Cardiothoracic Surgery

Permanent URI for this community

https://scholar.sun.ac.za/handle/10019.1/179

Browse

Browsing Cardiothoracic Surgery by Author "Janson, Jacques"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    A case report of an aorto-pulmonary-venacaval fistula after penetrating cardiac injury
    (Oxford University Press, 2020-12-15) Koen, Johannes Gerhardus; Wagenaar, Riegardt; Janson, Jacques
    Background: Penetrating cardiac injury (PCI) is an accepted burden in high violent crime areas. Traumatic intracardiac fistulae are however not that commonly detected on initial presentation, with most of these injuries being detected post-operatively or at routine follow-up. The literature is devoid of general principles around the pre-operative planning and intra-operative management in these cases, and thus warrant documented case reports by clinical units experienced in the management of these challenging clinical scenarios. Case summary: We describe a case report of a 29-year-old male patient presenting to our Cardiothoracic Unit with an aorto-pulmonary-venacaval fistula after a traumatic PCI. We describe the clinical presentation, diagnostic challenges, and institutional experience in the operative management of this case. Discussion: The patient was treated successfully with repair via sternotomy and femoral cardiopulmonary bypass with no neurological, pulmonary, or cardiac sequelae at early follow-up. The importance of selective pre-operative imaging in PCI, appropriate pre-operative surgical planning, and surgical experience in the management of these injuries is highlighted in this case presentation.
  • Thumbnail Image
    Item
    COVID-19 and cardiothoracic surgery : a risk-adjusted approach in the context of a global pandemic
    (South African Heart Association, 2020) Reddy, Darshan; Kleinloog, Robert; Janson, Jacques; Manganyi, Rogers; Brink, Johan; Zilla, Peter; ns202102
    ENGLISH ABSTRACT: In the face of the novel coronavirus pandemic, the impact of COVID-19 infection has disrupted cardiothoracic surgical services globally. A risk-adjusted approach to restructuring the delivery of cardiothoracic surgical services has been proposed in accordance with international guidance to ensure that the surgical standard of care is maintained in the practice of adult and paediatric cardiac surgery, as well as thoracic surgery. The potential influx of COVID-19 patients with cardio-respiratory complications requiring intensive care management and associated surgical procedures falling within the gamut of the thoracic surgeon, is considered. Finally, the protection of healthcare workers, in particular the surgical team exposed to aerosolising procedures, is outlined.