Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Jun 2010
Clinical outcome of video-assisted thymectomy for myasthenia gravis and thymoma.
We reviewed our experience of video-assisted thoracoscopic thymectomy for myasthenia gravis and thymomas in 119 patients, aged 12-83 years, who were treated between 1998 and 2007. Disease severity was graded using the Osserman classification. To prevent rupture of the tumor capsule and tumor seeding, thymomas were resected using a modified no-touch technique. ⋯ After follow-up of 1.9-10 years (mean, 4.9 years), 74 (62%) patients remained asymptomatic, with 21% in complete stable remission. Using multivariate regression analysis, there were no statistical differences in median pre- and postoperative Osserman grades with regards to age, sex, duration of symptoms, and presence of thymoma. Video-assisted thoracoscopic thymectomy for myasthenia gravis and selected thymomas can achieve long-term clinical outcomes comparable to those of standard approaches.
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Asian Cardiovasc Thorac Ann · Jun 2010
Case ReportsPericardial tamponade after superior vena cava stent: are nitinol stents safe?
Placement of a single new-generation nitinol stent resulted in acute pericardial tamponade in a 70-year-old man with superior vena cava syndrome.
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Asian Cardiovasc Thorac Ann · Jun 2010
Extended three-patch technique for congenital supravalvular aortic stenosis.
We describe a modified extended 3-patch surgical procedure to relieve supravalvular aortic stenosis. This simple technique provides effective and lasting enlargement of the ascending aorta in patients with severe congenital supravalvular aortic stenosis.
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Thrombolytic therapy is still the fastest and most accessible treatment for patients presenting with acute ST-elevation myocardial infarction. The time to treatment is a pivotal parameter in reperfusion. We examined the effects of implementing a better organized team approach to reduce door-to-needle times in patients with acute myocardial infarction. ⋯ From April to December 2007, 60 patients with acute ST-elevation myocardial infarction were triaged to the coronary care unit and enrolled in this study. Improvements were seen in mean door-to-needle time (reduced from 80 to 30 min during regular hours, and 85 to 33 min outside regular hours) compared with 2005-2007 data. A better organized team-based approach with specifically trained personnel and equipment for early evaluation and triage of patients with suspected myocardial infarction decreased intervention times, with the potential to be broadly applied in clinical practice and to improve patient survival.
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Asian Cardiovasc Thorac Ann · Feb 2010
Midterm evaluation of hemodynamics of the Top Hat supraannular aortic valve.
The CarboMedics Top Hat supraannular aortic valve provides an orifice-to-annulus ratio of 1:1 in most patients, and enhances patient outcomes. This study compared the midterm echocardiographic parameters of 52 patients undergoing aortic valve replacement with a Top Hat valve with those in other studies of Top Hat or CarboMedics intraannular valves. Echocardiography was performed 6-48 months after surgery with Top Hat sizes 21-27. ⋯ Mean effective orifice area improved significantly from 0.73 cm(2) preoperatively to 2.04 cm(2) postoperatively. In patients with preoperative aortic valve stenosis, postoperative mean peak gradient was significantly reduced. The larger orifice-to-annulus ratio of the Top Hat valve improved hemodynamic parameters assessed by echocardiography up to 4 years postoperatively, with a lower transvalvular gradient, hence decreased left ventricular workload.