Kyobu geka. The Japanese journal of thoracic surgery
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A 69-year-old man who had a post-infarction left ventricular aneurysm underwent surgical repair. Preoperative left ventriculography showed a small aneurysm, 3.0 x 3.0 x 2.5 cm in size, with a narrow neck at the inferior wall suggesting a typical "false" aneurysm. But intraoperative and pathological examination revealed that this was a "true" aneurysm which contains coronary artery and myocardial cells in its wall. Left ventriculography is not necessarily the definite standard to differentiate between true and false left ventricular aneurysm.
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A 77-year-old male patient underwent laryngo-tracheal anastomosis for subglottic tracheal stenosis. He developed exertional dyspnea 10 month after tracheostomy. Anterior and lateral wall of the cricoid cartilage and the first two tracheal cartilages were resected, preserving the recurrent laryngeal nerves. ⋯ Oral intake was started on the 2nd postoperative day. The patient showed smooth recovery. The important points of this operation are: 1) preoperative evaluation of the residual subglottic space, 2) intraoperative care for preservation of the recurrent nerves, especially at the lateral sides of the crycoid cartilage, and 3) postoperative maintenance of the cervical anterior flexion.
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A case with a bronchial foreign body which had an uncommon way of entry through a wound in the chest wall was described. A 70-year-old man was admitted to our hospital because of productive cough and weight loss. He had been injured by a fragment of a hand grenade which penetrated his anterior chest wall at the front in China 45 years ago. ⋯ Computed tomography of the chest and bronchoscopy demonstrated a steel fragment lodging beside and in the right upper lobe bronchus. Right upper lobectomy was performed, and the patient remains well without any thoracic symptoms one and a half years after the operation. Problems in the treatment of traumatic intrapulmonary foreign bodies were discussed.
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Case Reports
[A case report of a massive pulmonary tumor embolism occurring during surgery for renal cell carcinoma].
A 59-year-old man, who suffered a massive pulmonary tumor embolism during surgery for renal cell carcinoma with vena caval invasion, was treated by emergency pulmonary embolectomy using cardiopulmonary bypass. Renal cell carcinoma occasionally extends into the inferior vena cava (IVC) as a tumor thrombus. ⋯ However, the massive pulmonary tumor embolism is a major potential hazard during radical surgical resection. To prevent intraoperative pulmonary embolisms from occurring, scheduled use of cardiopulmonary bypass with the cooperation of cardiovascular surgeons is recommended.