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 2013
Reoperative coronary artery bypass surgery: the role of on-pump and off-pump techniques on factors affecting hospital mortality and morbidity.
Short term results of on-pump and off-pump techniques in patients undergoing reoperative coronary artery bypass grafting (redo CABG) were investigated in this study. ⋯ Despite the lower morbidity and mortality in the off-pump group, the rate of target vessel bypass grafting was lower. Off-pump technique may be considered as a safer option for cardiopulmonary bypass in the high risk population.
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Ann Thorac Cardiovasc Surg · Jan 2013
Case ReportsAortic bleeding one week after removal of an intraoperative epicardial temporary pacing wire.
A 56-year-old man had left nephrectomy and resection of a cavoatrial tumor thrombus under a cardiopulmonary bypass assist for left renal cell carcinoma. An intraoperative bipolar temporary epicardial atrial pacing wire was removed on postoperative day 8. The patient collapsed on postoperative day 15. ⋯ It is well known that the intraoperative temporary epicardial pacing wire can cause bleeding or arrhythmia, especially when the wire is being removed. However, bleeding usually occurs from the inserted epicardial point of the pacing wire soon after removal of the wire. To our knowledge, this late bleeding complication of the pacing wire is a previously unreported serious iatrogenic complication after cardiac surgery.
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Ann Thorac Cardiovasc Surg · Jan 2013
Respiratory complications during mid- and long-term follow-up periods in patients who underwent pneumonectomy for non-small cell lung cancer.
Pneumonectomy is associated with higher early mortality and morbidity, and it is also known to predispose the patient to respiratory complications during mid- and long-term follow-up. Therefore, the purpose of this study was to identify risk factors associated with respiratory complications during the follow-up period after pneumonectomy. ⋯ Respiratory infection was a comparable risk factor of mortality in the mid- and long-term after pneumonectomy with cancer recurrence. The presence of preoperative pneumonia was an independent factor related to respiratory infection.Careful follow-up for these patients may be required.
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Ann Thorac Cardiovasc Surg · Jan 2013
Case ReportsComplete laceration of the middle lobe bronchus caused by blunt trauma.
Bronchial ruptures due to blunt trauma are rarely encountered injuries. A previously healthy 42-year-old man fell from heights of 8 meters. A prompt chest tube-drainage for suspected right sided tension pneumothorax and a tracheal intubation were performed. ⋯ The patient was transferred to a rehabilitation hospital on 20th post-operative day without complication. Early decision making for surgery resulted in a good outcome. When a complete atelectasis of the whole right lung and a massive air leakage continues despite appropriate chest-tube drainage in a blunt trauma patient, laceration of the tracheobronchial tree should be suspected.
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Ann Thorac Cardiovasc Surg · Jan 2013
Case ReportsSurgical embolectomy of a floating right heart thrombus and acute massive pulmonary embolism: report of a case.
Right heart thrombus represents a mobilized deep venous thrombosis that is lodged temporarily in the right atrium and ventricle, and is often referred to as "emboli in transit." Floating right heart thrombus is an uncommon but life-threatening condition, and usually coexists with an already massive pulmonary embolism. The presence of floating right heart thrombus appears to substantially increase the risk of mortality compared to the presence of pulmonary embolism alone. Floating right heart thrombus needs emergency treatment, but there is no clear consensus regarding optimal management, e. g.,thrombolytic therapy, anticoagulation therapy, or surgical removal. ⋯ The patient's postoperative course was uneventful, and she remained in good health without recurrence of pulmonary embolism. This success was based on rapid diagnosis by transthoracic echocardiography and computed tomography, prompt decision-making to proceed with surgical intervention and efficient postoperative care. In this case, surgical embolectomy was effective for a floating right heart thrombus with acute massive pulmonary embolism.