General thoracic and cardiovascular surgery
-
Gen Thorac Cardiovasc Surg · Nov 2008
Comparative StudySecondary spontaneous pneumothorax associated with emphysema and ruptured bullae at the azygoesophageal recess.
With secondary spontaneous pneumothorax (SSP) associated with emphysema, lesions responsible for pneumothorax can be located anywhere along the lung surface. Among such lesions, ruptured bullae at the azygoesophageal recess (AER) have received little attention thus far. ⋯ Bullae at the AER are common and possibly lead to rupture. The presence of a bulla at the AER seen by CT can be predictive of rupture. Although the AER is a unique location, video-assisted bullectomy is the method of choice for treating these lesions.
-
Gen Thorac Cardiovasc Surg · Nov 2008
Review Comparative StudyLung transplantation from donation after cardiac death (non-heart-beating) donors.
Although lung transplantation is a well-accepted treatment for advanced lung diseases, donor shortage remains a significant limiting factor resulting in an increasing number of deaths of people on waiting lists. Recently, some transplant centers have begun to use lungs retrieved from donors after circulatory arrest. This review outlines the relevant published experimental data and clinical experiences with lung transplantation from donation after cardiac-death donors (DCDs) or non-heart-beating donors (NHBDs). Techniques for lung preservation and ex vivo lung assessment of DCD (NHBD) lungs are reviewed, and aspects of primary graft dysfunction after DCD (NHBD) lung transplantation are discussed.
-
Gen Thorac Cardiovasc Surg · Nov 2008
Case Reports Comparative StudyLevosimendan and severe pulmonary hypertension during open heart surgery.
Weaning from cardiopulmonary bypass is the most important stage during mitral valve surgery, especially in patients with severe pulmonary hypertension. We report two patients with severe pulmonary hypertension who were operated on because of valvular heart disease. To reduce the pulmonary artery pressure, levosimendan was used because of its vasodilatory and cytoprotective effects. ⋯ Their postoperative course was uneventful. Levosimendan can be used to treat pulmonary hypertension during operations for heart valve disease. Patients clearly benefit from the vasodilator action of the drug for reducing pulmonary artery pressure.
-
Isolated tricuspid valve replacement, which is not a common operation, is associated with poor short and long-term results, and the postoperative morbidity and mortality rates are high. The main reason for these adverse effects is the acute manifestation of chronic right heart failure. ⋯ We report two cases of tricuspid valve replacement operations performed using levosimendan. Both patients receiving levosimendan tolerated the operations well, and their postoperative courses were uneventful.
-
Gen Thorac Cardiovasc Surg · Nov 2008
Case ReportsSurgical management and treatment of a traumatic right atrial rupture.
We have treated three patients with blunt traumatic right atrial rupture, all of whom survived after an emergent cardiac repair without cardiopulmonary bypass. Cardiac tamponade was seen in two of the three cases on ultrasonographic cardiography (UCG). ⋯ Some patients with a right atrial rupture respond to initial volume resuscitation. Suspecting some cardiac injuries in patients with traumatic pericardial effusion on UCG, a patient with a right atrial rupture can survive with a high probability, without the use of cardiopulmonary bypass.