Kyobu geka. The Japanese journal of thoracic surgery
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Case Reports
[A surgical repair of partial anomalous pulmonary venous drainage to the high superior vena cava].
A 7-year-old boy with partial anomalous pulmonary venous drainage to the high superior vena cava (SVC) underwent surgical repair by Williams procedure. Right upper pulmonary vein was drained to the left atrium via the SVC and the surgically enlarged sinus venosus type ASD. ⋯ Autologous pericardium was patched anteriorly to create a new SVC pathway. The postoperative course was uneventful without arrhythmia and cardiac catheterization 1 month postoperation revealed no stenosis of the SVC and right upper pulmonary venous return.
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Case Reports
[Left diaphragmatic hernia due to blunt chest trauma complicated with intrapleural gastric perforation].
A 17-year-old male was injured by traffic accidents. Multiple left rib fractures, radiopacity of left hemithorax and rightward mediastinal shift lead us to the diagnosis of traumatic hemothorax. But left tube thoracostomy could not obtain any fluid. ⋯ Laparotomy disclosed rupture of left hemidiaphragm and intrathoracic displacement of the stomach and spleen. After reposition of stomach, we discovered 5 cm fissure of the stomach and left thoracic cavity filled with leaked gastric contents. Though reports of combined diaphragmatic hernia and gastric rupture are rare, these combination could occur if a patient with diaphragmatic hernia encounters blunt chest trauma on a full stomach.
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Clinical Trial
[Aortic arch aneurysm: new modification of aortic arch reconstruction and selective cerebral perfusion].
Selective cerebral perfusion (SCP) has been widely used as the method for cerebral protection during aortic arch repair in the treatment of aortic arch aneurysms in our institution. Recently, we modified our technique of aortic arch reconstruction and SCP in order to reduce the neurological complication. Following institution of SCP into both innominate and left common carotid arteries at 22 degrees C, the distal graft anastomosis and left subclavian reconstruction were performed while the descending aorta was left opened. ⋯ The hospital mortality was 3.3% (1 of the 30 patients). There was no neurological complication. We conclude that the present techniques are useful methods for preventing the neurological complication in the treatment of aortic arch aneurysms.
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A 41-year-old man was admitted to our hospital complaining of severe right chest pain and dyspnea. Soon after, right thoracocentesis was done and pleural free air was aspirated. Twenty minutes later he fell into a shock status. ⋯ Bleeding point was a ruptured stump of pleural adhesion of the apical parietal pleura. His postoperative course was almost good, and discharged on the tenth postoperative day. Careful observation after thoracic aspiration is necessary in the treatment of spontaneous pneumothorax.
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Case Reports
[A successful surgical treatment in a patient with penetrating left ventricular injury].
A 46-year-old man underwent emergency operation for penetrating cardiac injury resulting in cardiac tamponade. Echo cardiogram showed moderate pericardial effusion. ⋯ The wound was closed with direct mattress suture. He was successfully treated and doing well now.