[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1995
Case Reports[A case report of chronic traumatic thoracic aneurysm (thrombotic closure type) which appeared as a mediastinal tumor in preoperative findings].
Chronic traumatic thoracic aneurysm is considered to be an uncommon disease. A case of 59-year-old man who had a history of blunt chest trauma with a traffic accident thirty years ago is reported. He has no symptoms and no signs since the accident. ⋯ At surgery, it was found to be a thoracic semispherical pseudo-aneurysm (thrombotic closure type) measuring 3 cm diameter with slightly hard fibrous tissue contained aseptic brownish fluids. Following partial clamping of the aorta, the thoracic pseudo-aneurysm was opened and the direct closure of the aortic tear with teflon felt was performed. It is important to check the presence of the thoracic pseudo-aneurysm for following-up the patient after the thoracic trauma.
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Nihon Kyobu Geka Gakkai Zasshi · Jan 1995
Case Reports[Valve replacement in an infant with congenital mitral stenosis--report of a case which showed hemodynamics similar to that of hypoplastic left heart syndrome in neonatal period].
In the neonatal period, the patient showed severely hypoplastic left ventricle, severe mitral stenosis, patent foramen ovale and patent ductus arteriosus with right-to-left shunting, which resulted in the hemodynamics similar to that of hypoplastic left heart syndrome. However, progressive left ventricular growth was recognized after spontaneous closure of the foramen ovale, and the cardiac catheterization at the age of 6 months revealed almost normal left ventricular volume and systolic forward flow from the left ventricle to the descending aorta. The operation was performed at the age of 7 months under cardiopulmonary bypass with moderate hypothermia and cardiac arrest. ⋯ We consider that there were two important hemodynamic factors which led to successful biventricular repair in this case. First, early spontaneous closure of the foramen ovale accerelated the left ventricular growth and prevented right ventricular failure resulting from increased pulmonary blood flow. Second, considerable part of the systemic output was supplied through a large ductus arteriosus, and thus over-systemic pulmonary hypertension was avoided.