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 · Oct 2008
Case ReportsSchwannoma of the brachial plexus presenting as an enlarging cystic mass: report of a case.
We report a rare case of schwannoma of the brachial plexus presenting as an enlarging cystic mass. A 52-year-old woman was found to have a rapidly enlarging cystic lesion in the left pectoralis minor space. ⋯ The patient showed no sign of neurological disorders postoperatively. Although schwannoma sometimes accompanies the cystic lesion in part, schwannoma of the brachial plexus manifesting as a cystic lesion is very rare.
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Ann Thorac Cardiovasc Surg · Oct 2008
Maximum aortic diameter as a simple predictor of acute type B aortic dissection.
To identify the most prognostic predictor of Stanford type B aortic dissection at admission. ⋯ Our results indicated that a maximum aortic diameter > or =40 mm at admission was the most prognostic factor for developing late dissection-related events, rather than the presence of a patent false lumen.
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Ann Thorac Cardiovasc Surg · Oct 2008
Evaluation of respiratory status in patients after thoracic esophagectomy using PiCCO system.
Thoracic esophagectomy for esophageal cancer is among the most invasive operations, requiring thoracotomy and laparotomy. With regard to postoperative status, the increment of vascular permeability caused by various inflammatory cytokines might influence the postoperative respiratory condition. The PiCCO (pulse contour cardiac output) system (Pulsion Medical Systems AG, Munich, Germany), a new technique based on an arterial thermodilution technique, allows the measurement of extravascular lung water (EVLW). In this study, we hypothesized that EVLW might be a useful parameter to assess the respiratory condition and evaluated respiratory status using values for EVLW after thoracic esophagectomy. ⋯ EVLWI may be a useful parameter for evaluation of the respiratory condition after thoracic esophagectomy.
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Ann Thorac Cardiovasc Surg · Aug 2008
Case ReportsSeptal myectomy, papillary muscle resection, and mitral valve replacement for hypertrophic obstructive cardiomyopathy: a case report.
We report a case of hypertrophic obstructive cardiomyopathy (HOCM) successfully treated with septal myectomy and mitral valve replacement (MVR) combined with a resection of the hypertrophic papillary muscles. The patient, a 74-year-old woman, first underwent the conventional septal myectomy through aortotomy. The papillary muscles revealed a marked hypertrophy, but extended myectomy and precise resection of the hypertrophic papillary muscles were thought to be difficult through the aortotomy. ⋯ The patient has been doing well in the New York Heart Association (NYHA) functional class between I and II during 45 months of follow-up, without complications related to the use of a prosthetic valve. Septal myectomy is the procedure of choice in the surgical treatment of HOCM for most cases, but some may require additional mitral valve procedures. In patients with marked hypertrophic papillary muscles, MVR and resection of the muscles may be an option of treatment to ensure a relief of the outflow obstruction and to abolish systolic anterior movement in units with limited experience.
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Ann Thorac Cardiovasc Surg · Aug 2008
Randomized Controlled Trial Comparative StudyInhibition of platelet aggregation by combined therapy with aspirin and cilostazol after off-pump coronary artery bypass surgery.
Although off-pump coronary artery bypass (OPCAB) has become an increasingly common surgical procedure, recent concerns have been raised regarding the existence of a hypercoagulable or prothrombotic state associated with OPCAB. To determine the optimal antiplatelet regimen after OPCAB, we investigated the effects of aspirin alone and of combined therapy with aspirin + cilostazol on platelet aggregation in patients after OPCAB. ⋯ The results of this study suggest that combined therapy with aspirin + cilostazol is more effective than aspirin monotherapy in reducing platelet aggregation in patients after OPCAB. This combination therapy may represent a new therapeutic option for an anti-thrombotic regimen in patients after OPCAB.