Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Jun 2012
Case ReportsAn unusual case of pleural empyema in a tsunami survivor.
A 74-year-old man who survived the tsunami after the Great East Japan Earthquake, was admitted to our department because of respiratory distress. He developed aspiration pneumonia and pleural empyema of the right thorax. ⋯ An unsuspected aspirated pine tree branch and pulmonary pleural fistula were discovered. The branch was removed, the pleural fistula was opened for drainage of the intrapulmonary abscess, and the patient made a good recovery.
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Asian Cardiovasc Thorac Ann · Jun 2012
Outcome after mitral valve operations with depressed left ventricular function.
We retrospectively investigated 42 patients (27 men, 15 women; mean age, 67 years) with severe mitral valve incompetence and endstage cardiomyopathy (ejection fraction<30%) who were operated on between January 2002 and March 2009. Of these, 14 were in New York Heart Association class IV, and 27 were in class III. The etiology was ischemic in 18 patients and idiopathic dilated in 24. ⋯ Freedom from reoperation at 2 years was 85%; 6 patients needed reoperation for recurrent mitral regurgitation. Despite high operative risk, mitral valve surgery can be performed successfully with acceptably low mortality in patients with endstage cardiomyopathy. Patients experience substantial clinical improvement and a moderate recovery of left ventricular function.
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Asian Cardiovasc Thorac Ann · Jun 2012
Analysis of open heart surgery in patients with liver cirrhosis.
Open heart surgery in patients with liver cirrhosis is considered to be very risky, but the predictors of poor outcomes in such cases have not been established. We report the perioperative results of open heart surgery in patients with liver cirrhosis in our hospital. We reviewed the results of 13 cases in 12 patients with liver cirrhosis who underwent open heart surgery between January 2001 and December 2010. ⋯ Statistically significant differences in liver-related mortality were evident in the model for end-stage liver disease scores and serum cholinesterase levels. We concluded that a high Child-Turcotte-Pugh class was associated with increased morbidity. Cardiopulmonary bypass and crossclamp times were also related to high morbidity, while high model for end-stage liver disease scores and low serum cholinesterase levels predicted liver-related mortality.
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Asian Cardiovasc Thorac Ann · Jun 2012
Risk factors and outcomes of acute renal failure after open cardiac surgery.
The incidence, risk factors, and outcome of acute renal failure following open cardiac surgery were assessed prospectively in 5,164 consecutive patients undergoing open heart surgery between March 2006 and February 2011. Acute postoperative renal failure (creatinine>1.5 mg·dL(-1) within 3 days after surgery) developed in 64 (1.2%) patients with normal preoperative renal function (study group). A control group of 238 cardiac surgery patients who had postoperative creatinine levels≤1.5 mg·dL(-1) were selected randomly during the study period. ⋯ Five of the 10 patients (50%) who needed dialysis died. The most significant prognostic factor for mortality was cardiac dysfunction. This study confirmed that impairment of renal function after cardiac surgery is uncommon without preoperative renal impairment, but carries an increased mortality rate.
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Asian Cardiovasc Thorac Ann · Jun 2012
Simple and safe graft insertion in the elephant trunk technique.
The elephant trunk technique is a well-established procedure, but aortic wall injury or aneurysmal rupture may occur if the graft is forcibly pushed to insert it into the distal aorta. We have developed simple and safe insertion technique using a syringe.