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 · Jan 2011
Case ReportsTwo lung adenocarcinomas in the same lobe: multiple primaries or intrapulmonary metastasis?
Abnormal nodules were found in the left lung of a 52-year-old woman in segments 6 and 10 on a chest CT. These nodules showed no changes for 18 months, and we discontinued follow-up. Almost 5 years later, an abnormal shadow was found in her left lower lung field on a medical check-up chest X-ray. ⋯ Epidermal growth factor receptor gene mutations were examined, and the 2 lesions shared an L858R mutation. Although we expected EGFR gene mutation analysis would help us distinguish the 2 lesions from each other, it was of little help. Disease history can be more important in evaluating multiple pulmonary cancers.
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A paraganglioma is a rare tumor that develops out of extra-adrenal chromaffin cells and pheochromocytomas originating from the adrenal medulla. Early diagnosis and surgical planning are crucial, since the tumor secretes catecholamine and is adjacent to large vessels in the abdomen. ⋯ Here, we present a case of paraganglioma in a 32-year-old male patient who initially presented with a stomachache. After conducting the required tests, we resected the tumor that was pressing against the vena cava in the interaortocaval region.
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Ann Thorac Cardiovasc Surg · Jan 2011
Zero mortality of continuous veno-venous hemodiafiltration with PMMA hemofilter after pediatric cardiac surgery.
Continuous veno-venous hemodiafiltration (CVVH) is used as one of the modalities of continuous renal replacement therapy (CRRT) in pediatric intensive units. The aim of our study was to investigate the use of CVVH in small children with acute renal failure (ARF) after cardiac surgery. ⋯ Continuous veno-venous hemodiafiltration with PMMA-CVVH without ECMO achieved a surprisingly Zero mortality.
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Ann Thorac Cardiovasc Surg · Jan 2011
Randomized Controlled TrialCerebroprotective effect of piracetam in patients undergoing open heart surgery.
Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. ⋯ Piracetam had no cerebroprotective effect in patients undergoing open heart surgery. Unlike the patients who underwent coronary surgery, piracetam did not reduce the early postoperative decline of neuropsychological abilities in heart valve patients.
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Ann Thorac Cardiovasc Surg · Jan 2011
ReviewThoracic endovascular aortic repair--indications and evidence.
Since its introduction more than a decade ago, thoracic endovascular aortic repair (TEVAR) has shown promising results for patients with various thoracic aortic diseases. The aim of the current review is to assess the current literature to evaluate the safety and efficacy of TEVAR. ⋯ Despite numerous encouraging results from a large number of publications in recent years, there remains a lack of level 1 evidence to support an improvement of long-term overall survival for patients who underwent TEVAR when compared with traditional treatment modalities. There appears to be an urgent need to conduct well-designed randomized-controlled trials in this rapidly expanding intervention.