Case Report
Endovascular Therapy for Thoracic Aortic Mobile Thrombus
Issue:
Volume 10, Issue 1, February 2024
Pages:
1-5
Received:
20 January 2024
Accepted:
19 February 2024
Published:
29 February 2024
Abstract: Thoracic aortic mobile thrombus (TAMT) in the absence of atherosclerosis, traumatic injury, or thrombophilia represents an uncommon but well-acknowledged form of a non-cardiogenic thromboembolic source. The morbidity and mortality of acute visceral thromboembolism from an aortic thrombus remains elevated, though delay in diagnosis is common given its underappreciated source as a potentially catastrophic aetiology. Nomenclature to describe any thromboembolism to abdominal viscera remains varied throughout the literature with a cardiac source from arrhythmias most prevalent. Computerized tomographic angiogram (CTA) of chest and abdomen is the modality that most commonly diagnoses TAMT. Trans-esophageal echocardiography (TEE), however, has been the imaging modality of choice in defining the specific thrombus morphology of TAMT. Patient morbidity and mortality of TAMT may entail devastating thromboembolism to myriad sites: cerebrum, mesentery, renal and upper and/or lower extremity peripheral vasculatures. Risks factors of developing aortic mural thrombus are explored within each case. Herein are two illustrative cases of TAMT presenting with acute peritoneal signs and symptoms of visceral ischemia, respectively involving spleen and kidney in the first, and spleen and intestine, the second case. Both cases were successfully managed by physical examination, CTA-diagnosis, intravascular ultrasound (IVUS) to define the morphology of the aortic thrombus, and subsequent thoracic endovascular aortic repair (TEVAR) graft deployment.
Abstract: Thoracic aortic mobile thrombus (TAMT) in the absence of atherosclerosis, traumatic injury, or thrombophilia represents an uncommon but well-acknowledged form of a non-cardiogenic thromboembolic source. The morbidity and mortality of acute visceral thromboembolism from an aortic thrombus remains elevated, though delay in diagnosis is common given i...
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Review Article
Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review
Phan Quang Thuan*
Issue:
Volume 10, Issue 1, February 2024
Pages:
6-13
Received:
12 April 2024
Accepted:
3 May 2024
Published:
17 May 2024
Abstract: Background: Cardiac surgery is a complex medical specialty known for its potential complications, necessitating accurate evaluation and reporting. Current prediction scales have limitations in capturing the full spectrum of complications experienced by patients undergoing cardiac surgery. The Clavien-Dindo Complications Classification (CDCC) and the Comprehensive Complications Index (CCI) have emerged as promising tools for assessing complications in various surgical specialties, including cardiac surgery. Method: This comprehensive review synthesizes the available literature to assess the application of CDCC and CCI in the context of cardiac surgery. The effectiveness of CDCC and CCI in measuring the nature and clinical impact of complications in this specialized field is explored. Additionally, methods from other medical specialties are reviewed to enhance our understanding of the practical implementation of these classification systems in cardiac surgery. Results: The present study, including significant contributions by Mélanie Hébert et al., highlights the potential of CDCC and CCI to quantify both the number and severity of complications in adult cardiac surgery. Their utility in this specialized field presents opportunities for robust data collection and outcome evaluation. Conclusion: While the application of CDCC and CCI in cardiac surgery shows promise, the notable scarcity of comprehensive evaluation studies has hindered the accessibility of these systems to clinicians. This study provides a clear and accessible reference for healthcare professionals seeking to integrate CDCC and CCI into their cardiac surgery practice. Additionally, we propose the need for guideline studies to address this gap in the field.
Abstract: Background: Cardiac surgery is a complex medical specialty known for its potential complications, necessitating accurate evaluation and reporting. Current prediction scales have limitations in capturing the full spectrum of complications experienced by patients undergoing cardiac surgery. The Clavien-Dindo Complications Classification (CDCC) and th...
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