General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · Oct 2012
Comparative StudyComparative study of brain protection in ascending aorta replacement for acute type A aortic dissection: retrograde cerebral perfusion versus selective antegrade cerebral perfusion.
Postoperative disorders of the central nervous system remain a major problem in thoracic aortic surgery. Both retrograde cerebral perfusion and selective antegrade cerebral perfusion have become established techniques for cerebral circulatory management. In this study, we compared neurologic outcomes and mortality between retrograde cerebral perfusion and antegrade selective cerebral perfusion in patients with acute type A aortic dissection who underwent emergency ascending aorta replacement. ⋯ Both retrograde cerebral perfusion and antegrade selective cerebral perfusion were associated with acceptable levels of postoperative neurologic deficits, mortality, and morbidity. Either of these techniques for brain protection can be used selectively, based on a comprehensive assessment of general condition, in patients undergoing surgery for acute type A aortic dissection.
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Gen Thorac Cardiovasc Surg · Oct 2012
Comparative StudyHospital volume and outcomes of cardiothoracic surgery in Japan: 2005-2009 national survey.
To elucidate the relationship between hospital volume and cardiothoracic surgical outcomes in Japan using the annual survey data, obtained between 2005 and 2009, collected by the Committee for Scientific Affairs of the Japanese Association for Thoracic Surgery. ⋯ There is a weak or no inverse correlation between the hospital volume and the mortality in cardiothoracic surgery in Japan. Most of the low-volume hospitals are not associated with inferior outcomes. The performance of the lower-volume hospitals should be carefully scrutinized using risk adjustment.
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Gen Thorac Cardiovasc Surg · Oct 2012
Case ReportsReconstruction of the right ventricular outflow tract after surgical removal of a cardiac hemangioma.
An asymptomatic 73-year-old man underwent resection of a cardiac tumor arising from the right ventricular outflow tract, and reconstruction of the right ventricular outflow tract using an expanded polytetrafluoroethylene sheet. Histological examination revealed a cavernous-capillary type cardiac hemangioma, which is a very rare cardiac tumor.
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Gen Thorac Cardiovasc Surg · Oct 2012
Traumatic diaphragmatic injury: experience from a tertiary emergency medical center.
We investigated our 12-year experience of traumatic diaphragmatic injury (TDI) in our emergency medical center. This study aimed to clarify clinical features of TDI and identify factors affecting mortality and morbidity in TDI treatment. ⋯ TDI occurs in cases of multiple trauma. Higher ISS and lower Ps predict death; therefore, prompt diagnosis of TDI and immediate repair of diaphragmatic injury are important.
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Gen Thorac Cardiovasc Surg · Sep 2012
Case ReportsTakotsubo cardiomyopathy associated with pulmonary resections after induction chemoradiotherapy for non-small cell lung cancer.
Takotsubo cardiomyopathy (TTC), also known as transient left ventricular (LV) apical ballooning syndrome, is characterized by transient LV dysfunction. We present the case of a 72-year-old man who was diagnosed as having TTC after surgery for two lung tumors. The patient was treated with induction chemoradiotherapy (CRT) followed by pulmonary resections for double primary non-small cell lung cancers (NSCLC): cT4N1M0 disease in the right lung and cT2N0M0 in the left lung. ⋯ An echocardiogram revealed akinesis at the apex with a 30 % ejection fraction. He was diagnosed as having TTC and recovered with supportive care. This case is the first report of TTC occurring after tri-modality therapy for NSCLC.