The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Sep 2007
Intercostal bundle-splitting thoracotomy reduces chronic post-thoracotomy pain.
Intercostal nerve damage is the probable cause of chronic post-thoracotomy pain, but the precise mechanism is not known. To reduce this pain, we devised a simple method of rib spreading and closure (intercostal bundle-splitting thoracotomy), which avoids the intercostal nerve during thoracotomy, and then verified its effectiveness. The devised method appears to result in less chronic pain than the conventional method.
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Thorac Cardiovasc Surg · Sep 2007
Echocardiographic evaluation of the left atrium and left atrial appendage function in patients with atrial septum aneurysm: implications for thromboembolic complications.
Our study aimed to assess left atrium (LA) and left atrial appendage (LAA) function in patients with atrial septum aneurysm (ASA) and to relate it to thromboembolic complications. ⋯ (1) Atrial septum aneurysm impairs left atrium systolic function. (2) In patients with atrial septum aneurysm, left atrium appendage function changes; its systolic as well as a reservoir function improve. (3) The enhancement of LAA function in ASA may be a compensatory mechanism for LA systolic function deterioration. (4) As LAA systolic function is enhanced, it is rather unlikely that LAA is the place of origin of thrombi, which occur relatively frequently (according to the literature) in patients with ASA. The thrombi seem to be formed in the bulging sack of ASA, i.e., in the part of the LA whose systolic function is depressed.