Kyobu geka. The Japanese journal of thoracic surgery
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Thoracolithiasis is a rare condition with only 16 cases of surgically removed nodules reported in the literature in Japan. We report an additional thoracoscopically removed case. ⋯ Video-assisted thoracic surgery (VATS) was performed and a white 11 mm completely free nodule in the left pleural cavity was removed. Pathological findings revealed necrotic fat tissue in the center surrounded by hyalinized fibrous tissue, being consistent with thoracolithiasis.
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A 48-year-old woman was admitted to the hospital for coronary artery bypass grafting (CABG) of ischemic coronary disease, including left main trunk disease. She had a history of moyamoya disease with bilateral internal carotid artery occlusion. Her cerebral blood flow and cerebral vascular reactivity were evaluated by single photon emission computed tomography. ⋯ We performed off-pump CABG supported by intra-aortic ballon pumping to maintain appropriate cerebral blood flow intraoperatively. Moreover, during operation, systolic blood pressure and blood Paco2 level were constantly maintained above 100 mmHg and 40 mmHg. Her postoperative course was uneventful without transient ischemic attacks or stroke.