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 · Jun 2005
Review Case ReportsSuccessful surgical treatment of rupture of coronary arteriovenous fistula with unconsciousness after chest and back pain.
A 65 year-old woman was admitted to our hospital, because of unconsciousness after chest and back pain. Echocardiography showed pericardial effusion. She suffered from pre-shock due to cardiac tamponade. ⋯ Many patients with these anomalies remain asymptomatic, but some patients develop symptoms of congestive heart failure, infective endocarditis, myocardial ischemia, arrhythmia, or rupture of an aneurismal fistula. Usually, the dilatation of fistula is common, and although 19% of this may become aneurysmal, the rupture of the aneurysm is very rare. We report a case of ruptured coronary arteriovenous fistula who underwent successful emergent surgery.
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Ann Thorac Cardiovasc Surg · Apr 2005
Review Case ReportsPrimary lung cancer arising from the wall of a giant bulla.
We report a 58-year-old man who underwent surgical treatment of primary lung cancer arising from the wall of a giant bulla. Chest roentgenography and computed tomography revealed multiple emphysematous bullae in the bilateral upper lobes, and a right upper giant bulla with a mass measuring 6 cm arising on the bulla wall. ⋯ In general, patients with both pulmonary bullous disease and primary lung cancer have a very poor prognosis, because they receive treatment when the tumor is at an advanced stage. On the basis of our review of the literature, we recommend that middle-age male patients with a giant bulla who smoke should have annual chest roentgenography and/or chest computed tomography to screen for lung cancer arising in or close to the bullous disease, and that a giant bulla should be resected in patients older than 50 years because of the high incidence of coexisting cancer and bulla, to improve the prognosis of this disease.
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Ann Thorac Cardiovasc Surg · Feb 2005
Case ReportsAcquired arteriovenous fistula of the right forearm caused by repeated blunt trauma: a report of a rare case.
In acquired arteriovenous fistula (AVF), there is usually a history of penetrating injury and hemorrhage. We report a very rare case of an elderly man with acquired AVF of the right upper extremity without any history of penetrating trauma and hemorrhage, but with a history of repeated blunt trauma on his right forearm. Although no surgery was performed for the AVF, it was concluded close follow up would be prudent.
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Ann Thorac Cardiovasc Surg · Feb 2005
Gastrointestinal complications in patients undergoing coronary artery bypass grafting.
Gastrointestinal complications (GICs) such as gastroduodenal ulcer, enterocolitis, and ischemic colitis after coronary artery bypass grafting (CABG) are rare, but are associated with high mortality and morbidity. The present study was performed to detect risk factors and to investigate outcomes following GICs after CABG. ⋯ Our results suggested that GICs after CABG with cardiopulmonary bypass are rare but can be lethal. Early diagnosis and prompt intervention can be difficult but are potentially life saving for patients in whom GICs develop.
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Ann Thorac Cardiovasc Surg · Dec 2004
Comparative StudySurgical treatment of lung cancer combined with interstitial pneumonia: the effect of surgical approach on postoperative acute exacerbation.
Postoperative acute exacerbation of interstitial pneumonia (IP) is known to be a serious complication in the surgical treatment for primary lung cancer combined with IP. This retrospective study was conducted to investigate the influence of three different approaches to the thorax on postoperative acute exacerbation of IP in lung cancer patients. Forty-seven lung cancer patients who developed it underwent pulmonary resection between 1982 and 2003. Among them, approaches to the thorax consisted of posterolateral thoracotomy (PLT) (n=15), muscle-sparing thoracotomy (MST) (n=15), and video-assisted thoracic surgery (VATS) (n=17). Seven of 47 suffered from acute exacerbation of IP. Single variable analysis suggested that exertion dyspnea (Hugh-Jones classification), serum C-reactive protein, serum lactate dehydrogenase and total lung capacity were considered to be preoperative risk factors of acute exacerbation. As for the VATS patient, there was little frequency of postoperative complication in comparison with the other two approaches. However no significant difference was shown in the incidence of acute exacerbation between the three approaches. ⋯ The use of VATS did not prevent acute exacerbation of IP. However, the incidence of postoperative complications in VATS seemed to be low, therefore further trials are required.