Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Dec 2009
Multicenter StudyEtiopathology and management challenges of blunt chest trauma in Nigeria.
Blunt chest trauma had not been roundly studied in Nigeria. This study was conducted to determine the etiopathological and management challenges of chest trauma in a developing country. In a prospective multicenter hospital-based study of 10-years duration in the city of Lagos, the data of 896 patients were recorded. ⋯ Lung parenchymal injuries occurred in 66% of patients, and cardiac trauma in 0.1%. Isolated chest trauma was found in 85% of patients, and 134 had associated injuries. The incidence of blunt chest trauma could be reduced if the number of road traffic accidents in Nigeria is reduced.
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Asian Cardiovasc Thorac Ann · Dec 2009
Case ReportsType A aortic dissection, right-sided aortic arch, and thoracic aortic aneurysm.
A previously healthy 78-year-old woman presented with severe chest pain. Computed tomography revealed a right-sided aortic arch with an aberrant left subclavian artery originating from Kommerell's diverticulum, a thoracic aortic aneurysm, and Stanford type A acute aortic dissection. Successful emergency repair of the ascending aorta, total arch, and descending aorta were performed through a median sternotomy only.
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Beating-heart continuous coronary perfusion (BHCCP) has been promoted as an alternative to the technique of cardioplegic arrest in valve surgery. Its potential advantage is the elimination of cardioplegia and the corollary risk of ischemic reperfusion injury. The use of CCP has been recommended especially when performing more complex operations, such as mitral valve repair, and particularly as surgeons become more familiar with beating-heart coronary surgery. ⋯ On the other hand there is weak evidence that it may reduce functional and biochemical markers of myocardial injury. In conclusion, BHCCP is an operative strategy in valve surgery with some potential benefits. There is, however a need for a high quality, prospective, randomized control trial to establish the exact role for BHCCP in complex valve surgery.
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Asian Cardiovasc Thorac Ann · Dec 2009
Case ReportsMalignancy of congenital cystic adenomatoid malformation of lung in aged.
Congenital cystic adenomatoid malformation is rare in adults, and often asymptomatic. We describe a case of malignant degeneration of a congenital cystic adenomatoid malformation in a 77-year-old man. ⋯ Rigorous preoperative staging must be undertaken. Anatomic resection with extensive lymphadenectomy remains the treatment of choice.
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Asian Cardiovasc Thorac Ann · Dec 2009
Blunt traumatic bronchial rupture in patients younger than 18 years.
The aim of this study was to evaluate our results of management of bronchial rupture after blunt chest trauma in young patients. Between January 2000 and December 2007, 34 patients aged 6-18-years old were treated for bronchial rupture; 25 presented early and 9 presented late. The 21 (62%) boys and 13 (38%) girls had a mean age of 11.58 +/- 2.51 years. ⋯ Reimplantation of the main bronchus after debridement of the edges was possible in 4 (44%) of the chronic cases, and pulmonary resection was required in 5 (56%). Four (11.8%) patients died due to perioperative cardiac arrest and cerebral hypoxia with failure of resuscitation. Meticulous collaboration between the surgeon and anesthetist is important to ensure survival.