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 · Aug 2010
Video-assisted thoracic surgery for patients with lung cancer and interstitial pneumonia.
A serious complication following primary lung cancer surgery on patients with interstitial pneumonia (IP) is the postoperative acute exacerbation of IP. Because few studies have examined the feasibility of using video-assisted thoracic surgery (VATS) on these patients, we reviewed our experience with this technique. ⋯ VATS is the preferred surgical choice for lung cancer patients with IP.
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Ann Thorac Cardiovasc Surg · Jun 2010
Evaluation of prognosis in patients with respiratory failure requiring venovenous extracorporeal membrane oxygenation (ECMO).
In this study, we analyzed the respiratory status and the prognosis of patients, including adults with acute respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV ECMO) to maintain respiratory status. We then evaluated the differences between patients who could be removed from VV ECMO and those who could not. ⋯ The early introduction of ECMO may be desirable if the causes of respiratory failure are recoverable. It is presumed that VV ECMO removal will be difficult if the ECMO flow cannot be weaned within 48 hours after ECMO introduction in patients with severe respiratory failure.
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Ann Thorac Cardiovasc Surg · Jun 2010
ReviewAdditional lung-protective perfusion techniques during cardiopulmonary bypass.
Postoperative cardiopulmonary bypass (CPB)-induced lung dysfunction still remains as a serious complication that could lead to life-threatening problems. CPB is associated with a whole-body inflammatory response. The contact of blood components with the artificial surface of the bypass circuit causes activation of complements, upregulation of cytokines and adhesion molecules, and induction of oxygen-free radicals. ⋯ Thus the systemic inflammatory response and ischemia-reperfusion during CPB constitute a vicious network in the pathogenesis of CPB-derived lung injury. Accordingly, it is postulated that additional pulmonary perfusion could alleviate CPB-induced lung damage. This review article summarizes recent literature on the mechanisms involved in lung dysfunction after CPB, and it also summarizes current reports on lung-protective perfusion techniques.
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Ann Thorac Cardiovasc Surg · Apr 2010
Case ReportsOff-pump coronary bypass via left thoracotomy resulting from sternoclavicular arthritis.
We report a case of coronary artery bypass grafting through the left thoracotomy in a patient who suffered from sternoclavicular joint infection with methicillin-resistance Staphylococcus aureus. We performed off-pump coronary bypass surgery, using the left internal thoracic artery to the left anterior descending coronary artery and a saphenous vein graft from the aorta to the circumflex artery, with a successful outcome. This approach seems to be safe and effective for coronary bypass grafting in situations where median sternotomy is not favorable, as in the described patient.
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Ann Thorac Cardiovasc Surg · Dec 2009
Case ReportsA case report of central extracorporeal membrane oxygenation after implantation of a left ventricular assist system: femoral vein and left atrium cannulation for ECMO.
The left ventricular assist system (LVAS) is often used for end-stage heart failure. However, in severe lung disorder, the patient needs extracorporeal membrane oxygenation (ECMO) because oxygenation using only a ventricular assist system (VAS) is insufficient. We report a successful case of combining the use of LVAS and right VAS (RVAS) with ECMO. ⋯ LVAS combined with RVAS-ECMO in right and left atrial cannulation is a useful option for patients with severe pulmonary damage.