Kyobu geka. The Japanese journal of thoracic surgery
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Case Reports
[Surgical Treatment for Kommerell's Diverticulum with Aortic Dissection;Report of a Case].
A 43-year-old man was referred to our hospital with chest pain. Computed tomography revealed thrombosed type B aortic dissection and distal aortic arch aneurysm with maximum diameter of 56 mm accompanied by an aberrant right subclavian artery (Kommerell's diverticulum). After performing anti-hypertensive treatment, we planned surgical treatment the operation. ⋯ Postoperative course was uneventful and he was discharged on the 9th postoperative day. Kommerell's diverticulum with aortic dissection is a relatively rare condition. Here we describe our surgical strategy with a review of the literature.
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In an aging society, the high incidence of surgery for the patients with ischemic heart disease(IHD)or atrial fibrillation(Af) under antiplatelet or anticoagulant therapy is a great problem. Interruption of antiplatelet or anticoagulant oral agents in the perioperative period may increase the risk of coronary or cerebral events. We retrospectively reviewed the surgical outcomes for lung cancer patients with IHD or Af. ⋯ There were no hemorrhagic or thromboembolic complications in a perioperative period except 1 case of pulmonary hemorrhage and 1 case of cerebral infarction. No perioperative hospital death was documented. Short-term interruption of antiplatelet or anticoagulant drugs before lung cancer surgery and heparinization was acceptable from the view of perioperative outcomes.
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Traumatic asphyxia is a crush injury of the chest characterized by facial edema, cyanosis, conjunctival hemorrhage, and petechiae on the face and chest. The prognosis depends on the duration of chest compression and early cardiopulmonary resuscitation after cardiopulmonary arrest. Here we report a case of full recovery from cardiopulmonary arrest caused by traumatic asphyxia. ⋯ Rewarming his body to 36 °C took place over 48 hours. Thereafter, he recovered completely and was discharged on the 12th hospital day without neurologic sequela. Therapeutic hypothermia was possibly effective in this case.
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Case Reports
[Repair of Cardiac and Pulmonary Damage caused by Stabbing with a Kitchen Knife;Report of a Case].
A 51-year-old woman was stabbed in the chest with a kitchen knife. Twenty minutes after arrival at our hospital by ambulance, she was transferred to the operating room, and a cardiopulmonary bypass was established from the right femoral artery and vein, and a median sternotomy was performed. The knife had damaged the surface of the heart and penetrated the lingular segment of the left lung. ⋯ Chest X-rays taken after closing the chest showed bleeding in the left lung probably because of the administration of heparin. Bleeding was controlled by lingulectomy. The postoperative course was uneventful.
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Case Reports
[Successful management of nonocclusive mesenteric ischemia after aortic valve replacement;report of a case].
Non-occlusive mesenteric ischemia (NOMI) is a fatal complication after cardiovascular surgery, but early diagnosis is difficult because the clinical symptoms are not specific. We report a case of NOMI with successful management due to early diagnosis and treatment. A 78-year-old male complained of sudden abdominal pain after aortic valve replacement. ⋯ Since angiography showed vasospasm of the mesenteric artery, we also started a continuous intra-arterial infusion of papaverine. Each vasodilator drug was started within a few hours after the onset of NOMI. His subsequent hospital course was uneventful, and he was discharged without enterectomy or fatal intestinal necrosis.