Kyobu geka. The Japanese journal of thoracic surgery
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A 55-year-old man was diagnosed with infective endocarditis( IE) of the mitral valve caused by Streptococcus sanguinis. His IE was controlled immediately after the initiation of intravenous antibiotic therapy lasting for 4 weeks. A few days before surgery, he complained of abdominal discomfort and computed tomography (CT) scan revealed rupture of the mycotic iliocolic artery aneurysm. ⋯ After additional 4 weeks' intravenous antibiotic therapy, the mitral valve was replaced. Mycotic visceral artery aneurysms are rare in IE. Early diagnostic approaches and interventions such as TAE are crucial.
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A 61-year-old woman was admitted to our hospital because of hemosputum. When chest computed tomography (CT) was performed, sudden and massive hemoptysis occurred. ⋯ Bronchial artery embolization (BAE) was performed, however, hemoptysis recurred, and the left pneumonectomy was performed. She has been free from hemoptysis after operation, and has been discharged from the hospital 73 days after surgery.
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Comparative Study
[Comparative study between landiolol and amiodarone for therapeutic efficacy after open heart surgery].
Tachyarrhythmia, especially atrial fibrillation, remains as a common complication after open heart surgery and sometimes leads to fatal condition. Many reports showed that landiolol (ultra short-acting beta one blocker) and amiodarone were effective against postoperative atrial fibrillation (POAF). ⋯ Our study suggests that landiolol be the 1st choice for rate control of tachyarrhythmia because of easy dose adjustment and mild side effects. Amiodarone may be useful for the patients whose left ventricular function is poor.
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We review our experience of surgical repair for pectus excavatum without the introduction of exogenous material. Two hundred seven patients underwent surgical repair. Sterno-costal elevation was adopted for 196 patients. ⋯ There were neither operative death nor any severe complications, and in all cases the deformities were corrected satisfactorily. Patients resumed unlimited daily activities within 3 months after surgery. Our technique represents a less invasive procedure with low operative risk for the repair of pectus excavatum in any age group.
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The left superior vena cava (LSVC) is often complicated with congenital heart defect. Although we simply clamp LSVC during cardio-pulmonary bypass (CPB), appropriateness of this technique has not been clarified. We noninvasively evaluate cerebral tissue oxygenation while the clamping of LSVC under CPB by near-infrared spectroscopy (NIRS). ⋯ These data demonstrated that LSVC could be safely clamped when LSVC pressure was under 30 mmHg.