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 2012
Case ReportsRib fixation for severe chest deformity due to multiple rib fractures.
The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. ⋯ Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.
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Ann Thorac Cardiovasc Surg · Jan 2012
Case ReportsMalignant solitary fibrous tumor of pleura accompanied with first symptoms of chest pain and hemoptysis: a case report.
Solitary fibrous tumor of the pleura (SFTP) is a rare tumor especially presents malignant features. Such symptoms of hemoptysis and dyspnea were rarely seen and take 5% and 4% respectively in malignant SFTP. A 26-year-old Chinese man, presenting with hemoptysis in the emergency room, was hospitalized because of dyspnea. ⋯ There was at least a 5000-ml mixture of blood and tumor tissue in the right chest cavity because of continuous bleeding, leading to a tumor capsule split. Histopathology and immunohistochemistry identified the tumor as malignant SFTP, but CD34 was negative. In this case, the tumor grew rapidly and aggressively in two months, indicating that close follow-up and active treatment are needed.
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Ann Thorac Cardiovasc Surg · Jan 2012
Comparative StudyShould right coronary bypass grafts be anastomosed proximal or distal to the crux? A comparison of graft patencies.
Late occlusion of bypass grafts is one of the main issues associated with long-term survival after coronary artery bypass grafting (CABG) surgery. Left coronary system is generally revascularized using arterial conduits, whereas saphenous venous grafts are used for right coronary system. We investigated the prognostic factors that are related to the patency and risk of occlusion of saphenous venous grafts used for revascularization of diseased right coronary arteries. ⋯ Based on the results of our study we suggest that even though an appropriate segment for anastomosis is available proximal to the crux of the RCA, right posterior descending artery (PDA) should be preferred for revascularization when RCA is the target vessel in CABG.
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This study aimed to evaluate the clinical outcomes of chest wall reconstruction using a relatively new expanded polytetrafluoroethylene prosthesis Gore-Tex(®) dual mesh. ⋯ Chest wall reconstruction using Gore-Tex(®) dual mesh demonstrated acceptable durability.
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A 44-year-old woman was found to have an abnormal shadow on a chest X-ray during a regular health checkup, and visited our department. Chest computed tomography showed multiple nodular shadows in both lungs. The patient had no history of neoplasm except for myomectomy for uterine leiomyoma 6 years previously. ⋯ Benign metastasizing leiomyoma is defined as a histologically benign uterine smooth muscle tumor that acts in a somewhat malignant fashion and produces benign metastases. Although it is a rare condition, it should be considered in asymptomatic women of reproductive age with a history of uterine leiomyoma, who present with solitary or multiple pulmonary nodules. Herein, we report a case of pulmonary benign metastasizing leiomyoma.