The Thoracic and cardiovascular surgeon
-
Thorac Cardiovasc Surg · Dec 2012
Case ReportsBilateral tension pneumothoraces leading to cardiac arrest after coronary artery bypass surgery.
Bilateral pneumothoraces are a very rare event. In clinical settings, inadvertent incursion into the pleural space resulting from diagnostic or therapeutic medical interventions such as bilateral venipunctures or damage to the lung parenchyma due to high pressure ventilation may be causative. Bilateral pneumothoraces postcardiac surgery are rarely reported. ⋯ Thoracic chest tubes (retrosternal and intrapericardial) and a left pleural tube were removed 24 hours prior to the incident. Diffuse sternal pain sensation accompanied by slow progressive respiratory distress and confusion shortly before the incident were all developed over a period of 12 hours. A prompt cardiopulmonary resuscitation and bilateral chest tube insertion had prevented a fatality in the patient.
-
Thorac Cardiovasc Surg · Dec 2012
Quality of life following surgery of ascending aorta and aortic arch with selective antegrade cerebral perfusion.
Surgery of the ascending aorta and aortic arch has been challenging since its inception as neurological complications may occur significantly affecting the quality of life (QOL). ⋯ The QOL after following the surgery of ascending aorta and aortic arch with selective antegrade cerebral perfusion is excellent on the long-term as assessed by the SIP.
-
Thorac Cardiovasc Surg · Oct 2012
Comparative StudyMidterm results of beating heart coronary bypass surgery for non-left internal thoracic artery anastomosis according to grafting design and implications of intraoperative flow characteristics on graft patency.
The aim of the present study was to investigate the midterm patency of coronary artery bypass grafting (CABG) surgery according to the grafting design and intraoperative flow characteristics. Between March 2007 and July 2008, 218 beating heart CABG patients were prospectively divided into two groups according to the non-left internal thoracic artery (LITA) bypass grafting design; Group I (n = 161, aorta-saphenous vein) and Group II (n = 57, LITA-radial artery composite grafting). Preoperative patient characteristics and the additive EuroSCORE were similar between the two groups (p = 0.82). ⋯ The overall rates of freedom from graft occlusion for the non-LITA to LAD bypasses at 100, 200, and 300 days were 99, 98, and 89%, respectively, in group I, and 95, 88, and 70%, respectively, in group II (P < 0.01). Overall freedom from graft occlusion for LITA to LAD bypasses showed no significant differences between the two groups (98 vs. 93%, p = 0.053). The results suggest superior intraoperative flow characteristics of the direct aorta-saphenous vein bypass grafting design to be attributable for its favorable patency results.
-
Thorac Cardiovasc Surg · Oct 2012
Video-assisted thoracoscopic surgery for posttraumatic hemothorax in the very elderly.
Thoracic injury is a life-threatening condition with advanced age being an independent risk factor for both higher morbidity and mortality. Furthermore, elderly patients often have severe comorbidity and in case of chest trauma with rib fractures and hemothorax, their clinical condition is likely to deteriorate fast. Aim of this study is to investigate the feasibility and results of video-assisted thoracoscopy for the treatment of posttraumatic hemothorax in very elderly patients of 80 years or more. ⋯ Video-assisted thoracoscopic surgery for treatment of posttraumatic hemothorax shows excellent results in very elderly patients of 80 years or more. Despite severe comorbidity and often delayed surgery all patients recovered. We therefore conclude that advanced age is no contraindication for surgical management of posttraumatic hemothorax by means of video-assisted thoracoscopy.
-
Thorac Cardiovasc Surg · Sep 2012
Comparative StudyManagement of lung metastases from colorectal cancer: video-assisted thoracoscopic surgery versus thoracotomy--a case-matched study.
The benefits of video-assisted thoracoscopic surgery (VATS) for performing pulmonary metastasectomy are considered controversial. This case-matched study aimed to compare long-term outcomes after surgical resection of pulmonary metastases from colorectal cancer using different approaches (VATS vs. thoracotomy). ⋯ Our case-matched study showed that survival outcome of pulmonary metastasectomy using VATS is not inferior to that of open thoracotomy in selected cases.