简介:AbstractObjective:To review current literature and experience with Gore-Tex® implant extrusion following medialization thyroplasty, as well as to report the unique case of Gore-Tex® implant extrusion following revision medialization thyroplasty.Methods:Review of existing literature and description of personal experience with unique case of Gore-Tex® implant extrusion following revision medialization thyroplasty.Results:Review of existing literature found no prior reported cases of Gore-Tex® implant extrusion following revision medialization thyroplasty. Risk factors for implant extrusion include the pressure of the implant on insertion and the inability to secure the implant. Cases of implant extrusion can be managed operatively via an endoscopic or via an external open approach.Conclusion:This is the first reported case of Gore-Tex® implant extrusion following revision medialization thyroplasty. Careful consideration should be given in revision medialization thyroplasty as additional implant material may cause increased pressure, a risk factor for implant extrusion.
简介:BackgroundChordaereconstructionisoneofthekeypointsinrepairofmitralvalveprolapse,especiallyforanteriorleaflets.Hereweintroduceourexperiencesofusingecho-determinednormalchordaellengthtomaketheloopspreoperativelyandrebuildtheelongated/rupturedchordaeintraoperatively.MaterialsandmethodFromJune2011toFebruary2012,19consecutivecaseswithmitralanteriorleafletprolapseunderwentvalverepairprocedures.Echocardiographywasusedtodeterminethelengthofnormalchordaethattheprolapsedleafletsshouldhavefornormalcoaptation.Theartificialchordaewasfabricatedinloopsaccordingtoecho-determinedlength.ResultsAllpatientssurvivedtheoperations.2.8preoperativelypreparedloopswereusedperpatienttorestoretheanteriorleaflets,aswellasposteriorleaflets.Artificialmitralvalveringswereappliedto18patientsformitralannuloplasty.16patientswereunderwentdifferentconcomitantoperations.Echocardiographicresultsatdischargeshowedthatgradeofmitralregurgitation,leftventricularend-diastolic,end-systolicdimensiondecreaseddefinitely,respectivelyfrom3.26±1.10,53.79±15.03mm,33.00±12.05mmpreoperativelyto0.47±0.61(P<0.01),44.74±10.28mm(P<0.01),30.16±10.58mm(P<0.05)postoperatively.AllpatientsimprovedclinicallyandNYHAfunctionalclassdecreasedsignificantlyfrom2.17±0.81to1.12±0.33.ConclusionReconstructionofprolapsedanteriorleafletchordaewithartificialloopsinpreoperativelyecho-determinedlengthissafeandeffective,andinitialclinicaloutcomeissatisfactory.
简介:摘要目的探讨胸主动脉覆膜支架分段释放技术联合"潜望镜"技术在Stanford B型主动脉夹层腔内修复术后远端破口处理中的临床应用价值。方法回顾性分析2019~2020年5例Stanford B型主动脉夹层腔内修复术后胸主动脉远端假腔扩张患者的临床资料。结果5例患者均为男性。主动脉CTA影像资料显示内脏区主动脉存在夹层再破口,支架远端夹层动脉瘤形成。均采用Gore C-TAG支架的分段释放定位联合"潜望镜"技术方法处理夹层远端破口。手术成功率100%,无中转开腹和围手术期死亡病例。术后复查主动脉CTA显示夹层远端破口隔绝完全,分支血管灌注通畅。结论采用Gore C-TAG支架分段释放技术联合"潜望镜"技术方法处理夹层远端破口技术操作简单,成功率高,近期效果满意。