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 2006
Review Case ReportsChronic contained rupture of an abdominal aortic aneurysm with vertebral erosion: report of a case.
A 73-year-old man had lumbago of unknown cause for several months prior to presentation. At examination prior to surgery for gastric cancer, an abdominal aortic aneurysm (AAA) of 6 cm in maximum diameter, retroperitoneal hematoma and vertebral erosion were found on abdominal computed tomography (CT). Hematological examination revealed mild anemia and stable hemodynamics. ⋯ After surgery, the lumbago was alleviated. The patient was transferred to the Department of Surgery and a gastrectomy was performed. The patient's postoperative course was uneventful.
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Ann Thorac Cardiovasc Surg · Aug 2006
Comparative StudyThe use of a water seal to manage air leaks after a pulmonary lobectomy: a retrospective study.
The methods for managing chest drainage tubes during the postoperative period differ among thoracic surgeons and, as a result, the optimal method remains controversial. ⋯ These observations suggest that applying chest tubes on water seal seems to be an effective method for preventing postoperative air leak in clinical practice. However, a prospective randomized trial using a larger series of patients is warranted for this subject.
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Ann Thorac Cardiovasc Surg · Jun 2006
Clinical TrialEarly angiographic results of multivessel off-pump coronary artery bypass grafting.
Recently off-pump coronary artery bypass grafting (CABG) is being widely used for coronary revascularization. However, there is some evidence that off-pump surgery increases the risk of recurrent angina and the need for reintervention, suggesting poor graft quality or incomplete revascularization. We describe our experience to demonstrate the feasibility of multiple coronary revascularization in off-pump CABG (OPCAB). ⋯ These results indicate that complete revascularization can be achieved in OPCAB in patients with diffuse coronary arterial disease. Complete revascularization with in situ arterial conduits only is technically feasible and yields a high early graft patency, even in the off-pump situation.
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Ann Thorac Cardiovasc Surg · Jun 2006
Case ReportsA case of cuff stenosis following tracheostomy responding well to T-tube stent insertion: with special reference to methods of dilating the stenosed site.
A 74-year-old man, receiving home oxygen therapy (HOT), required tracheal intubation and artificial ventilation because of methicillin-resistant staphylococcus aureus (MRSA)-induced pneumonia. Tracheostomy was additionally performed. One month later, he had recovered from pneumonia and the tracheostomy tube was withdrawn, allowing the patient to be discharged. ⋯ For these reasons, stent insertion is usually considered as necessary when dealing with cuff stenosis. Our technique of tracheal dilation is safe and simple, and does not require any special device or tool other than tracheal tubes. We report that silicon T-tube stents are optimal for treatment in cases of cuff stenosis.
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Ann Thorac Cardiovasc Surg · Jun 2006
Case ReportsThoracoscopic surgery combined with a supraclavicular approach for removing a cervico-mediastinal neurogenic tumor: a case report.
The neurogenic tumors in the posterior mediastinum sometimes extend into the vertebral canal, known as dumbbell tumors, but cases in which the neurogenic tumor extends to the cervical region are rare. A 19-year old female with a right-sided posterior mediastinal mass, without either Horner's syndrome or pain on the right upper extremity, was referred to our hospital. The chest computed tomography (CT) revealed a large posterior mediastinal mass, measuring 80x50x50 mm in size, which was suspected to be a neurogenic tumor, and the right vertebral artery (RVA) was involved in the tumor at the Th1 to C7 spinal level. ⋯ The RVA had to be sacrificed in order to remove the tumor. She was discharged from the hospital on the 12(th) postoperative day. The combined approach using video-assisted thoracic surgery (VATS), with a limited mini-transverse axillary and supraclavicular incision was useful for the removal of a cervico-mediastinal tumor.