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 2002
Surgical treatment of atherosclerotic and dysplastic aneurysms of the extracranial internal carotid artery.
Atherosclerotic and dysplastic aneurysms of the extracranial internal carotid artery are rare in Japan. We have experienced only four cases since 1982. The patients were two men and two women with a mean age of 67 years (range 51 to 82 years). ⋯ All patients survived without neurologic deficits. These findings indicate that intraluminal shunting may be unnecessary during aneurysm repair if the patient does not have obstructive disease in the contralateral carotid artery and if no somatosensory evoked potentials or regional cerebral oxygen saturation abnormalities occur during proximal arterial clamping. After aneurysmectomy, end-to-end anastomosis of the internal carotid artery is the preferred method of repair if the length of the distal internal carotid artery permits.
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Ann Thorac Cardiovasc Surg · Jun 2002
Off-pump CABG attenuates myocardial enzyme leakage but not postoperative brain natriuretic peptide secretion.
Off-pump coronary artery bypass surgery is considered to be less invasive compared with a conventional coronary artery bypass surgery, while objective assessment of its invasiveness has not been well established. The grade of invasiveness of off-pump CABG was evaluated by biochemical markers released from the myocardium. ⋯ Although off-pump CABG seems to be less invasive to the myocardial cells from the aspect of enzyme leakage, ischemic stress to the heart assessed by brain natriuretic peptide secretion was similar to that of conventional CABG. Careful monitoring and management throughout postoperative period is mandatory even in off-pump CABG procedure.
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Ann Thorac Cardiovasc Surg · Apr 2002
Case ReportsPapillary muscle resection as a treatment for midventricular obstruction.
We have experienced a surgically treated case of midventricular obstruction. A simple mitral valve replacement was effective to relieve the obstruction and to increase the cavity of the left ventricular outflow tract without a myectomy through the aortic valve.
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Ann Thorac Cardiovasc Surg · Apr 2002
Comparative StudyEmergency thoracotomy for blunt thoracic trauma.
The indications for emergency thoracotomy are controversial for blunt trauma. The best results were seen in those patients who were stable enough to undergo thoracotomy in the operating theatre and survived the operation. ⋯ The results of emergency department thoracotomy in our series were extremely poor compared with the results of other reports, mainly due to rapid deterioration of hemodynamic condition caused by severe cardiac injury. The outcome from emergency thoracotomy in the operating theatre was encouraging, due particularly to the patients' status being stable enough to be transferred to a fully equipped operating theatre. We emphasize the importance of emergency medicine education programmes on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory support.
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Ann Thorac Cardiovasc Surg · Apr 2002
Pulmonary vein isolation for chronic atrial fibrillation associated with mitral valve disease: the midterm results.
The Cox Maze procedure is widely performed for the surgical treatment of atrial fibrillation. However it requires numerous incision lines and therefore is a time-consuming operation. We report a simplified operation for chronic atrial fibrillation associated with mitral valve disease. ⋯ Compared with the Maze procedure, this operation was less invasive and preserved the atrial appendage and was thought to have a normal level of secretion of atrial natriuretic peptide. This study suggests that the pulmonary vein isolation procedure may be an effective and simple maneuver for atrial fibrillation associated with mitral valvular disease.