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
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
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
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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When a rapidly reexpanding lung has been in a state of collapse for more than several days, pulmonary edema sometimes occurs in it. This is called reexpansion pulmonary edema (RPE). In this article, I present my views on the history, clinical features, morphophysiological features, pathogenesis, and treatment of RPE. ⋯ Although the most effective treatment method is to treat the histological abnormalities of the pulmonary microvessels formed in a chronically collapsed lung, the cause of these abnormalities is not clear, making it difficult to put forward a precise treatment method. However, reasonably good effects can be expected from a symptomatic therapy that reduces the level of mechanical stress during reexpansion. In the future, it is expected that the cause of histological changes of the pulmonary microvessels in a chronically collapsed lung will be revealed, and appropriate therapies will therefore be developed according to this cause.
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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.