Kyobu geka. The Japanese journal of thoracic surgery
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Acute massive pulmonary thromboembolism (APE) is still associated with a high mortality rate. Furthermore, significantly higher mortality rates are observed in patients who underwent cardiopulmonary resuscitation (CPR) because of severe brain damage or multiple organ failure. We present successfully treated 4 patients who were transferred from outside hospitals under continuous CPR. ⋯ Open pulmonary thrombectomy was successfully performed under on pump beating cardiopulmonary support. All patients dramatically improved and were discharged without any complication. When hemodynamic instability or cardiac arrest occurs in patients with APE, rapid CPR, rapid diagnosis with echocardiography, and quick PCPS establishment are keys in our management strategy.
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Case Reports
[Reoperation of Blalock-Taussig shunt for double outlet right ventricle and pulmonary atresia in an adult].
A 36-year-old man was admitted to our hospital due to dyspnea and pneumonia. He had undergone left classical Blalock-Taussig shunt at 5 years old and right modified Blalock-Taussig shunt at 16 years old, because he was judged as no indication for any radical operation. Since the last surgery, he had stopped visiting hospital. ⋯ After pneumonia was improved by antibiotic treatment, he underwent reoperation of the right modified Blalock-Taussig shunt using 8 mm knitted Dacron graft. Postoperative course was uneventful and dyspnea and cyanosys were improved. We successfully treated a complicated case of an adult congenital heart disease by reoperation of the right modified Blalock-Taussig shunt.