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 2006
Limitations of retrograde continuous tepid blood cardioplegia for myocardial remodeling.
We assessed potential limitations of retrograde continuous tepid blood cardioplegia (RCTBC) for myocardial remodeling, represented by hypertrophied and/or dilated myocardium in patients with severe cardiomyopathy following single aortic valve replacement. ⋯ The study suggests preoperative high DeltaPG, small aortic root diameter, and low LVEDV, namely, concentrically hypertrophied myocardium, as risk factors for severe cardiomyopathy after RCTBC. RCTBC in patients with any risk factor should be accompanied by an increase in initial continuous perfusion flow and/or aggressive use of intermittent antegrade coronary perfusion.
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Ann Thorac Cardiovasc Surg · Dec 2006
Case ReportsDelayed hemopericardium with constrictive pericarditis after blunt trauma: a report of a surgical case.
Constrictive pericarditis (CP) following hemopericardium has been reported in the literature but its pathogenesis is open to question. Proposed mechanisms include trauma leading to damage of the mesothelial lining resulting in decreased fibrinolytic activity in the presence of blood. ⋯ We performed a pericardiectomy to relieve the compression. Closely prolonged monitoring and emergent operation are suggested for such kinds of delayed complications.
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Liposarcomas are extremely rare in the mediastinum. They may achieve considerable size before causing any symptoms. ⋯ Excision of adjacent structures like the pericardium may be needed if the tumor infiltrates them. We report on a case of a giant liposarcoma of the mediastinum involving both hemithoraces and extending into the neck, which was successfully managed by complete surgical excision.
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Ann Thorac Cardiovasc Surg · Dec 2006
Case ReportsPulmonary torsion following right upper lobectomy.
We report on a case of postoperative lobar torsion in a 51-year-old woman following right upper lobectomy. A right middle lobar torsion was diagnosed by postoperative observation with chest X-ray and bronchofiberscopy. ⋯ Careful postoperative observation with chest radiography and bronchofiberscopy is important for the precise diagnosis of a lobar torsion. In a case of lobar torsion following lobectomy, rethoracotomy should be immediately carried out.
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Ann Thorac Cardiovasc Surg · Dec 2006
Case ReportsOff-pump coronary artery bypass grafting for a patient with anomalous origin of the right coronary artery from the pulmonary artery.
We report on a case of a 70-year-old chronic hemodialysis patient. He presented with anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) and severe left anterior descending coronary artery (LAD) stenosis, which supplied collateral flow to the right coronary artery (RCA). ⋯ Previous reports described that the myocardial ischemia was a rare complication with the ARCAPA patients. However, this case required coronary revascularization because of the atherosclerotic LAD stenosis as a collateral source of the RCA.