Kyobu geka. The Japanese journal of thoracic surgery
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We report 2 cases of surgical treatment of blunt cardiac trauma. The postoperative course was uneventful in either case. Pericardial drainage in patients with cardiac rupture should be performed with preparation for thoracotomy. ⋯ Low blood pressure and chest computed tomography demonstrated cardiac tamponade, and subxiphoid pericardial drainage was performed. Blood pressure was recovered, but persistent hemorrhage necessitated emergency thoracotomy, which revealed a laceration at the right atrium near IVC. The injury was sutured to achieve complete hemostasis.
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In recent years thoracotomy by "clamshell incision" has frequently been chosen for heart-lung transplantation, bilateral lung tumors and mediastinal tumor merging into lung tumor because this approach provides very good visibility to access the whole bilateral lung including the lower lobe and mediastinal organs. In our hospital, 4 patients underwent bilateral thoracotomy by clamshell incision for pulmonary metastasectomy between 2001 and 2005. ⋯ Regarding the surgical approach to bilateral pulmonary metastases that did not need lobectomy, clamshell incision is one of the useful approaches that can allow wedge resection anywhere in the whole lung. In cases that are expected multiple procedures, bilateral thoracotomy by clamshell incision is recommended because it allows another route for thoracotomy at reoperation.
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We describe our 1st case of off-pump coronary artery bypass grafting following percutaneous angioplasty (PTA) and intra-aortic balloon pumping (IABP) insertion. A 66-year-old man presented with cardiogenic shock due to acute coronary syndrome. ⋯ He underwent coronary artery bypass grafting following PTA and IABP insertion. Even in an emergency case with PVD, PTA and IABP insertion could be an option to facilitate off-pump coronary artery bypass grafting.
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The purpose of this study is to assess the feasibility of utilizing the proximal right internal thoracic artery (RITA) extended with the radial artery (RA) as I-composite graft (RITA-RA graft) in off-pump coronary artery bypass grafting (OPCAB), which preserves the left internal thoracic artery to the left anterior descending artery as an isolated graft and the ascending aorta no-touch technique. ⋯ OPCAB using RITA-RA graft is feasible and safe. It provides satisfactory early clinical and angiographic outcomes.