Asian cardiovascular & thoracic annals
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An unusual case of a sewing needle in the heart is reported for its rarity. The relevant literature is briefly reviewed.
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Asian Cardiovasc Thorac Ann · Feb 2006
Case ReportsSpontaneous cervical emphysema and pneumomediastinum in an 18-year-old woman.
Pneumomediastinum or mediastinal emphysema is a known complication of traumatic injury or disease whereas spontaneous pneumomediastinum remains a rare clinical entity. We present the case of a young woman with a diagnosis of spontaneous pneumomediastinum combined with cervical emphysema without any precipitating factors or disease.
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Asian Cardiovasc Thorac Ann · Feb 2006
Ascending aorta or arch surgery: is previous cardiac surgery a risk factor?
Surgery on the ascending aorta +/- arch is a challenge. The risks involved in such operations after previous cardiac surgery were assessed in elective and emergency settings in a single institution. Over a 10-year period, 29 patients underwent replacement of the ascending aorta +/- arch following previous cardiac surgery. ⋯ The incidences of permanent stroke (3.4%) and renal failure (3.4%) were similar to first-time operations. Elective re-operation for ascending aorta +/- arch repair can be accomplished with acceptable mortality and morbidity. Outcomes in emergency cases carry a higher early mortality but still conform to contemporary expectations and are similar to emergency first-time aortic surgery.
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High-dose propofol infusion for sedation of patients in the intensive care unit can result in rhabdomyolysis, acute renal failure, metabolic acidosis, hyperkalemia, ventricular arrhythmia, hyperthermia, and death. The death of a patient with such complications after lung biopsy is reported. Until a safer dosage range has been determined, propofol infusion at rates higher than 5 mg x kg(-1) x h(-1) should be discouraged for long-term sedation (> 48 h).
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Asian Cardiovasc Thorac Ann · Feb 2006
Perioperative circulating blood volume and cardiac function in valve disease.
Circulating blood volume is important in managing fluid balance and cardiac function after surgery under cardiopulmonary bypass. Appropriate management differs among the valve disorders, but perioperative blood volume has not yet been considered. From February 2001 to March 2003, perioperative blood volume, fluid balance, cardiac index, and left ventricular stroke work index were measured in 31 patients: 10 with aortic stenosis, 9 with aortic regurgitation, 3 with mitral stenosis, and 9 with mitral regurgitation. ⋯ Postoperatively, there was a positive correlation between cardiac index and blood volume in all groups. The left ventricular stroke work index in the mitral regurgitation group was significantly higher than other groups, the aortic stenosis group was slightly lower, the mitral stenosis and mitral regurgitation groups were higher than the baseline, and the aortic regurgitation group was essentially unchanged. Thus, it is necessary to consider blood volume perioperatively in different valvular diseases to manage water balance.