Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
-
Ann Thorac Cardiovasc Surg · Jan 2015
Case ReportsA 3.5-cm Single-Incision VATS Anatomical Segmentectomy for Lung Cancer.
The results of several pulmonary resections using a uniportal approach have been published. However, there are no reports of uniportal thoracoscopic anatomic segmentectomy in Japan. We have a fundamental belief in "reduced-port surgery" and therefore routinely perform uniportal thoracoscopic surgery for patients with pneumothorax. ⋯ Postoperatively, no analgesics were needed. The operative procedure is described in detail and includes technical tips such as the pulley method, extra-vessel exposure, the shaft-on-shaft technique, one-hand encircling, and one-hand exposure. The selection criteria for uniportal thoracoscopic segmentectomy limit its use.
-
Ann Thorac Cardiovasc Surg · Jan 2015
Comparative StudyNasal methicillin-resistant S. aureus is a major risk for mediastinitis in pediatric cardiac surgery.
Mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious complication after pediatric cardiac surgery. An outbreak of surgical site infections (SSIs) provided the motivation to implement SSI prevention measures in our institution. ⋯ SSI prevention measures significantly reduced the occurrence of SSIs and mediastinitis. Preoperative MRSA colonization should be a serious risk factor for mediastinitis following pediatric cardiac surgeries.
-
Ann Thorac Cardiovasc Surg · Jan 2015
The impact of preoperative and postoperative pulmonary hypertension on long-term surgical outcome after mitral valve repair for degenerative mitral regurgitation.
The aim of this study is to elucidate the impact of preoperative and postoperative pulmonary hypertension (PH) on long-term clinical outcomes after mitral valve repair for degenerative mitral regurgitation. ⋯ Early surgical indication should be advocated for degenerative mitral regurgitation before the progression of pulmonary hypertension and tricuspid regurgitation.
-
Ann Thorac Cardiovasc Surg · Jan 2014
Randomized Controlled TrialEffects of positive end-expiratory pressure on mechanical ventilation duration after coronary artery bypass grafting: a randomized clinical trial.
Patients undergoing cardiac surgery remain on mechanical ventilation postoperatively until they regain consciousness. Positive end-expiratory pressure (PEEP) may influence the duration of mechanical ventilation after coronary artery bypass grafting (CABG). The aim of this study was to compare the effects of different levels of PEEP on the duration of mechanical ventilation after coronary artery bypass grafting. ⋯ From the point of weaning from mechanical ventilation until 12 hours after intensive care unit (ICU) admission, we saw a statistically different duration of mechanical ventilation between groups (p=0.029). In Group A, the average mechanical ventilation time was 6.7±3.2 hours; it was 6.8±3.3 hours in Group B and 5.1±2.9 hours in Group C. The use of higher levels of PEEP was associated with shorter duration of mechanical ventilation in postoperative CABG patients.
-
Ann Thorac Cardiovasc Surg · Jan 2014
Pleural effusion complicating after Nuss procedure for pectus excavatum.
The Nuss procedure is a minimally invasive method for the correction of pectus excavatum (PE). Pleural effusion complicating following the Nuss procedure was uncommon but may be critical. We evaluated the risk factors of postoperative pleural effusion after Nuss repair. ⋯ Pleural effusion complicating after Nuss procedure was uncommon. It occurred most on adult patients with placement of double bars. Close follow-up in adults after more than one bar insertion is recommended. Administration of temporary medications of indomethacin/steroid and/or thoracocentesis could obtain a satisfying result. Early administration of indomethacin/steroid in adult patients repaired by two bars with mild pleural effusion for preventing pooling of effusion could also be considered.