General thoracic and cardiovascular surgery
-
Gen Thorac Cardiovasc Surg · Sep 2018
Effect of early tracheostomy on clinical outcomes in critically ill lung transplant recipients.
The purpose of this study was to evaluate the effect of early tracheostomy in patients following lung transplantation and to determine its optimal timing and influence on clinical outcomes. ⋯ Early tracheostomy following lung transplantation decreased both intensive care and hospital stay, due to improved postoperative recovery, even in patients with poor preoperative conditions. Furthermore, length of hospital stay in patients with early tracheostomy was similar to that of patients without tracheostomy after lung transplantation.
-
Gen Thorac Cardiovasc Surg · Sep 2018
Case ReportsAtraumatic tension hemothorax associated with ruptured aneurysm of intercostal artery-azygous fistula: a case report.
Atraumatic tension hemothorax is extremely rare. We report a case of 62-year-old woman presented with obstructive and hypovolemic shock status by tension hemothorax due to ruptured aneurysm of congenital intercostal artery-azygous fistula. ⋯ Our experience indicates that the rupture of congenital arteriovenous fistulas (AVFs) of systemic circulation in the thoracic cavity might cause not only hypovolemic shock but also atraumatic tension hemothorax. Surgery following preoperative endovascular embolization offers a feasible treatment strategy for ruptured aneurysms associated with AVFs.
-
Gen Thorac Cardiovasc Surg · Aug 2018
Case ReportsA case of an elderly man who required repeated repair of a ventricular septal defect and tricuspid rupture after blunt chest trauma.
Several cases of traumatic ventricular septal defect (VSD) have been reported. However, traumatic VSD complicated by tricuspid rupture is rare. We report a case of traumatic VSD with tricuspid rupture who required repeated repair of both conditions. ⋯ The borders of the defect were very fibrotic and strong compared with those in the first operation. Surgical treatment of traumatic VSD should be postponed in hemodynamically stable patients. When emergent repair is performed, careful follow-up is necessary to diagnose new VSD.
-
Gen Thorac Cardiovasc Surg · Jul 2018
ReviewSurgical strategies for pulmonary atresia with ventricular septal defect associated with major aortopulmonary collateral arteries.
Treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries is challenging and controversial. Basically, the collateral arteries are treated surgically by unifocalization to integrate them and unify the blood flow in the pulmonary circulation. These major collateral arteries are anatomically similar to the bronchial arteries; however, they develop into different vessels because of different environmental exposures. ⋯ Recently, single-stage unifocalization performed during infancy has become the preferred method for achieving low right ventricular pressure after closing the ventricular septal defect. Furthermore, for the maintenance of the lowest possible right ventricular pressure after definitive repair, combination therapy or hybrid therapy with catheter and surgical intervention is essential. The surgical treatment strategy for a single ventricle with major aortopulmonary collateral arteries is more difficult than that involving two ventricles.
-
Gen Thorac Cardiovasc Surg · Jul 2018
The impact of junior surgical jobs in cardiothoracic surgery on career choice in the United Kingdom.
Cardiothoracic surgery is a small specialty, often with a limited presence on the undergraduate curriculum. In the past, there was a heavy reliance on postgraduate exposure to inform career choice. Recent changes in recruitment to the specialty in the United Kingdom may reduce exposure of the best trainees to the specialty, and reduce the quality of future surgeons. This study will evaluate the impact of junior surgical jobs on future career preferences. ⋯ The role of junior surgical jobs in the specialty is immensely important on career choice. Moving to a more junior recruitment may exclude excellent candidates who have simply not experienced cardiothoracic surgery.