Kyobu geka. The Japanese journal of thoracic surgery
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Blunt tracheobronchial injury is rare but crucial injury. We discussed some problems about blunt tracheobronchial injury and presented our experience. To rescue patients with blunt tracheobronchial injury, surgical treatment within 24 hours from injury is recommended when general anesthesia is acceptable. ⋯ We present a 29 year-old male who had blunt tracheobronchial injury and underwent reconstruction of carina in our hospital. Rupture of carina was recognized by bronchscopy and pneumomediastinum was shown in chest computed tomography (CT). Operation was successfully performed 22 hours later from injury and the patient discharged 28 days after from injury.
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A 17-year-old woman with scimitar syndrome without an atrial septal defect was operated by intra-cardiac conduit repair. Computed tomography (CT) and magnetic resonance imaging (MRI) showed resolution images of anatomical findings of scimitar vein. ⋯ The detection of precise anatomy of scimitar syndrome is important for determining the appropriate surgical procedure. Images of 3-dimensional (3-D) CT and MRI of scimitar syndrome were demonstrated.
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A 10-year-old boy with partial anomalous pulmonary venous connection to the high superior vena cava (SVC) underwent surgical repair by Williams method. The SVC was divided above the orifice of the anomalous pulmonary vein. ⋯ The anomalous pulmonary vein was rerouted to the left atrium via the SVC and the surgically enlarged central type atrial septal defect (ASD). The postoperative course was uneventful except transient sinus bradycardia and catheter study showed no stenosis of the SVC and the RAA.
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Eighty consecutive patients who underwent off-pump coronary artery bypass (OPCAB) were studied. They were divided into group I (n = 10) which received preoperative intraaortic balloon pumping (IABP), and group II (n = 70) which did not receive IABP. The indications for preoperative IABP were severe left main coronary artery disease in 7 patients, severe 3 vessel disease in 3 patients, unstable angina in 5 patients, acute myocardial infarction in 3 patients. ⋯ There was no IABP-related complication in group I. IABP was very effective to perform OPCAB surgery safety. Preoperative IABP may be effective modality to support OPCAB surgery not only in emergent case but also in elective case.
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We report an extremely rare case of multi-vessel dissection including left carotid artery, ascending aorta and thoracoabdominal aorta independently. A 65-year-old man suffered from cerebral infarction due to left carotid artery dissection. Five days later, he complained of severe back pain and was diagnosed as acute DeBakey type IIIb aortic dissection. ⋯ The ascending aorta was replaced on August 8, 2001. Then replacement of the descending thoracic aorta with reconstruction of the eighth and tenth intercostal arteries was performed on September 26, 2001. The left carotid artery dissection has been treated medically.