Martin-Trenor, A. (Alejandro)
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- Surgical approach for cardiac surgery in a patient with tracheostoma(Oxford University Press, 1998) Lopez-Coronado, J.L. (José Luis); Legarra, J.J. (Juan José); Martin-Trenor, A. (Alejandro); Sarralde, J.A. (José Aureliio)The thoracic approach for cardiac surgery in a patient with a tracheostoma can result in difficult problems, such as mediastinitis, stoma necrosis or inadequate operative exposure. We present a distinct approach consisting of an incision at the second intercostal space, transverse sternum transection and longitudinal median sternotomy to the xiphoid process, performed for coronary artery bypass grafting and aortic valve replacement, in a patient with previous tracheotomy. This approach permitted adequate surgical exposure for cardiopulmonary bypass, aortic valve replacement and coronary revascularization procedures.
- Surgical treatment of aortobronchial fistula after thoracic endograft failure(BioMed Central, 2011) Dell’Aquila, A.M. (Angelo Maria); Gallo, A. (Alina); Mastrobuoni, S. (Stefano); Olavide, I. (Isidro); Martin-Trenor, A. (Alejandro)Endovascular stent grafting has been recently considered as a less invasive alternative to either medical therapy or open surgical treatment for many patients with descending thoracic aortic disease. Late complications are rarely described in literature. Herein, we described the occurrence of an aorto-bronchial fistula and a retro-A dissection in a 73-year-old man after stent-grafting for a penetrating atherosclerotic ulcer (PAU) of the descending thoracic aorta and the successful surgical technique adopted in order to remove the stent-graft.
- Comunicación entre la arteria coronaria derecha y la aurícula derecha(Universidad de Navarra, 1979) Saenz-de-Buruaga, J.D. (J. D.); Arcas, R. (R.); Alegria, E. (Eduardo); Alonso, A. (A.); Martinez-Caro, D. (Diego); Martin-Trenor, A. (Alejandro)Two cases of anomalous communication of the right coronary artery with the right atrium (the so-called coronary artery fistula) are presented. Both were young females in which a continuous murmur was heard during routine examination. The x-ray image was typical, with a huge bulge in the right border similar to that seen in cases of right atrium enlargement. The ECG was normal in both patients. The diagnosis was made during cardiac catheterization and angiocardiography. A slight left-to-right shunt was present and the aneurismatic dilatation of right coronary artery and communication with the right atrium could be documented. In both cases a surgical closure of the defect was performed, both being well after two years and eight months respectively.
- Aneurisma de aorta ascendente en pacientes con sustitución valvular aórtica previa(Elsevier España, 1993) Herreros, J. (Jesús); Alava, E. (Enrique) de; Gil, O. (O.); Calabuig, J. (José); Martin-Trenor, A. (Alejandro); Llorens, R. (Rafael); Gonzalez-Fernandez, A.L. (A. L.)We conclude that an aggressive surgical approach should be adopted in patients with degenerative aortic regurgitation and moderate dilatation of the ascending aorta because of the rapid progression of the aortic disease. We advise complete replacement of the aortic root.
- Falso aneurisma aórtico 30 años después de la corrección de una coartación: tratamiento quirúrgico bajo hipotermia profunda(Ediciones Universidad de Navarra, 2014) Lopez-Coronado, J.L. (José Luis); Saenz-de-Buruaga, J.D. (J. D.); Martinez-Caro, D. (Diego); Martin-Trenor, A. (Alejandro)We report a case of a large false aortic aneurysm that had developed in a 43-year-old man who had had coarctation repair 30 years previously. The coarctation repair had been done by inserting an end-to-end Dacron tubular graft which was sutured with silk. The re-operation was successfully performed under deep hypothermic arrest and it was noted that there was complete separation of the graft from both ends and no sutures were visualised. The deep hypothermic technique has considerably improved the ease and safety of this operation. We attribute this complication to the reabsorption of the silk sutures. Patients after coarctectomy with graft material should have regular chest X-rays for life in order to detect false aneurysm
- Chronic aneurysm of the descending thoracic aorta presenting with right pleural effusion and left phrenic paralysis(Texas Heart Institute, 1999) Lopez-Coronado, J.L. (José Luis); Rabago, G. (Gregorio); Martin-Trenor, A. (Alejandro)A 62-year-old man was admitted to the emergency department with chronic dysphagia and lower back pain. Chest radiography revealed a wide mediastinal shadow and an elevated left diaphragm, which proved to be secondary to left phrenic paralysis. The patient was diagnosed with an aneurysm of the descending thoracic aorta and was admitted to the hospital. After the patient was admitted, the aneurysm ruptured into the right chest. The patient underwent an emergency operation to replace the ruptured segment with a synthetic graft. Postoperative recovery and follow-up were uneventful. This report describes an unusual presentation of a thoracic aortic aneurysm. Hemidiaphragmatic paralysis caused by compression of the phrenic nerve is an unusual complication that, to our knowledge, has not been previously reported.
- Reoperación coronaria por toracotomía izquierda sin circulación extracorpórea después de laringuectomía: seguimiento a nueve años(Servicio de Publicaciones de la Universidad de Navarra, 2002) Zabala, M. (M.); Dávalos, G. (G.); Alegria, E. (Eduardo); Martin-Trenor, A. (Alejandro)The use of left thoracotomy is an alternative approach in redo coronary surgery in selected patients for whom median sternotomy is potentially hazardous. We present a patient in whom a redo reoperative coronary revascularization was performed off-pump via left thoracotomy to avoid a tracheal stoma. Nine years after reoperation the patient remains free of cardiac symptoms. In selected patients, redo coronary bypass grafting can be performed without cardiopulmonary bypass through a left thoracotomy, with a low perioperative morbidity and mortality rate and good long-term symptomatic improvement.
- Cirugía de la fibrilación auricular(Gobierno de Navarra. Departamento de Salud, 2011-01) Hernandez-Estefania, R. (Rafael); Levy-Praschker, B.G. (Beltran G.); Rabago, G. (Gregorio); Martin-Trenor, A. (Alejandro)Atrial fibrillation surgery is based on creating scars in the atrium, in order to avoid re-entry phenomena that may initiate and perpetuate arrhythmia, and driving the normal stimuli from the sinus node to the atrio-ventricular node. The complexity and increased risk of the initial surgical technique, based on a "cut-and-sew" procedure, have enhanced other current procedures, in which different energies are used making it possible to perform scars in a safer and less invasive way. At present, atrial fibrillation surgery is not performed routinely in all cardiothoracic surgical centers, and there is no consensus in which is the best type of technique. Even if the results are good, they depend on multiples factors such as duration of arrhythmia, atrial size and type of technique employed. In addition, there is some variability in the description within the scientific community of the results and procedures used, which makes its analysis confusing. In this paper we review the different techniques described, the results and their application in minimally invasive surgery.
- Tumor glómico plantar del pie(Elsevier, 1968) Osorio, L.M. (Leopoldo M.); Martin-Trenor, A. (Alejandro)
- Endocarditis por Listeria monocytogenes sobre bioprótesis de Hancock(Elsevier España, 1988) Saenz-de-Buruaga, J.D. (J. D.); Castello, R. (R.); Aparici, M. (M.); Martin-Trenor, A. (Alejandro); Peteiro, J. (J.); Frades, M. (M.); Hidalgo, R. (R.)