General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · Jul 2008
Case ReportsPoststernotomy pseudoaneurysm of the internal mammary artery.
We present a case of a 79-year-old man who underwent mitral valve and aortic valve replacement. The patient's postoperative period was almost uneventful. ⋯ Angiography demonstrated that it was a pseudoaneurysm of the left internal manmary artery. The lesion was embolized using coils, which successfully occluded the lesion.
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Gen Thorac Cardiovasc Surg · Jun 2008
Case ReportsIntraoperative contralateral pneumothorax during single-lung transplantation.
Contralateral intraoperative tension pneumothorax is a rare complication of thoracic surgical procedures. Here we present three cases of tension pneumothorax that developed during single-lung transplantation for emphysema and pulmonary fibrosis. To the best of our knowledge, this is only the second report of contralateral intraoperative tension pneumothorax during single-lung transplantation. A high index of clinical suspicion is required for the detection of this potentially catastrophic complication.
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Gen Thorac Cardiovasc Surg · Jun 2008
ReviewRole of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer.
Endobronchial ultrasound (EBUS) is a promising new modality first introduced during the early 1990s. The radial probe EBUS was initially developed seeking for high-resolution imaging of processes in the airway wall and outside the airways. The structure of special importance was lymph nodes, walls of the central airways, and the mediastinum. ⋯ To date, there are no reports of major complications related to EBUS-TBNA. EBUS-TBNA is a novel approach with a high diagnostic yield that is safe. The aim of this article was to review the current role of EBUS-TBNA for the management of lung cancer patients.
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Gen Thorac Cardiovasc Surg · Jun 2008
Comparative StudyNear-infrared spectroscopy for noninvasive evaluation of chest wall ischemia immediately after left internal thoracic artery harvesting.
The conclusions remain controversial about whether the sternal blood flow is preserved or diminished after internal thoracic artery (ITA) harvesting for coronary artery bypass grafting (CABG), especially in diabetic patients. We investigated the blood supply of the chest wall noninvasively using near-infrared spectroscopy (NIRS) immediately after CABG. ⋯ The technique of NIRS enables noninvasive, continuous monitoring of chest wall perfusion immediately after ITA harvesting. Our study using NIRS showed a decrease in blood flow and oxygen metabolism of the hemisternum after LITA harvest in diabetic CABG patients.
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Gen Thorac Cardiovasc Surg · May 2008
Case ReportsThe utility of an autologous blood salvage system in emergency thoracotomy for a hemothorax after chest trauma.
In Japan, little is known about using the Cell Saver in treating blunt or penetrating chest trauma. We therefore report the utility of this autologous blood salvage device. Two patients underwent emergency thoracotomies with the Cell Saver to treat massive hemothorax and made full recoveries. ⋯ The second was a 51-year-old man involved in a car crash; 1600 ml blood was collected from the thorax, of which about 500 ml was reinfused. When no banked blood is available for an emergency thoracotomy, the Cell Saver is an extremely useful machine. This device is also effective in treating progressive hemorrhagic shock and helpful when the rate of blood loss exceeds the supply available from the blood bank.