The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 1980
Case ReportsTracheal stenosis: an unusual presenting complication of idiopathic fibrosing mediastinitis.
Idiopathic fibrosing mediastinitis is a rare, obliterative, inflammatory process which is characterized by an abnormally exuberant proliferation of fibrous tissue within the superior mediastinum, resulting in the encroachment and occlusion of its contained structures. Usually, this is one of the low-pressure vascular structures, most often the superior vena cava. ⋯ In this article, a patient with this complication is presented in whom emergent surgical treatment and tracheal decortication afforded permanent relief. The clinial presentation, morphology of the disease, and treatment are reviewed.
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J. Thorac. Cardiovasc. Surg. · Aug 1980
A technique for continuous intercostal nerve block analgesia following thoracotomy.
Early after thoractomy, incisional chest pain may lead to a sequence of undersirable effects on respiratory function, in addition to causing patient discomfort. Pharmacologic blockade of the intercostal nerves innervating the incisional area can improve respiratory function as well as patient comfort. The postoperative production of continuous intercostal nerve blockade can be accomplished by the insertion of indwelling analgesic catheters at the time of thoracotomy closure.
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A major change has occurred in the incidence and management of pulmonary tuberculosis in patients of all ages. This review emphasizes the effectiveness of drug therapy and the declining role of surgical management of pulmonary tuberculosis in children. ⋯ The remaining 138 children were treated successfully with anti-tuberculous drugs. Pulmonary tuberculosis in children is primarily a medical disease and only rarely is surgical intervention indicated.
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J. Thorac. Cardiovasc. Surg. · Jul 1980
Randomized Controlled Trial Comparative Study Clinical TrialMembrane versus bubble oxygenator for cardiac operations. A prospective randomized study.
The advantages of membrane oxygenators over bubble oxygenators for cardiopulmonary bypass during clinical cardiac operations are controversial. A prospective randomized double-blind experimental design was utilized in 64 adult patients undergoing elective cardiac operations with either the Travenol microporous polyprolyene membrane oxygenator or the Bentley Q-100 bubble oxygenator. Sixteen patients in each group underwent coronary artery bypass grafting (CABG) and 16 underwent valvular or other types of operation. ⋯ Higher relative platelet counts (percent of control) were observed immediately after bypass in CABG patients in whom the membrane oxygenator was used. Otherwise, no significant differences were noted in objectively assessed results between the two oxygenators in regards to bleeding, pulmonary, renal, cardiac, and neurologic function, duration of ICU stay, and postoperative hospital stay. Thus no significant advantages in terms of clinical results could be detected with this type of membrane oxygenator versus another type of bubble oxygenator for elective cardiac operations in adults.