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 · Aug 2010
Randomized Controlled Trial Comparative StudyThe effects of sheet-type absorbable topical collagen hemostat used to prevent pulmonary fistula after lung surgery.
Numerous reports have been published on the application of fibrin glues, biological adhesives used as sealants for air leaks after pulmonary resection; however, the use of blood products has been questioned from both safety and economic perspectives. Therefore we were prompted to attempt the use of Integran (method C), a sheet-type absorbable topical collagen hemostat that is neither expensive nor derived from blood. ⋯ In a randomized controlled trial of sealing with a sheet-type collagen vs. a combined approach of fixing a collagen sponge, using fibrin glue for closure of air leaks, the use of Integran, a sheet-type absorbable topical collagen hemostat, is feasible to prevent pulmonary fistula after lung surgery. It is also affordable and safe because it is not a blood product.
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Ann Thorac Cardiovasc Surg · Aug 2010
Review Case ReportsVideo-assisted thoracoscopic surgery for non-small cell lung cancer in patients on hemodialysis.
There have been a few reports of pulmonary resection for lung cancer in patients on hemodialysis (HD), but no reports of video-assisted thoracoscopic surgery (VATS) in these patients have been submitted. We describe two patients on HD undergoing thoracoscopic resection for lung cancer. For the thoracoscopic operation, anatomies of the patients were confirmed by three-dimensional multidetector computed tomography (3D-MDCT). ⋯ A review of the literature reveals that morbidity and mortality for pulmonary resection on HD are 74% and 11%, respectively. Thoracoscopic operations for lung cancer patients on HD may minimize the operative invasiveness. Preoperative 3D-MDCT angiography was useful because it supports understanding of the patient's personal anatomy for VATS.
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Ann Thorac Cardiovasc Surg · Aug 2010
Randomized Controlled TrialEvaluation of the effects of ischemic preconditioning with a short reperfusion phase on patients undergoing a coronary artery bypass graft.
This study was conducted to evaluate the effects of ischemic preconditioning (IP) with a short period of reperfusion (2 min) during brief ischemic preconditioning (6 min) on patients undergoing coronary artery bypass grafting (CABG). ⋯ A short period of reperfusion phase declined post-CABG inotrope requirements; however, it did not reduce the cardiac enzymes. Our results suggested that reperfusion should be longer than 2 min to be capable of reducing cardiac enzymes.
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Ann Thorac Cardiovasc Surg · Aug 2010
Safe approach for redo coronary artery bypass grafting--preventing injury to the patent graft to the left anterior descending artery.
In redo coronary artery bypass grafting (CABG), repeat median sternotomy is a routine approach when the graft to the left anterior descending artery (LAD) is occluded. However, it is important to avoid injury to the patent graft to LAD during repeat sternotomy. We retrospectively reviewed our cases to assess our combined strategy for a safer redo CABG. ⋯ According to the circumstances, conduits and a proximal anastomosis should be selected. For redo CABG patients who have a patent graft to LAD, it is important to choose the optimal approach to avoid injury to the previous patent graft.
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Ann Thorac Cardiovasc Surg · Aug 2010
Case ReportsSuccessful management of fulminant myocarditis with left ventricular assist device: report of a severe case.
We report a 65-year-old man with fulminant myocarditis undergoing percutaneous cardiopulmonary support (PCPS) and left ventricular assist device (LVAD). PCPS and intra-aortic balloon pumping was initially introduced for cardiogenic shock in the emergency department. ⋯ He was discharged on postoperative day 63 with no complications. We here report the appropriate timing of LVAD application for fulminant myocarditis.