Kyobu geka. The Japanese journal of thoracic surgery
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Between October 1996 and June 2003, endovascular stent graft repair was performed in 87 patients with descending thoracic aortic aneurysms, graft replacement was performed in 24 patients with thoracoabdominal aortic aneurysms, and endovascular stent graft repair with concomitant surgical bypass of abdominal visceral arteries was performed in 3 patients with thoracoabdominal aortic aneurysms. The retrievable stent graft was inserted and evoked spinal cord potential were monitored in order to predict spinal cord ischemia for stent graft repair. There was no paraplegia or hospital death, although 3 patients had paraparesis in stent graft repair. ⋯ The concomitant surgical procedure was a good technique for patients in whom cardiopulmonary bypass could not be used. Our results of stent graft repair and surgical operation for descending thoracic or thoracoabdominal aortic aneurysms were acceptable. The retrievable stent graft was useful for prediction of spinal cord ischemia before endovascular stent graft repair of descending thoracic or thoracoabdominal aortic aneurysm.
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A case of familial spontaneous pneumothorax was reported. A 52-year-old man was referred to our hospital complaining of exertional dyspnea. He had experienced right spontaneous pneumothorax and cured with tube drainage last year. ⋯ Partial resection of the lung with open thoracotomy surgery was performed. Air leaks sealed in 14 days and the patient discharged the hospital with inadequate expansion of the left lung. Three years later the patient experienced right hemicolectomy for colon cancer and died for recurrence 7 years later with adequate expansion of the left lung.
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A 66-year-old man underwent successfully on one-staged operation for aneurysms of the descending thoracic aorta and abdominal aorta. For the operation of descending thoracic aortic aneurysm, a temporary bypass was used from the proximal side of aneurysm to the distal one. The sacculer aneurismal wall of the descending thoracic aorta was repaired by patch formation using a knitted graft. ⋯ Blood transfusion was not needed. The postoperative course was uneventful. It is suggested that one-staged operation for descending thoracic aortic aneurysm under the assist of temporary bypass and abdominal aortic aneurysm is possible.
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This report concerns 2 cases with blunt traumatic hernia of the diaphragm. The diagnosis of these cases had been delayed by 1 month and 6 years, respectively. The former was a left sided case, which had suddenly suffered severe dyspnea. ⋯ The right lobe of the liver dislocated into the right thoracic cavity. The delayed case of traumatic diaphragmatic hernia tends to be overlooked without suspicion. In all patients with thoracoabdominal blunt injury, a rupture of the diaphragm must be suspected.
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Papillary fibroelastoma is a rare cardiac tumor. We report a case of surgical treatment for aortic valve papillary fibroelastoma. The patient was a 64-year-old female. ⋯ A tumor was on the non-coronary-cusp of the aortic valve, which was successfully removed followed by aortic valve replacement with 21 A Carpentier-Edwards bio-prosthetic valve. The tumor was histologically diagnosed papillary fibroelastoma. Following uncomplicated postoperative course, the patient was discharged on twenty-first postoperative day.