The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Mar 2010
Case ReportsMetastasis after resection of huge primary pericardial pleomorphic liposarcoma with cardiopulmonary bypass.
Liposarcoma is the most commonly diagnosed soft tissue sarcoma in adults and occurs predominantly in the lower limbs or retroperitoneal area. However, of the five types of liposarcoma, primary pleomorphic liposarcoma originating in the pericardium is extremely rare. ⋯ However, there is no previous report warning of the possible dangerous effect of cardiopulmonary bypass. We present a rare case of huge malignant primary pericardial pleomorphic liposarcoma with early postoperative multiple metastases which may be due to cardiopulmonary bypass.
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Thorac Cardiovasc Surg · Mar 2010
Case ReportsGiant fluid-filled bulla treated by instillation of antibiotics after percutaneous drainage.
A 46-year-old man was admitted 3 years ago with symptoms of right chest discomfort. A chest X-ray and CT scan revealed an air-fluid level in a previously diagnosed giant bulla in his right upper lung field. ⋯ Two years later almost complete disappearance of the cavity was noted. Although immediate resolution of the giant fluid-filled bulla was not obtainable, the infection was controlled and an invasive procedure avoided.
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Thorac Cardiovasc Surg · Mar 2010
Valve-sparing operation for aortic root aneurysm in patients with Marfan syndrome.
We report our experience with aortic valve-sparing procedures in patients with Marfan syndrome and aortic root aneurysm. ⋯ The early and mid-term results of the valve-sparing operations were favorable, and the durability of the preserved valve should encourage use of this technique in patients with Marfan syndrome.
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Thorac Cardiovasc Surg · Feb 2010
Comparative StudyMinimizing circulatory arrest by using antegrade cerebral perfusion for aortic arch reconstruction in infants causes fewer postoperative adverse events.
Because deep hypothermic circulatory arrest (DHCA) carries a risk for neurological damage, antegrade cerebral perfusion (ACP) is used increasingly for aortic arch surgery in infants. We assessed the short-term effects of minimal DHCA (< 30 minutes) versus prolonged DHCA (> 30 minutes) during biventricular aortic arch reconstruction. ⋯ Minimal DHCA results in fewer adverse events and a reduced length of stay, compared with prolonged DHCA. Therefore, during aortic arch surgery in infants, DHCA should be minimized by using antegrade cerebral perfusion.
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Thorac Cardiovasc Surg · Feb 2010
Case ReportsIatrogenic tracheal rupture during intubation with a double-lumen tube.
Iatrogenic tracheal rupture after intubation with a double-lumen endotracheal tube is rare. An endobronchial tube positioning guide stylet, which is generally used during intubations with a double-lumen tube, may tear the trachea. A 76-year-old patient with right upper lobe carcinoma was scheduled for videothoracoscopic lobectomy. ⋯ The tear in the membranous part of the trachea was repaired. Use of stylets during intubation may cause tracheal injury. To prevent such an injury, the stylet should be withdrawn after the tip of the tube has passed through the vocal cords.