General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · Jun 2019
Correction to: Thoracic and cardiovascular surgery in Japan in 2016 : Annual report by The Japanese Association for Thoracic Surgery.
In the original publication of the article, the values of the row "Norwood procedure", under "(3) Main procedure" in Table 3 were published incorrectly. The corrected part of the table is given in this Correction.
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Gen Thorac Cardiovasc Surg · Mar 2019
Case ReportsSuccessful surgical treatment with tracheal resection for a symptomatic vascular ring in an adult.
Vascular rings are congenital anomalies of the aortic arch, which may cause compression of the trachea and esophagus. Compression symptoms usually present in infants and children. ⋯ Here, we present an adult case of symptomatic vascular ring formed by the right aortic arch and persistent left ligamentum arteriosus. Respiratory symptoms were predominantly due to severe tracheal stenosis caused by tracheal wall thickening through remodeling during long-standing compression, and were relieved by surgery with transection of the persistent followed by resection and reconstruction of the trachea.
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Gen Thorac Cardiovasc Surg · Feb 2019
Analysis of the perioperative change in cognitive function of patients with risk factors for cognitive impairment in cardiovascular surgery.
The purpose of the present study is to assess the perioperative changes in the cognitive function of patients after cardiovascular surgery (CVS) and to find out risk factors for early postoperative cognitive decline. ⋯ Although preoperative cognitive decline and patients' age were the risk factors for early postoperative cognitive impairment after CVS, a significant recovery can be expected even in elderly patients or patients with low preoperative cognitive function by the time of discharge.
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Gen Thorac Cardiovasc Surg · Feb 2019
ReviewPerioperative intervention by oral medicine team in cardiovascular surgery patients.
In brief, perioperative oral intervention consists of elimination of odontogenic foci and maintenance of oral hygiene in patients undergoing surgery. The importance of oral intervention before, during, and after medical treatments is well-known, especially in cancer patients, because odontogenic foci such as untreated deep dental caries or periodontitis can cause systemic infection in patients with myelosuppression resulting from chemotherapy. Although perioperative oral intervention is currently recommended for patients with cardiovascular disease, its efficacy in this population has not been established. This article consists of three sections: first, we review the current knowledge about the association between dental disease and cardiovascular disease to show the importance of oral hygiene maintenance and the risks of invasive dental procedures in patients with cardiovascular disease; second, we introduce pertinent, but limited evidence concerning the effect of oral care in preventing postoperative pneumonia; and finally, we present the optimal strategy for perioperative oral intervention in cardiovascular surgery patients.
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Bicuspid aortic valve related aortopathy is known to significantly increase the risk for catastrophic aortic events and, therefore, represents a considerable health burden. Albeit of ongoing research in this field including genetic, molecular, hemodynamic and morphologic aspects, bicuspid aortic valve related aortopathy still represents an imperfectly understood disorder. This lack in knowledge results in a lack of consistency considering different therapeutic approaches. ⋯ In this context, there is evidence that regurgitation of bicuspid aortic valves is the more fatal pathomechanism. Furthermore, "age" represents an aspect that should be taken into account when deciding whether to replace the aorta or not, because the diameter depends mainly on a patients age. The same diameter of the aorta in a 70-year old and a 20-year old patient has to be interpreted differently and should, therefore, result in different therapeutic strategies.