Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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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.
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Ann Thorac Cardiovasc Surg · Jan 2012
Case ReportsSeptal myectomy and myotomy attenuate left ventricular hyper-contractility in a child with hypertrophic obstructive cardiomyopathy.
Septal hyper-contractility is thought to be the principal cause of significant left ventricular outflow tract obstruction (LVOT) and systolic anterior motion (SAM) of the mitral valve by making the distance between the mitral valve and papillary muscle shorter. A seven-year-old patient with severe hypertrophic obstructive cardiomyopathy underwent direct interventricular septal myectomy/myotomy using the resection/crush method to modify hyper-contractility. ⋯ Postoperative echocardiographic vector velocity imaging (VVI) study revealed a reduced twist angle, depicting attenuated ventricular contraction power from a maximum twist 17.9° to 7.9°. Perioperative VVI revealed that interventricular septal myectomy/myotomy is useful, not only in reducing LVOT obstruction, but also in reducing hyper-contractility, which increases the distance from the mitral valve to the papillary muscle and relieves SAM.
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Ann Thorac Cardiovasc Surg · Jan 2012
Case ReportsNon-obstructive mesenteric ischemia: a potentially lethal complication after cardiovascular surgery: report of two cases.
We report two cases of non-obstructive mesenteric ischemia (NOMI), a rare but potentially lethal complication after cardiovascular surgery, which was successfully managed. In both cases (a 74-year-old chronic hemodialysis patient who underwent emergency aortic valve replacement and coronary artery bypass graft (CABG), and a 74-year-old patient who underwent emergency abdominal aortic aneurysm operation), NOMI occurred early postoperatively (on day 8 and 22, respectively). They suffered from severe abdominal pain, confusion, and metabolic acidosis. ⋯ It was effective in both cases to halt progressive bowel ischemia and bided our time to perform a hemicolectomy of the necrotic segment. Contrast-enhanced MDCT scan and subsequent selective angiography are vital for diagnosis. If the condition does not improve after selective papaverine infusion, exploratory laparotomy and resection of necrotic intestinal segment should be performed immediately.