General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · May 2007
Case ReportsSelective lobar bronchial blockade using a double-lumen endotracheal tube and bronchial blocker.
We report our experience of a selective lobar bronchial blockade (SLBB) technique with a bronchial blocker (BB) which was employed successfully with a routine double-lumen endotracheal tube (DLT) in three patients. For the first case, we selectively blocked the infected left lower lobe in a surgical patient with a lung abscess in a DLT setting. ⋯ For the third case, selective continuous positive airway pressure (CPAP) to the blocked lobes on the operative side resulted in oxygenation improvement with one-lung ventilation (OLV) in a DLT. This novel technique provides benefits during general thoracic surgery by preventing contamination, providing a better operative field, and improving oxygenation with lobar CPAP.
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Gen Thorac Cardiovasc Surg · May 2007
Case ReportsSurgical repair of coronary sinus orifice atresia with persistent left superior vena cava in heterotaxia.
A 6-month-old boy was diagnosed with coronary sinus orifice atresia, double-outlet right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and moderate common atrioventricular valve regurgitation associated with heterotaxy syndrome. Cardiac venous flow drained through a persistent left superior vena cava. ⋯ Bidirectional Glenn anastomosis and edge-to-edge common atrioventricular valve repair were concomitantly performed. After a 1-year follow-up period, the patient is alive and well without any ischemic event.
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Gen Thorac Cardiovasc Surg · May 2007
Case ReportsFive cases of blunt traumatic cardiac rupture: success and failure in surgical management.
We report five cases of blunt cardiac rupture seen in our hospital during the last 6 years. All these patients sustained blunt chest trauma due to motor vehicle or motorcycle accidents, and all had vital signs on arrival at the emergency department. We suspected cardiovascular injuries from the findings of echocardiography and CT scans, and all five cases were operated on 2-6 h after injury. ⋯ The tears were repaired using simple suture or ligation techniques for all patients, with cardiopulmonary bypass in three patients. One patient died during the operation, and four patients survived, therefore the survival rate was 80%. We believe that patients with cardiac rupture who are alive when they reach hospital can often be saved by prompt diagnosis and immediate, adequate surgical repairs.
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Gen Thorac Cardiovasc Surg · May 2007
Case ReportsA middle lobe tractotomy of the lung for a stab injury: report of a survival case.
We report the case of a patient who survived after a pulmonary tractotomy. A 54-year-old man was stabbed in the back with a knife and was admitted to our emergency department. Imaging findings showed that there was hemopneumothorax of the right lung. ⋯ It was found that the wound penetrated through a middle lobe to the surface of an upper lobe of the right lung. A right middle lobe tractotomy was performed, and the patient's postoperative course was uneventful. Selected patients can be rescued without resection of a massive amount of lung tissue.
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Gen Thorac Cardiovasc Surg · Mar 2007
Management of vital organ malperfusion in acute aortic dissection: proposal of a mechanism-specific approach.
We report our strategy for malperfusion accompanying acute aortic dissection, especially that involving the abdominal organs, which is based on the mechanism and includes percutaneous management. ⋯ Central aortic operation or fenestration is effective for aortic-type malperfusion, whereas the branch type may require stenting or bypass grafting.