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 2001
Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management.
The incidence of a bronchopleural fistula (BPF) as a major complication after non-small cell lung carcinoma (NSCLC) surgery has decreased in recent years, due to new surgical refinements and a better understanding of the bronchial healing process. We reviewed our most recent experience with BPFs and tried to determine methods which may effectively reduce its occurrence. ⋯ A BPF remains a major complication in the surgery of NSCLC because of its high mortality and morbidity rate. A BPF is more common after right-sided pneumonectomy and is frequently associated with postoperative mechanical ventilation. The management varies according to the initial type of surgery, the size of the BPF, the overall patient condition and that of the remaining lung. Endoscopic treatment is reserved only for small fistulas associated with poor general condition.
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Ann Thorac Cardiovasc Surg · Oct 2001
Case ReportsRecovery of an impalement and transfixion chest injury by a reinforced steel bar.
A 36-year-old man was admitted to our hospital because of impalement injury due to a downwards fall upon some reinforced steel rods. An emergency operation was performed using percutaneous cardiopulmonary support (PCPS). ⋯ We performed a bronchoplasty of the torn and separated right main bronchus, and repaired the impaled left lung without any pulmonary resection. He recuperated without sequelae.
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Ann Thorac Cardiovasc Surg · Aug 2001
Comparative StudyUse of the silicone T-tube to treat tracheal stenosis or tracheal injury.
Tracheal stenosis or tracheal injury is a troublesome disease. Traditional temporary tracheostomy and reconstruction can resolve some problems. However other problems such as subglottic stenosis and supracarinal stenosis, cannot be resolved by simple tracheostomy. The silicone tracheal T-tube presents a substitute for stent of this complicated disease. ⋯ The silicone T-tube is a useful prosthesis for tracheal stenosis or tracheal injury with minimal complication in place of traditional tracheostomy or complex tracheal reconstruction.
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Ann Thorac Cardiovasc Surg · Apr 2001
Comparative Study Clinical Trial Controlled Clinical TrialEffect of papaverine applications on blood flow of the internal mammary artery.
The aim of this prospective study was to compare the effect of different papaverine applications on the free blood flow in the internal mammary artery (IMA) prepared for coronary artery bypass grafting (CABG). The patients were divided into three groups: group I (n=50; intraluminal papaverine application), group II (n=50; topical papaverine application), and group III (n=50; periarterial papaverine application). The free flow from the distal cut end of the IMA was measured under controlled hemodynamic conditions (Flow 1). ⋯ After papaverine application, the mean blood flow in group I was 129.3+/-10.0 ml/min, in group II, it was 87.7+/-3.8 ml/min, and in group III, it was 130.6+/-9.2 ml/min (p<0.0001). Proportional increases in blood flow observed in group I (106.3%) and group III (116.2%) were higher than in group II (44.2%) (p<0.0001). Consequently, to relieve perioperative spasm of the IMA, application of papaverine injected into the periarterial tissues of its pedicle was considered to be a safe and effective alternative to topical or intraluminal application.
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Ann Thorac Cardiovasc Surg · Apr 2001
Shape and movement of the interatrial septum predicts change in pulmonary capillary wedge pressure.
We aimed to assess whether movement of the interatrial septum predicts change in pulmonary capillary wedge pressure (PCWP). In 71 patients undergoing cardiac surgery, the interatrial septum was categorised by its shape and movement using transesophageal echocardiography. Fixed curvature (FC) was identified by bowing of the interatrial septum from left to right throughout the cardiac cycle, mid-systolic reversal (MSR) by minimal septal movement and transient reversal (right to left) during mid-systole, and mid-systolic buckling (MSB) by marked movement and buckling of the septum during mid-systole. ⋯ The mean PCWP at which a change in pattern occurred was 8.9 mmHg (8.3 to 9.6) for MSR to MSB, and 10.9 mmHg (10.1 to 11.8) for MSR to FC (p<0.001). There was no significant difference in mean values for all three observers. Movement of the interatrial septum predicts change in PCWP.