Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
-
Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsAn unusual complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): the needle breakage.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is now becoming a widely accepted procedure to investigate the mediastinum for the staging of non-small-cell lung cancer and diagnosing mediastinal lesions. During the intervention, some minor or major complications may occasionally occur. The present case report describes the first reported case of needle breakage during EBUS-TBNA.
-
Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsDelayed right-sided diaphragmatic rupture and laparoscopic repair with mesh fixation.
Diaphragmatic rupture is usually an immediate, left-sided complication of high-velocity thoraco-abdominal trauma. Here we present a rare case of delayed, right-sided diaphragmatic rupture and its laparoscopic mesh repair.
-
Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsStructural valve deterioration of porcine bioprosthesis soon after mitral valve repair and replacement.
An 81-year-old woman, who had undergone mitral valve replacement (MVR) with a porcine bioprosthesis after mitral valve repair, presented with hemolysis 4 years and 6 months after MVR. Transthoracic echocardiography (TTE) revealed trivial mitral regurgitation, which was diagnosed based on the observed perivalvular leakage. Hemolysis gradually increased, and she developed dyspnea and edema 2 years after the appearance of mitral regurgitation. ⋯ The postoperative course was uneventful. Microscopic examination verified collagen degeneration, histiocyte infiltration, and hyalinization. It is important to perform TEE to rule out structural valve deterioration (SVD) even when regurgitation occurs soon after valve replacement.
-
Ann Thorac Cardiovasc Surg · Jan 2014
Randomized Controlled TrialEarly results of human atrial natriuretic peptide infusion in non-dialysis patients with chronic kidney disease undergoing isolated coronary artery bypass grafting: the NU-HIT trial for CKD-II.
Chronic kidney disease (CKD) is an important risk factor for cardiac surgery. In the most recently reported NU-HIT trial for CKD with CKD patients underwent coronary artery bypass grafting (CABG) as subjects, carperitide was reported to be effective in terms of renal function. In the present study, a subanalysis was performed on patients registered in the NU-HIT trial for CKD from the standpoint of renin-angiotensin system, natriuresis and renal function. ⋯ In on pump isolated CABG patients with CKD, carperitide showed a potent natriuretic action and inhibited the renin-angiotensin system, suggesting that it prevented deterioration of postoperative renal function. Our findings raise new possibilities for the perioperative and postoperative management of patients undergoing surgery with cardiopulmonary bypass.
-
Ann Thorac Cardiovasc Surg · Jan 2014
Randomized Controlled Trial Comparative StudyPrevention of atrial fibrillation with ultra-low dose landiolol after off-pump coronary artery bypass grafting.
Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery that is associated with an increased incidence of other complications. The goal of this prospective randomized study was to evaluate the effect of ultra-low dose landiolol hydrochloride for prevention of AF after off-pump coronary artery bypass grafting (CABG). ⋯ Ultra-low dose landiolol is effective for preventing AF after CABG without worsening hemodynamics.