypass (‘open’ operations) are done through a midline skin incision and a median sternotomy is always a long sternal scar. Drains scars are usually in the epigastrium. Coronary artery bypass procedures often involve the use of either one or both long saphenous veins, so that there will be long scars on the medial aspect of the legs. Some centres use tissue glue to stick the incision together and no sutures are present in these cases. Occasionally, veins from the arms are used when saphenous veins are unavailable (previous operation) or are unsuitable (varices). The internal thoracic arteries (left internal mammary artery (LIMA)) are used as arterial grafts to the left anterior descending coronary artery, combined with the venous grafts to the circumflex (obtuse marginal branches), or posterior descending coronary artery. Minimally invasive surgery via partial upper sternotomy for aortic root surgery represents an alternative to the full median sternotomy.
Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
For some patients, stable angina is only a slight aching sensation. It can quickly become severe and intense, usually described as a crushing sensation, but not usually described as pain. Discomfort is most common under the sternum. It may radiate to the left shoulder and outside portion of the left arm. The discomfort can reach the fingers, move to the back, and jaws. Some patients have described discomfort in the upper abdomen. Atypical angina is less common and involves abdominal distress, bloating, and gas. The patient often believes that indigestion is the cause. Ischemic symptoms usually require a minute or longer to resolve, so very brief sensations are usually not from angina.
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The thoracic spine is distinguished by its 12 ribs, attaching either side of 12 thoracic vertebrae (see Figure 7.35). Each rib attaches to its vertebrae at two points, the costovertebral and costotransverse joints. The rib circles around the body and attaches anteriorly to the sternum via the costal cartilage. The function of the ribs is to protect the vital organs – the heart, lungs, kidneys and liver – from traumatic injury.
Ultrasound -guided erector spinae plane block (ESPB) versus intravenous opioids based analgesia in patients with rib fractures
Published in Egyptian Journal of Anaesthesia, 2023
Soha Elmansy, Mohammed Abdelkhalek, Sherif Farouk, Randa Shoukry, Ahmed Khames
Patients who refused the intervention or participation in this study.Patients who could not achieve effective communication.Patients with a fractured sternum.Bleeding disorders.Relevant drug allergy.Significant lung or pleural injuries.Significant traumatic injuries, e.g., pelvic or spine fractures, injuries of the abdominal viscera, or severe injuries affecting the spinal cord or the brain.Intubated patients.Local infection at the site of intervention.
Risk Stratification for Postoperative Pulmonary Complications following Major Cardiothoracic and Abdominal Surgery – development of the PPC Risk Prediction Score for Physiotherapists Clinical Decision-making
Published in Physiotherapy Theory and Practice, 2023
Janne Hastrup Jensen, Lotte Sørensen, Sebastian Breddam Mosegaard, Inger Mechlenburg
We found two surgical incision sites to be strongly associated with PPC, which is also supported by the literature (Smetana, Lawrence, and Cornell, 2006). Sternotomy is performed in most major cardiac surgeries, and the instability and pain related to the sternum split might lead to hypoventilation and insufficient cough. Thoraco-abdominal incision used for esophagectomies and thoraco-abdominal aorta aneurism repair facilitates greater surgical stress responses related to the extended tissue damage (Kehlet and Wilmore, 2008). Patients undergoing esophagectomy were found to have five times increased risk of PPC compared to patients undergoing other major abdominal procedures (Yang, Teng, Lee, and Rose, 2015). Thoracoscopic, thoracotomy and laparotomy procedures were not significantly associated with increased risk of PPC, yet PPCs still occurs after these surgical procedures. Possible reasons could be the presence of predictors related to patient health status, intra- or postoperative events as well as the moderate discrimination of the model.
Rare case of low-grade fibromyxoid sarcoma of the thoracic wall with complete sternum reconstruction
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
João Nunes Pombo, Artur Nixon Martins, Catarina Paias Gouveia, Ágata Nawojowska, Samuel Mendes, Daniel Cabral, Francisco Félix, Bruno Rosa, Carlos Pinheiro, Miguel Andrade, Gaizka Saenz Ribeiro
Sternal reconstruction is essential for protection of the mediastinal contents, stabilization of the thorax and for maintenance of respiratory physiology. Usually, titanium plates or meshes are the chosen method for reconstruction but molding of the plates is dependent on surgeon’s experience. Recently, there has been an interest in developing 3 D printed custom-made prostheses for total sternum reconstruction [16]. These prostheses have evolved from titanium to high-density porous polyethylene (StarPore™ – Anatomics™), which is significantly lighter and more flexible. It also allows intraoperative modification and fast tissue integration [15]. We have selected a StarPore™ prostheses, manufactured from a preoperative CT of the patient. For soft tissue reconstruction a latissimus dorsi muscle free flap was chosen as it presented adequate size and thickness to fully cover the prosthesis and the soft tissue defect.