European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Feb 2007
Case ReportsSupradiaphragmatic thoracic duct clipping for chylothorax through left-sided video-assisted thoracoscopic surgery.
Chylothorax is a life-threatening clinical entity. Traditional surgical management for cases refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy or closure of the site of duct laceration through an open thoracotomy. We report herein two patients with left chylothorax successfully treated by supradiaphragmatic thoracic duct (STD) ligation through left-sided video-assisted thoracoscopic surgery (VATS). This approach offers optimal exposure for the thoracic duct ligation and is useful for treatment of left chylothorax after left-sided thoracic surgery and idiopathic left chylothorax.
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Eur J Cardiothorac Surg · Feb 2007
Case ReportsMediastinal hematoma and left main dissection following blunt chest trauma.
A 40-year-old man sustained blunt chest trauma resulting in sternal fracture, mediastinal hematoma, and dissection of the left main coronary artery. Because of associated injury, the coronary angiogram was performed 7 days after the accident and off-pump coronary bypass surgery was performed immediately. Two months later, follow-up angiogram revealed completely healed left main dissection. The patient continues to do well 4 months postoperatively.
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Eur J Cardiothorac Surg · Feb 2007
Randomized Controlled TrialThe effect of sodium nitroprusside infusion on renal function during reperfusion period in patients undergoing coronary artery bypass grafting: a prospective randomized clinical trial.
Acute renal failure remains a common and serious complication of cardiac surgery. In this randomized trial, we aimed to assess whether sodium nitroprusside (SNP) infusion during cardiopulmonary bypass (CPB) could prevent renal dysfunction after coronary artery bypass grafting (CABG) surgery. ⋯ SNP administration during rewarming period of non-pulsatile CPB in patients undergoing CABG surgery is associated with improved renal function compared with conventional medical treatment providing adequate preload and mean arterial pressures.
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Eur J Cardiothorac Surg · Feb 2007
Randomized Controlled TrialEfficiency of fleece-bound sealing (TachoSil) of air leaks in lung surgery: a prospective randomised trial.
Persistent air leakage following pulmonary resection is a major limiting factor for discharge from hospital. The aim of this study was to evaluate the sealing capacity of TachoSil for the closure of alveolar air leaks following parenchymal resections and to determine its effect on time to chest drain removal and duration of hospitalisation. ⋯ The use of TachoSil following pulmonary resection resulted in a reduction in air leakage compared with standard techniques. This reduction in air leakage resulted in a significant reduction in both the time to chest drain removal and the period of hospitalisation.
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Eur J Cardiothorac Surg · Feb 2007
Randomized Controlled TrialThe approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy.
To evaluate two different approaches used to perform fused fissures in lobectomies in terms of persistent air leak (PAL) and their impact on length of hospital stay. ⋯ The fissureless technique appears to be a superior approach for fused fissures in terms of both preventing persistent air leak and reducing the length of hospitalisation. This technique can be performed safely at no additional cost and without adverse consequences.