tailieunhanh - Báo cáo y học: "ransternal repair of a giant Morgagni hernia causing cardiac tamponade in a patient with coexisting severe aortic valve stenosis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Transternal repair of a giant Morgagni hernia causing cardiac tamponade in a patient with coexisting severe aortic valve stenosis. | Nenekidis et al. Journal of Cardiothoracic Surgery 2011 6 30 http content 6 1 30 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Transternal repair of a giant Morgagni hernia causing cardiac tamponade in a patient with coexisting severe aortic valve stenosis MonolziHic1 t Ấ GrìĨTi Ạ I2t AFiTihmhric 7icic3t Ahrich c Drr 1IzTilzic 4 I l l kAloi cic1t lodnnis Nenekidis Vdnid Al Idgnostdkou Cl Idrdldl I Ibos Zisis Cimstos Prokdkis Listldtius N Koletsis Efstrdtios Apostoldkis4t Pdndgiotis Dedeilids1 t Abstract Background Fordmen of Morgdgni hernids hdve trdditiondlly been repdired by Idpdrotomy Idpdscopy or even thoracoscopy. However the trdns-sterndl dpprodch should be used when these rare hernids coexist with other cdrdidc surgicdl disedses. Case presentation We present the cdse of d 74 yedr-old symptomdtic mdle with severe dortic valve stenosis dnd globdl respiratory fdilure due to d gidnt Morgdgni hernid cdusing ddditiondlly cdrdidc tdmpondde. The pdtient underwent simultdneous repdir of the hernid defect dnd dortic vdlve repldcement under cdrdiopulmondry bypdss. The hernid wds repdired through the sternotomy dpprodch without opening of its content dnd during cdrdiopulmondry reperfusion. Conclusions Morgdgni hernid cdn rarely dccompdny cdrdidc surgicdl pdthologies. The trdns-sterndl dpprodch for its mdndgement is ds effective ds other populdr reconstructive procedures unless viscera strangulation and necrosis are suspected. If severe compressive effects to the hedrt domindte the pdtient s clinicdl presentdtion correction during the cdrdiopulmondry reperfusion period is mdnddtory. Background Morgagni hernias are very rare in adults accounting for 2-3 of all diaphragmatic hernias 1 . Although obstructive symptoms of the herniated viscera represent the most common clinical presentation there have been rare cases of severe compressive symptoms to the heart 2 . We present the case of a 75 year old male admitted to the hospital