General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · Jun 2010
Case ReportsPorridge-like tuberculous cardiac tamponade: treatment difficulties in the Horn of Africa.
A 16-year-old boy was hospitalized for fever, chest pain, and cardiovascular collapse. Transthoracic echocardiography revealed a 30-mm circumferential echogenic "porridge-like" pericardial effusion with signs of cardiac tamponade. Tuberculosis (TB) was suspected because of its prevalence in Djibouti. ⋯ After 3 months of follow-up, there was no sign of constrictive pericarditis. Pericardiocentesis may fail in cases of advanced-stage fibrinous TB pericardial effusion. Thus, pericardiotomy with complete open draining is the only lifesaving procedure.
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Gen Thorac Cardiovasc Surg · Jun 2010
Case ReportsRupture of the diaphragm and pericardium with cardiac herniation after blunt chest trauma.
A 61-year-old man was transferred to our institution because of blunt chest trauma after accidentally falling. A chest roentgenogram (CXR) and computed tomography (CT) revealed bilateral hemopneumothorax and fractures of multiple left ribs, the pelvis, and the left femur. On the second day in hospital, the patient suddenly complained of dyspnea. ⋯ They were repaired, and there were no cardiopulmonary complications during or after the operation. Pericardiodiaphragmatic rupture with cardiac herniation after multiple blunt traumas is rare. We describe the successful treatment of a diaphragmatic and pericardial rupture with cardiac herniation, with special reference to pericardial injuries.
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Gen Thorac Cardiovasc Surg · May 2010
Case ReportsSurgically treated infective endocarditis involving the aortic bicuspid valve and ventricular septum revealing aortic regurgitation and a Gerbode defect.
A 41-year-old man who had been previously diagnosed with bicuspid aortic valve presented to our hospital with repeating episodes of fever. Echocardiography revealed vegetation in the bicuspid valve as well as left-to-right shunt, making one suspicious of rupture of the sinus of Valsalva. ⋯ Operative findings showed normal sinus of Valsalva; but a communication between the left ventricle and right atrium was present, suggesting a Gerbode defect. The patient was treated by autologous pericardial patch closure and aortic valve replacement and was dismissed from the hospital without major complications.
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Gen Thorac Cardiovasc Surg · Apr 2010
Predictive factors for postoperative acute exacerbation of interstitial pneumonia combined with lung cancer.
Postoperative acute exacerbation (AE) of usual interstitial pneumonia (UIP) is a serious complication in the surgical treatment for primary lung cancer combined with UIP. The purpose of this study was to determine the predictors of AE of UIP after a major lung resection. ⋯ Preoperative %VC plus serum LDH values were considered the predictive factors for AE of UIP after surgery for lung cancer.