General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · Sep 2012
Case ReportsAnterior chest wall reconstruction with titanium plate sandwiched between two polypropylene sheets.
Extensive sternal resection carries the risk of difficult reconstruction and surgical complications. A 79-year-old woman underwent sternal resection and reconstruction for sternal chondrosarcoma. ⋯ Reconstruction of the anterior chest wall using a titanium plate sandwiched between two polypropylene mesh sheets is described. This method is potentially applicable to extensive anterior chest resection, and its advantages compared with conventional prostheses are rigidity, flexibility, and usability.
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Gen Thorac Cardiovasc Surg · Aug 2012
Case ReportsDeath due to undetected heparin-induced thrombocytopenia after cardiac surgery.
A 41-year-old male patient was diagnosed acute myocardial infarction. An intra-aortic balloon pump was inserted to treat heart failure, and off-pump coronary artery bypass surgery was performed. Postoperative cardiac catheterization revealed occlusion of all the 3 bypass grafts, and percutaneous coronary intervention (PCI) was performed. ⋯ Cardiopulmonary arrest occurred suddenly after PCI, and the patient died. Undetected HIT may have caused the sudden change. HIT should be suspected and aggressively treated when thrombocytopenia occurs even during assisted circulation.
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Gen Thorac Cardiovasc Surg · Aug 2012
Case ReportsModified patch repair for bicuspid aortic valve with thickened raphe.
We report a successful repair of bicuspid aortic valve having thickened raphe using pericardial patch. After excising the thickened portion, the patch was sewn to the remaining leaflet and root. To note, the height the patch was sewn to the root was lowered to the equivalent level of the corresponding portion of the other cusp, to create symmetrical bicuspid configuration. Postoperative echocardiography revealed trivial aortic regurgitation with improved leaflet motion and transvalvular flow.
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Gen Thorac Cardiovasc Surg · Aug 2012
Case ReportsInflammatory myofibroblastic tumor of the lung: a benign lesion with aggressive behavior.
Inflammatory myofibroblastic tumor is a rare solid tumor that most often affects children and young adults. They present as myofibroblastic cell proliferations accompanied by inflammatory cells made up mostly of plasma cells. Although benign, the tumor may be very aggressive locally. In this report we describe a 22-year-old woman with primary invasive myofibroblastic tumor of the left lower lobe leading to a left pneumonectomy.
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Gen Thorac Cardiovasc Surg · Aug 2012
Case ReportsEndovascular aneurysm repair of saccular descending thoracic pseudoaneurysm possibly associated with tuberculosis.
In 2010, an 84-year-old man underwent thoracic endovascular aneurysm repair (TEVAR) for the saccular descending thoracic pseudoaneurysm (DTAA), which was adherent to the pulmonary lobe and thoracic vertebrae. Past medical history comprised twice anti-tuberculous medications for pulmonary tuberculosis and tuberculous vertebral osteomyelitis. The dilated aorta was detected at the time of medication for tuberculous vertebral osteomyelitis 24 years ago. ⋯ The association of tuberculosis bacilli was suspected through clinical course as an origin of DTAA, although the histopathological examination was not performed because of invasion. TEVAR was performed considering: (1) no preoperative ongoing inflammation, (2) no evidence of tuberculosis recurrence, and (3) risk factors, such as pulmonary impairments and high age. Several months have been passed since the operation, and the patient remains well without perioperative anti-tuberculous medications.