Kyobu geka. The Japanese journal of thoracic surgery
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Review Case Reports
[A case of penetrating chest injury with tension hemothorax by gunshot].
The patient, a 36-year-old male, was admitted with massive hemoptysis. He had two gunshot wounds in the right lateral abdomen and supraclavicular fossa. His chest X-ray showed right tension hemothorax. ⋯ Massive bleeding from the right pulmonary artery (A4+5), lacerations in the diaphragm and injuries of the liver were found. We performed right middle lobectomy, S3 segmentectomy and plication of the diaphragm and liver. He was discharged uneventfully.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Repeat open heart surgery using continuous warm blood cardioplegia].
Myocardial protection during repeat open heart surgery still remains to be further improved. The purpose of this study was to evaluate the usefulness of continuous warm blood cardioplegia (CWBC) comparing with intermittent cold GIK cardioplegia (ICGC) in repeat open heart surgery. Twenty-four patients underwent repeat open heart surgery through re-sternotomy (11 mitral, 6 aortic 5 double, 2 congenital) were divided into two groups, that is 10 received CWBC (warm group) and 14 ICGC (Cold group). ⋯ Postoperative bleeding in the first 24 hours was less (553.8 +/- 38.9 ml) in warm group than that (974.3 +/- 54.1 ml) in cold group. In warm group 3 patients were operated on without homologous blood transfusion, in contrast none in cold group. Our results clearly demonstrated that CWBC was preferable to ICGC for myocardial protection in repeat open heart surgery.
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Comparative Study
[Myocardial protection during aortic valve replacement: effectiveness of continuous warm blood cardioplegia].
Effectiveness of continuous warm blood cardioplegia (CWBC) during aortic valve replacement (AVR) was studied by comparing with intermittent cold GIK cardioplegia (ICGC) in 32 patients who underwent AVR using CWBC in 16 and ICGC in the other 16 patients. There was no operative nor hospital death in this series. In CWBC group, spontaneous recovery of the heart beat following aortic declamping was seen in 14 of 16 patients (87.5%), in contrast only in 4 of 16 (25%) in ICGC group. ⋯ Right ventricular stroke work index significantly increased only in CWBC group as well. In CWBC group, myocardial oxygen and lactate extraction rates were maintained within normal range during aortic cross-clamping, suggesting satisfactory myocardial preservation with an aerobic metabolism. In conclusion, CWBC is superior to ICGC as a myocardial protection during AVR.