General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · Mar 2009
Case ReportsTraumatic ventricular septal defect following a stab wound to the chest.
A 51-year-old man who had been suffering from depression stabbed himself in the chest with an ice pick. At presentation, an ice pick lodged in the left fifth intercostal space was moving synchronously with his heartbeat. Echocardiography revealed that the tip was penetrating the anterior wall of the right ventricle. ⋯ The pulmonary-tosystemic flow ratio was 1.1 by echocardiographic measurement. No sign of heart failure was present. Although it was agreed to manage the ventricular septal defect conservatively, careful echocardiographic follow-up is mandatory.
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Gen Thorac Cardiovasc Surg · Mar 2009
Case ReportsRare type of congenital aneurysm of the right sinus of Valsalva protruding superiorly into the pericardial space.
We report a rare type of aneurysm of the sinus of Valsalva. The orifice of the aneurysm was in the right sinus of Valsalva and protruded superiorly, which is a direction not typical of right sinus of Valsalva aneurysms. ⋯ The aneurysm was obliterated with a pledgeted suture from outside the orifice of the aneurysm. Early prophylactic surgical treatment of the aneurysm makes the operation simple and prevents subsequent development of complications, such as compression of the coronary artery, thrombosis, and/or spontaneous rupture.
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Gen Thorac Cardiovasc Surg · Mar 2009
Effect of low-dose landiolol, an ultrashort-acting beta-blocker, on postoperative atrial fibrillation after CABG surgery.
Postoperative atrial fibrillation is the most common complication after coronary artery bypass grafting (CABG). This complication is associated with prolongation of the intensive care unit stay and hospitalization time with attendant increased hospitalization costs, and it is an important risk factor for perioperative cerebrovascular accidents. Landiolol is a newly developed ultrashort-acting beta-adrenoceptor antagonist with a half-life of 3 min that is eight times more cardioselective than esmolol. The purpose of this study was to investigate the prophylactic effect of continuous administration of low-dose landiolol on postoperative atrial fibrillation. ⋯ Intraoperative and perioperative administration of low-dose landiolol has a preventive effect on the appearance of atrial fibrillation after CABG surgery.