Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Feb 2015
Modified application of a wound retractor for surgery in chest trauma.
Wound retraction is useful for chest wall surgery involving surgical rib fixation in patients with rib fractures. However, blunt chest trauma with rib fractures frequently involves lung injury, requiring simultaneous pulmonary repairs. ⋯ Therefore, we describe the modified application of a second wound retractor for surgery in the thorax and chest wall, and discuss its advantages and disadvantages. We call this method double-wound retraction.
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Asian Cardiovasc Thorac Ann · Feb 2015
ReviewSpinal cord injury following thoracic and thoracoabdominal aortic repairs.
To discuss the currently available approaches to prevent spinal cord injury during thoracic and thoracoabdominal aortic repairs. ⋯ Spinal cord injury after thoracic and thoracoabdominal aortic repair poses a real challenge to cardiovascular surgeons. However, with evolving surgical strategies, identification of predictors, and use of various adjuncts over the years, the incidence of spinal cord injury after thoracic/thoracoabdominal aortic repair has declined. Embracing a multimodality approach offers a good insight into combating this grave complication.
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Asian Cardiovasc Thorac Ann · Feb 2015
Observational StudyB-type natriuretic peptide as prognostic marker in tetralogy of Fallot surgery.
B-type natriuretic peptide has been extensively studied in patients with cardiovascular disease, but its impact on the perioperative outcome of patients with cyanotic congenital heart defects is still unclear. We assessed the perioperative changes in B-type natriuretic peptide levels and their correlation with preoperative factors and clinical outcomes in a large homogenous group of patients with tetralogy of Fallot undergoing definitive repair at a tertiary care center. ⋯ We demonstrated a rise in serum B-type natriuretic peptide levels in patients with tetralogy of Fallot undergoing definitive repair on cardiopulmonary bypass. B-type natriuretic peptide levels may be monitored to identify patients with cyanosis at increased risk of an augmented inflammatory response to cardiopulmonary bypass.
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Asian Cardiovasc Thorac Ann · Feb 2015
Case ReportsDissecting intramural hematoma of esophagus after thrombolytic therapy: a case report.
Esophageal hematoma is a relatively rare event. We report a case of severe chest pain associated with myocardial infarction and recurrent chest pain after administration of a thrombolytic agent. ⋯ Esophageal hematoma was confirmed after endoscopy and computed tomography. Esophageal hematoma is a relatively rare event after thrombolytic therapy.
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Asian Cardiovasc Thorac Ann · Feb 2015
Multicenter StudyOutcome of repair of bronchial injury in 10 patients with blunt chest trauma.
Bronchial avulsion is a serious complication of blunt chest trauma, which can be easily missed on initial presentation of a patient with multiple injuries. Missing the diagnosis may increase the risk of mortality and morbidity. ⋯ Early diagnosis of major airway injury is an important factor in successful management and a favorable outcome. With improvements in surgical technique, regular follow-up, and effective management of complications, we can expect successful bronchial repair to save the lung, even with a late diagnosis.