General thoracic and cardiovascular surgery
-
Gen Thorac Cardiovasc Surg · May 2012
Induction chemotherapy, extrapleural pneumonectomy, and adjuvant radiotherapy for malignant pleural mesothelioma: experience of Guy's and St Thomas' hospitals.
The treatment of malignant pleural mesothelioma (MPM) remains controversial. We present a prospective study of patients treated at our institution with neoadjuvant chemotherapy, extrapleural pneumonectomy (EPP), and radical radiotherapy. ⋯ Despite recent advances in chemotherapy, surgery, and radiotherapy, survival rates remain low for patients with MPM completing multimodality therapy including EPP.
-
Gen Thorac Cardiovasc Surg · May 2012
Insights of stroke in aortic arch surgery: identification of significant risk factors and surgical implication.
Although the outcomes of aortic arch surgery have improved, stroke remains one of the most devastating complications. Therefore, identification of true risk factors and understanding the pathogenesis of intraoperative stroke are necessary to decrease its occurrence. ⋯ Intraoperative strokes during elective aortic arch surgery under deep hypothermic circulatory arrest and antegrade selective cerebral perfusion are strongly influenced by the presence of a high-grade atheroma in the ascending aorta and prolonged brain ischemia time. The results suggest that these are key issues to reduce stroke in aortic arch surgery.
-
Gen Thorac Cardiovasc Surg · May 2012
Case ReportsPseudoaneurysm following percutaneous balloon angioplasty for aortic arch recoarctation after the Norwood procedure.
We experienced a rare case of 5-month-old male infant presenting with a pseudoaneurysm following percutaneous balloon angioplasty for aortic arch recoarctation after undergoing the Norwood procedure. The pseudoaneurysm, which measured 1 cm in diameter, was located between the left carotid artery and the left subclavian artery. Under deep hypothermic circulatory arrest, resection of the pseudoaneurysm and reconstruction of the neoaortic arch were performed successfully.
-
Gen Thorac Cardiovasc Surg · May 2012
Case ReportsComplete atrioventricular block subsequent to thrombosed-type acute aortic dissection.
We report a case of complete atrioventricular block subsequent to thrombosed-type acute aortic dissection. An 81-year-old woman with thrombosed-type acute aortic dissection experienced cardiopulmonary arrest and complete atrioventricular block 6 days after aortic dissection. ⋯ Atrioventricular conductivity disorders that result in complete atrioventricular block are rare complications developing after aortic dissection, especially thrombosed-type aortic dissection. We discuss the cause of atrioventricular block subsequent to aortic dissection.
-
Gen Thorac Cardiovasc Surg · May 2012
Short-term and long-term outcomes of postinfarction ventricular septal perforation.
Ventricular septal perforation represents a serious complication after acute myocardial infarction. This study aimed to evaluate the short-term and longterm outcomes of postinfarction ventricular septal perforation (VSP). ⋯ The long-term survival outcome of VSP patients during the postoperative period was comparatively good, but the prognosis of VSP patients with multivessel disease was not satisfactory because of congestive heart failure or ventricular arrhythmia. We believe that postoperative medical treatment for preventing cardiac remodeling is important for improving long-term survival outcomes in such patients.