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 · Dec 2002
Surgical treatment of aortic arch aneurysm combined with coronary artery stenosis.
We present operative results of aortic arch aneurysm associated with coronary artery stenosis, and evaluate the operative risk of graft replacement of the aortic arch and concomitant coronary artery bypass grafting (CABG). ⋯ CABG combined with graft replacement of the aortic arch does not increase operative risk when the number of bypassed vessels is within two vessels, but may increase risk when three or more vessels are bypassed.
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Ann Thorac Cardiovasc Surg · Oct 2002
Case ReportsMethylene blue administration in severe systemic inflammatory response syndrome (SIRS) after thoracic surgery.
A 66-year-old male patient developed significant pleural effusion on the right side six years after coronary bypass grafting and mitral valve replacement. After pleurocentesis, hemo-pneumothorax developed and finally resulted in complete atelectasis of the right lung. Three weeks later, the patient was transferred to our department, and underwent a right lateral thoracotomy. ⋯ Four hours postoperatively the patient developed severe SIRS with beginning multiorgan failure. Even extremely high doses of norepinephrine could not raise the systemic vascular resistance. Single intravenous administration of methylene blue lead to significant and permanent improvement of the hemodynamic status.
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Ann Thorac Cardiovasc Surg · Oct 2002
Development of a new hollow fiber silicone membrane oxygenator for ECMO: the recent progress.
Throughout the last 50 years, many improvements have been made for a more effective oxygenator. A large plate type membrane oxygenator, used by Clowes, and a coil type, used by Kolff, has evolved into the small hollow fiber oxygenator. The complex bubble oxygenator, or rotating disk oxygenator, has become a small disposable bubble oxygenator. ⋯ Currently in the United States, there are no clinically applicable hollow fiber ECMO oxygenators available, in spite of the extended ECMO application. Therefore, the development of a small, yet efficient, silicone hollow fiber membrane oxygenator for long-term ECMO usage was attempted. Based on the results of many experimental models, preclinical oxygenator models for long-term ECMO were developed in our laboratory using an ultra-thin silicone rubber hollow fiber membrane.
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Ann Thorac Cardiovasc Surg · Aug 2002
Case ReportsSuccessful emergency repair of blunt right atrial rupture after a traffic accident.
A 53-year-old man crashed his motorcycle into a vehicle and was transported to our hospital by ambulance after about 30 min. Echocardiography revealed cardiac tamponade. ⋯ Patients with cardiac rupture who reach hospital alive can be saved by rapid transport, early detection, and early surgery. In particular, rapid echocardiography and pericardiocentesis via the subxiphoid approach under ultrasonic guidance are easy and helpful methods of making a diagnosis and achieving hemodynamic improvement prior to surgical intervention.
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Ann Thorac Cardiovasc Surg · Jun 2002
Case ReportsSlowly progressive adenocarcinoma of the lung: report of a case.
A case report of a slowly progressive adenocarcinoma of the lung, followed by computed tomography is herein discussed. The patient was a 76-year-old woman, who was operated on about four years after a small lung nodule on her left upper lobe was discovered. The tumor was suspected to be either well differentiated adenocarcinoma or atypical adenomatous hyperplasia (AAH) by the findings of chest computed tomography before the operation, and the resected specimen demonstrated well differentiated adenocarcinoma, without lymph node metastasis. This case demonstrates the possibility that some adenocarcinomas with particular histology are slowly progressive, and also there might be the option of lobectomy or segmentectomy for treating such tumors.