Kyobu geka. The Japanese journal of thoracic surgery
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The aim of this study was to evaluate the effect of intra-operative low-dose infusion of landiolol hydrochloride, a novel ultra-short acting beta-1 adrenergic receptor antagonist, on post-operative atrial fibrillation after off-pump coronary artery bypass grafting (OPCAB). ⋯ Intra-operative low-dose infusion of landiolol hydrochloride decreases the incidence of postoperative atrial fibrillation after OPCAB.
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Case Reports
[Marfan-like aortic aneurysm syndrome; A surgical experience with Loeys-Dietz syndrome].
A 17-year-old female patient complaining of chest pain was transferred to our hospital to treat annuloaortic ectasia associated with severe aortic valve insufficiency. She underwent a valve sparing operation with graft replacement of the ascending aorta and the proximal portion of the aortic arch. After the 1st operation, she was diagnosed with Loeys-Dietz syndrome (LDS), which is recently described as an autosomal dominant aortic aneurysm syndrome caused by heterozygous mutations in the transforming growth factor-beta receptor type 1 and 2 genes. ⋯ Computed tomography (CT) scan showed an expansion of the aortic arch. Total arch replacement using the elephant trunk technique and aortic valve replacement were performed successfully 4 months after the 1st operation. The rapidly progressive nature of the aortic disease in patients with LDS underscores the importance of meticulous surveillance of the entire aorta and the need for early surgical management.
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Minimally invasive surgery (Nuss procedure) is being accepted rapidly as a preferred method for pectus excavatum repair. This report describes single institution experience with the Nuss procedure. Patient records were reviewed for retrospective analysis. ⋯ A 3-point fixation system minimized the risk of bar shifting. The minimally invasive technique has evolved into an effective method of pectus excavatum repair. Mid-term results continue to be excellent.
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Spontaneous rupture of the thoracic aorta is extremely rare. It is very difficult to diagnose it preoperatively. ⋯ A case of spontaneous rupture of the thoracic aorta which was diagnosed the rupture of Stanford type B dissection preoperatively was successfully treated.