Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Dec 2001
Case ReportsExtended aortic grafting for acute ascending dissection after type B dissection.
A 31-year-old man was diagnosed with acute ascending aortic dissection and massive aortic regurgitation following acute type B dissection during drug treatment. Although the aortic arch was not dissected, we performed aortic replacement from the aortic root to the proximal portion of the descending aorta. The aim of the operation was the prevention of aortic arch dissection, and closure of initial entry of type B dissection.
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Ann Thorac Cardiovasc Surg · Dec 2001
Case ReportsSimultaneous mitral valve replacement and bypass grafting for mycotic aneurysm of the femoral artery during the active phase of infective endocarditis: a case report.
A 52-year-old woman with a 3-week history of fever and cough was diagnosed as having bacterial endocarditis with vegetation and severe mitral valve insufficiency by echocardiography. Blood culture revealed Streptococcus mitis. After antibiotic treatment for 3 weeks, the patient noticed swelling with pain in her left groin. ⋯ Pathohistological examination of surgical specimens revealed acute inflammatory findings, but no microorganisms were found, probably because of the preoperative antibiotic therapy. Her postoperative course was uneventful, and there was no recurrence of mycotic aneurysms in a period of 10 months after the operation. Prompt recognition and urgent simultaneous surgical treatments for mycotic aneurysms complicated with infective endocarditis were effective.
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Ann Thorac Cardiovasc Surg · Dec 2001
Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management.
The incidence of a bronchopleural fistula (BPF) as a major complication after non-small cell lung carcinoma (NSCLC) surgery has decreased in recent years, due to new surgical refinements and a better understanding of the bronchial healing process. We reviewed our most recent experience with BPFs and tried to determine methods which may effectively reduce its occurrence. ⋯ A BPF remains a major complication in the surgery of NSCLC because of its high mortality and morbidity rate. A BPF is more common after right-sided pneumonectomy and is frequently associated with postoperative mechanical ventilation. The management varies according to the initial type of surgery, the size of the BPF, the overall patient condition and that of the remaining lung. Endoscopic treatment is reserved only for small fistulas associated with poor general condition.