The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Apr 2006
Case ReportsMechanical circulatory support for profound cardiac circulatory shock status due to postoperative pulmonary artery bleeding.
A 77-year-old patient suffering from life-threatening pulmonary artery bleeding after pulmonary lobectomy was resuscitated but had refractory cardiogenic shock after the bleeding was controlled. We used mechanical circulatory support with extracorporeal membrane oxygenation and intra-aortic balloon pump to overcome the hemorrhagic shock-related cardiac suppression and multi-organ injury in the post-resuscitation critical period.
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Thorac Cardiovasc Surg · Mar 2006
Comparative StudyTransbronchial fine needle aspiration cytological examination: a useful tool for diagnosing primary lung cancer.
Obtaining a definitive preoperative diagnosis plays a critical role in deciding upon the treatment approach for lung carcinoma. However, success in making definitive diagnoses of small primary lung cancers will require new approaches because these cancers are difficult to detect using standard biopsy procedures. ⋯ The sensitivity of preoperative cytological diagnosis for primary lung cancers, especially transbronchial aspiration cytology, is high. Transbronchial fine needle aspiration cytology is useful for the preoperative diagnosis of primary lung cancer.
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Thorac Cardiovasc Surg · Mar 2006
Comparative StudyOpening and closure characteristics of different types of stented biological valves.
In an increasingly senescent population stented biological valves have regained renewed popularity because of the absence of anticoagulation, while the stented design allows for safe and easier implantation. Constructed bovine pericardial valves as well as valves with porcine cusps are used, both of which exhibit good clinical results although degeneration still appears. While clinical hemodynamic studies did not show particular differences between both valves types, the opening and closure behavior of native cusps and artificially constructed pericardial leaflets is different. It is unclear whether these phenomena account for differences in load and stress which may influence onset and course of degeneration. ⋯ While valves with constructed pericardium showed lower mean transvalvular gradients, particularly in the smaller sizes, this valve type exhibited alterations of movement performance in contrast to porcine valves. It can be speculated that constant power transfer to the valve's structures may result in an earlier degeneration because of the impact of the increased load and stress on the suspension apparatus of the constructed pericardial leaflets.
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Thorac Cardiovasc Surg · Feb 2006
Randomized Controlled TrialCoagulation factor XIII reduces postoperative bleeding after coronary surgery with extracorporeal circulation.
One cause of diffuse bleeding after cardiac operations may be a low plasma concentration of coagulation Factor XIII, which is essential for coagulation but is not covered by standard coagulation monitoring. ⋯ Factor XIII administration reduces postoperative blood loss and the extent of blood transfusion after coronary surgery, however administration is only helpful if plasma levels are below the normal value. Measurement of plasma levels is recommended before Factor XIII substitution.
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Thorac Cardiovasc Surg · Feb 2006
Comparative StudyPrognostic significance of subcarinal station in non-small cell lung cancer with T1-3 N2 disease.
Surgical resection may continue to offer the best chance of long-term survival for patients with non-small cell lung cancer (NSCLC). Generally, patients with N2 NSCLC have a poor prognosis. However, the surgical treatment of patients with N2 remains controversial as in these patients, some N2 subgroups have better prognoses than others. The objective of the current study was to evaluate the factors associated with N2, and to determine whether such factors are reliable predictors of survival. ⋯ Surgery for patients with T1-3 N2 NSCLC might be acceptable if subcarinal lymph node metastasis is predicted to be absent.