Kyobu geka. The Japanese journal of thoracic surgery
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The right atrium of the neonate may be too small for direct insertion of 2 venous catheters during intraoperative life support. We inserted a double lumen catheter into the right atrium, and venovenous (V-V) extracorporeal membrane oxygenation (ECMO) was instituted. The patient's arterial oxygen saturation was maintained at 70% to 90%, and hemodynamic stability was obtained during V-V ECMO. V-V ECMO using a double lumen catheter can be easily established in a small neonate, and is an effective support technique for untolerable hypoxemia during systemic-to-pulmonary artery shunt operations.
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Preoperative autologous blood donation is commonly used to reduce exposure to homologous blood transfusions among patients undergoing elective cardiac surgery. The purpose of this study was to ascertain how much volume of predonated autologous blood need to avoid of homologous blood transfusion in cardiac procedure. ⋯ Autologous blood transfusion is effective for reducing the homologous blood requirement. It also seems that predonation of 800 ml may be sufficient to avoid homologous blood transfusion in cardiac surgery, however predonation of 1,200 ml is desirable in cases of redo operation or CABG + valve replacement.
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Comparative Study
[Superior results of ketone body ratio in pulsatile normothermic cardiopulmonary bypass; comparison with non-pulsatile cardiopulmonary bypass].
Sixteen patients undergoing aortocoronary bypass surgery under normothermic cardiopulmonary bypass were divided into 2 groups according to the either addition or none of pulsatility induced by intra-aortic balloon pumping (IABP). In those patients, hepatic blood flow was measured 3 times before, during and after cardiopulmonary bypass. Additionally, arterial and hepatic ketone body ratios [(AKBR) and (HKBR)], and hepatic venous saturation (ShvO2) were measured throughout and after the surgery. ⋯ Pulsatile normothermic cardiopulmonary bypass induced by IABP provides better liver perfusion and results in a better hepatic metabolism than non-pulsatile cardiopulmonary bypass.
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An association between bicuspid aortic valve disease and ascending aortic aneurysma has long been recognized. Root replacement with a composite valve graft for such disease is a well-established technique. ⋯ Angiographic studies after surgery showed no residual aortic regurgitation (AR) and no deformity of aorta. This technique is an acceptable option for an aortic disease and ascending aneurysma in elderly patients.
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Case Reports
[Catamenial pneumothorax in a young patient diagnosed by thoracoscopic surgery; report of a case].
A 16-year-old woman presented with chest pain on 2 days before the onset of menstruation and was referred to our hospital because of a pneumothorax. She was diagnosed as spontaneous penumothorax and surgical treatment was performed. Thoracoscopy revealed the presence of multiple blueberry spots near central tendon of the diaphragm and little pleural effusion. ⋯ Histological findings of biopsied specimen did not contradict as an endometoriosis and catamenial pneumothorax was diagnosed. CA 125 level of the pleural effusion had increased to 99.2 U/ml. Because she was young, she did not receive a systemic hormonal therapy.