The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Apr 2009
Case ReportsVascular catheter mimicking persistent left superior vena cava.
We report the case of a 42-year-old woman with a double vascular catheter mimicking a false persistent left superior vena cava on a chest X-ray. Physicians should be aware of the correct course of these catheters in order to avoid serious clinical consequences.
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Thorac Cardiovasc Surg · Apr 2009
Comparative StudyMorbidity in video-assisted thoracoscopic lobectomy for clinical stage I non-small cell lung cancer: is VATS lobectomy really safe?
The objective of this study was to compare video-assisted thoracoscopic lobectomy (VATS lobectomy) with standard thoracotomy in terms of morbidity and mortality. ⋯ Pulmonary vessel injury, longer operation times, and greater blood loss have been frequently observed with VATS lobectomy. Proficiency is required to perform VATS lobectomy, and the procedure should be performed by a well-trained surgeon as indicated by the results of this study.
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Thorac Cardiovasc Surg · Apr 2009
Comparative StudyImportance of urinary measurement of glutathione S-transferase in renal dysfunction patients after on- and off-pump coronary artery bypass surgery.
Acute renal failure (ARF) occurring after on-pump and off-pump cardiac surgery was assessed by urinary alpha glutathione S-transferase measurement (alpha-GST) in patients who already had renal dysfunction. ⋯ Tubular damage produced by cardiopulmonary bypass is not the only factor associated with postoperative ARF. Because factors independent of pump usage can adversely affect renal function, excluding pump usage alone is not sufficient to prevent postoperative ARF in patients who have preoperative renal dysfunction.
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Thorac Cardiovasc Surg · Apr 2009
Long-term survival after surgery for acute coronary syndromes in relation to perioperative troponin T release and angina class - a prospective study in 200 patients.
Patients with acute coronary syndrome have an increased risk of cardiac death or myocardial infarction after urgent coronary artery bypass surgery (CABG). Symptoms and signs of ongoing ischemia, such as elevated cardiac troponin T and angina at rest at the time of the operation identify patients at particular risk of early death, but the impact of these parameters on long-term survival is poorly investigated. ⋯ In patients with acute coronary syndrome, parameters such as elevated troponin T and angina at rest herald an increased risk of postoperative myocardial infarction and indicate the need for pharmacological and mechanical inotropic support but have no bearing on long-term survival.
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Thorac Cardiovasc Surg · Apr 2009
Off-pump coronary artery bypass graft surgery: a training course for novices and its learning curve.
The learning curve for off-pump coronary artery bypass grafting (OPCABG) surgery still requires further discussion. Training programs aimed at the conversion of conventional coronary artery bypass grafting (CABG) to OPCABG have mainly been geared towards those persons who already have much experience in conventional CABG. The goals of this study were to retrospectively analyze the training process of two trainees who had no previous coronary surgery experience and to discuss the efficiency and feasibility of the training. ⋯ The appropriate qualifications for OPCABG trainees and the optimal OPCABG training program have not yet been resolved. In this study, the observed learning curves of cardiac surgeons who had no prior coronary surgery experience during their training to perform the OPCABG procedure by a sophisticated OPCABG surgeon indicated that the training program employed was feasible and its outcomes were reasonable.