The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 1985
Results of diaphragmatic plication for unilateral diaphragmatic paralysis.
Seven adult patients with dyspnea resulting from nonmalignant unilateral diaphragmatic paralysis underwent plication of the affected hemidiaphragm. Preoperatively, the patients complained of exertional dyspnea and orthopnea and had a reduced arterial oxygen tension, total lung capacity, vital capacity, expiratory reserve volume, and functional residual capacity. ⋯ The patients' symptoms were improved with plication and a significant decrease was recorded in breathlessness on a visual analogue scale. There were no postoperative complications and mean hospital stay was 12 days.
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J. Thorac. Cardiovasc. Surg. · Aug 1985
Bronchoplastic procedures and pulmonary artery reconstruction in the treatment of bronchogenic cancer.
Nineteen patients with primary bronchogenic carcinoma underwent bronchoplastic procedures (six wedge and 13 sleeve resections) between 1970 and 1982. In six of them lobectomy was combined with sleeve resection and reconstruction of the pulmonary artery: In one a synthetic prosthesis was inserted. Twelve patients had squamous cell carcinoma, five adenocarcinoma, and two large cell carcinoma. ⋯ No patient with resection of the pulmonary artery had vascular complications. Survival rates on the basis of nodal involvement indicate 50% survival at 5 years without nodal metastasis (11 cases) versus 9.7% with nodal involvement (eight cases) (p less than 0.05). Bronchoplastic procedures, even if accompanied by segmental resection of the pulmonary artery, can be performed safely with long-term results comparable to those following major pulmonary resections.
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J. Thorac. Cardiovasc. Surg. · Jul 1985
Management of congenital stenosis of a branch pulmonary artery with balloon dilation angioplasty. Report of 52 procedures.
Twenty-four children, aged 4 months to 16 years (nine patients 2 years old or younger), underwent balloon dilation angioplasty of hypoplastic or stenotic branch pulmonary arteries between July, 1981, and April, 1984. Most children had tetralogy of Fallot, with or without pulmonary atresia, or isolated peripheral pulmonary artery stenosis. Fifty-two dilations were attempted, 44 in the catheterization laboratory and eight in the operating room. ⋯ One child exsanguinated when the pulmonary artery ruptured during dilation, but other complications were few. Eight dilations, followed up for an average of 6 months after dilation, showed angiographic persistence of improvement; two of four lesions were successfully redilated to a larger size. Balloon dilation angioplasty appears beneficial, both short and long term, for some patients with hypoplastic or stenotic branch pulmonary arteries, especially if performed early in life.
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J. Thorac. Cardiovasc. Surg. · Jul 1985
Somatosensory evoked potentials and cerebral metabolism during cardiopulmonary bypass with special reference to hypotension induced by prostacyclin infusion.
Somatosensory evoked potentials and cerebral metabolism were studied during cardiopulmonary bypass in 41 patients undergoing coronary bypass. Twenty-two patients received prostacyclin 50 ng/kg/min during cardiopulmonary bypass for platelet protection and 19 patients served as controls. Mean arterial blood pressure in the prostacyclin group was below 30 mm Hg during the first 30 minutes of bypass, but it remained above 50 mm Hg in the control group. ⋯ There was no difference between the groups in regard to glucose and lactate. We conclude that cardiopulmonary bypass with hypothermia prolongs central conduction time. The hypotension induced by prostacyclin (50 ng/kg/min) did not further impair conduction in the central nervous system.
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J. Thorac. Cardiovasc. Surg. · Jul 1985
Case ReportsBronchial carcinoid arising in intralobar bronchopulmonary sequestration with vascular supply from the left gastric artery. Case report.
We report the unique case of a large, nonmetastasizing bronchial carcinoid tumor that arose within an intralobar bronchopulmonary sequestration in a 45-year-old man. The vascular supply to the sequestrated area within the left lower lobe as well as to the carcinoid tumor originated from atypical branches of the left gastric artery and the thoracic aorta. ⋯ Histologically, a typical carcinoid tumor without lymph node metastases was found (T2 N0 M0). Seven years postoperatively, the patient is without signs of recurrence.