Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsVenovenous extracorporeal membrane oxygenation support for treatment of bilateral spontaneous pneumothorax.
Bilateral spontaneous pneumothorax is a rare but serious cause of respiratory distress. We treated a 77-year-old male with severe hypoxia caused by bilateral spontaneous pneumothorax using video-assisted thoracoscopic bullectomy assisted by a venovenous extracorporeal membrane oxygenation (ECMO) device. The patient came to the emergency department of our hospital with complaints of cough and dyspnea, and was hospitalized with right-side spontaneous pneumothorax and left-side pneumonia. ⋯ A chest tube was inserted into the left pleural cavity, and surgery was performed for bilateral pneumothorax by video-assisted thoracoscopic surgery (VATS) assisted by venovenous ECMO. Gas exchange was satisfactory throughout the surgical procedure and the postoperative course was uneventful without complications. Venovenous ECMO was effective for facilitation of VATS and reduced the risk of an intra-operative hypoxic condition.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsExtrathoracic herniation of a lung bulla through a tube thoracostomy site.
We report a case of lung bulla herniation occurring two years after a tube thoracostomy application due to pneumothorax. A new bulla can develop or a pre-existing bulla can herniate through a weak part of thoracic wall, a tube thoracostomy site as in our case. Diagnostic and radiological features of this uncommon case are described.
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Interact Cardiovasc Thorac Surg · Dec 2008
Recent results regarding the clinical impact of smoking history on postoperative complications in lung cancer patients.
Cigarette smoking is a well-known risk factor for perioperative surgery-related complications; however, steady progress in perioperative management has been made year by year. This study investigated the influence of cigarette smoking on postoperative complications in patients with lung cancer over the last three years in our institution. Clinical records of 194 patients who had undergone a pulmonary resection for lung cancer were retrospectively reviewed. ⋯ In a subgroup of smokers subclassified by their smoking status or smoking index, there were no significant differences in postoperative complications. Over the recent three years of this study, smoking history was not a significant risk factor in postoperative complications. Especially in smokers, smoking status or smoking index was not a significant risk factor in postoperative complications, too.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsConsequences of incomplete repair of acute type A aortic dissection.
During emergency repair of acute Stanford type A aortic dissections, surgical compromises in the form of incomplete arch replacement are made due to the unstable condition of the patient and safety issues of the performing team. We report a case of delayed reoperation after previous incomplete surgery for acute type A aortic dissection in a young patient with Marfan's syndrome. ⋯ After a good progress during the first days after surgery, the patient died due to a ruptured thoraco-abdominal aneurysm on the fifth postoperative day. Extensive surgical reconstruction including aortic arch replacement should be considered in patients with Marfan's syndrome who present with aortic dissections type A to avoid unnecessary reoperations and their complications.
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Interact Cardiovasc Thorac Surg · Dec 2008
Case ReportsSurgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique.
A 50-year-old man was diagnosed with Stanford type A acute aortic dissection with cerebral malperfusion and unconsciousness. This clinical presentation was investigated by computed tomography which revealed a severe type A dissection involving all limb arteries. Successful operative treatment based on the direct arterial cannulation of the real lumen of dissected aorta at the level of Botallo's ligament by Seldinger technique achieves an appropriate perfusion and rapid cooling of the instable patient. To our knowledge this is the first reported case in the literature.