Kyobu geka. The Japanese journal of thoracic surgery
-
Aortic dissection usually result in chest pain and back pain. This patient is a 58 year-old man who received aortic valve replacement for aortic regurgitation 10 years ago. ⋯ He underwent modified Carbrol's operation under hypothermic cardiopulmonary bypass and circulation arrest on May 8, 1995. Dissecting aneurysm in the late term after aortic valve replacement is rare, and for it to result in superior vena cava syndrome is especially rare.
-
Case Reports
[Thoracoscopic surgery for pneumothorax with bullous emphysema in an elderly patient: a case report].
Recent advances in optical and endoscopic operating instruments have made thoracoscopic surgery easier. The authors report the case of an 83-year-old patient who was referred to our hospital for right spontaneous pneumothorax associated with severe bullous emphysema. Chest X-ray films showed 40% collapse of right lung and the right spontaneous pneumothorax was treated by chest tube drainage for 3 weeks. ⋯ His postoperative course was uneventful after removal of the chest drain. He was discharged on 27th postoperative day and had no shortness of breath in daily life. From our experience, thoracoscopic surgery appears to be much better than thoracotomy for spontaneous pneumothorax because of much less postoperative disability and preservation of respiratory function.
-
Left ventricular myxoma is very rare, and only 37 cases have been reported at present time. We here report a case of surgical extirpation of a left ventricular myxoma arising from the septal wall of the left ventricule. A 74-year-old woman was examined by transesophageal echocardiography because of palpitation. ⋯ The grayly gelatinous mass was 11 x 12 x 12 mm and weighed 0.6 g. It was diagnosed as a myxoma pathohistologically. The patient recovered uneventfully and was discharged four weeks after the operation.
-
We encountered a 40-year-old male patient diagnosed to have an atrial septal defect combined with pulmonary hypertension and left main coronary artery stenosis of 50% caused by a dilated pulmonary artery. Preoperative Trazoline tolerance test revealed an increase in pulmonary artery pressure from 77/22(40) to 85/24(42), and a decrease in pulmonary vascular resistance from 4.2 U.m2 to 3.6 U.m2. Moreover, his treadmill exercise test was positive. ⋯ The postoperative catheterization examination showed normal pulmonary artery pressure, mild mitral valve regurgitation, and improvement of the left main coronary artery stenosis from 50% to 41%. After 6 months, his treadmill exercise test was negative. We believe that it is important to estimate preoperatively for the possible reversibility of pulmonary hypertension in a patient with an atrial septal defect combined with a left main coronary artery stenosis caused by a dilated pulmonary artery.
-
Nonpenetrating blunt trauma causing pulmonary pseudocyst is very rare. A 25-year-old young male suffered from motor vehicle accident. He was transferred to our hospital with severe hemoptysis. ⋯ Therefore, one lung ventilation using a uni-vent tube blocker was performed. After twelve hours blockade, the cavity lesion was enlarged and trans-bronchial bleeding was continued severely. Emergency right lower lobectomy was carried out successfully.