Kyobu geka. The Japanese journal of thoracic surgery
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After right heart bypass operation, dopamine was continuously infused at 5 micrograms/kg/min. The patients had a stable hemodynamic status but relatively low SvO2, low urine output and peripheral insufficiency. Amrinone was continuously infused at 10 micrograms/kg/min in 5 patients (Group A), or milrinone was continuously infused at 0.5 microgram/kg/min in 5 patients (Group M). ⋯ These patients treated using temporary antiarrhythmia drug or temporary pacing. When the patients discharged, they recovered the normal sinus rhythm. In conclusion, after right heart bypass operation in infants, infusion of amrinone or milrinone appears to be effective and safe combining with dopamine.
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Between March 1996 and November 1997, 80 patients with a mean age of 70 years (45-89) have undergone minimally invasive direct coronary artery bypass grafting via anterior minithoracotomy or subxiphoid incision with left internal thoracic artery and right epigastric artery using local coronary occlusion on a beating heart. Cardiac-related hospital mortality was 2.5% (2/80). Routine angiographic assessment of anastomotic patency showed an overall patency. rate of 94.6%, but demonstrated the severe stenosis at the anastomotic site in 8 patients. Further study is required to establish the efficacy of minimally invasive direct coronary artery bypass grafting and combination therapy with PTCA.
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Traumatic lung cyst is an uncommon lung injury due to closed chest trauma. A 5-year-old boy was admitted to our hospital after being run over by motor vehicle. ⋯ Computed tomography taken 37 days after initial injury showed complete resolution of the cysts. Computed tomography was useful in diagnosing traumatic lung cyst and following its clinical course.
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The patient of 21-year-old female, who had undergone VSD closures at the age 5 and had been pointed out to have aortic valve stenosis at that time, was admitted to our hospital with complaints of palpitation and easy fatigability. Pressure gradient of 140 mmHg between left ventricle and ascending aorta, and poststenotic dilatation of max 55 mm in diameter from ascending aorta to hemi aortic arch was recognized by cardiac catheterization and aortogram. For fear of aortic dissection in late phase caused by dilatation of ascending aorta left over, graft replacement from ascending aorta to hemi aortic arch was carried out simultaneously adding to aortic valve replacement (AVR). We are of the opinion that not only AVR but also simultaneous graft replacement should be performed actively on the case with dilatation of ascending aorta of over 55 mm in diameter in order to prevent aortic dissection.
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Since open heart surgery may cause thyrotoxic crisis during the perioperative period in patients with hyperthyroidism, close monitoring and control are needed. We performed open heart surgery in 2 patients with hyperthyroidism, and good results were obtained. ⋯ In the two patients, cardiopulmonary bypass for a prolonged period was required during surgery. However, thyrotoxic crisis could be prevented by controlling thyroid function by preoperative treatment with anti-thyroid agents, concurrent medication with Lugol's iodine solution immediately before surgery and re-administration of anti-thyroid agents early after surgery.