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Annals of Thoracic and Cardiovascular Surgery

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https://www.readbyqxmd.com/read/29343663/the-efficacy-of-vats-and-intrapleural-fibrinolytic-therapy-in-parapneumonic-empyema-treatment
#1
Ozgur Samancilar, Tevfik İlker Akçam, Seyda Ors Kaya, Ozgur Ozturk, Onur Akcay, Kenan Can Ceylan
BACKGROUND: Development of multiloculation-septation is a challenging entity in empyema patients. In this study, it is aimed to investigate the success rates of videothoracoscopic deloculation (VATS-D) and intrapleural fibrinolytic (IPFib) application after tube thoracostomy. METHODS: The study retrospectively examined the patients diagnosed with empyema with multiloculation and septation between January 2005 and December 2014. Among these patients, the study included those who received VATS-D or IPFib therapy...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29343662/cost-benefit-performance-simulation-of-robot-assisted-thoracic-surgery-as-required-for-financiall-viability-under-the-2016-revised-reimbursement-paradigm-of-the-japanese-national-health-insurance-system
#2
Naohiro Kajiwara, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda
PURPOSE: To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. METHODS: All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. RESULTS: Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively)...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29343674/a-spontaneous-abdominal-aortic-pseudoaneurysm-treated-with-n-butyl-cyanoacrylate-and-coil-embolization-a-case-report
#3
Chan Sun Kim, Young Ho Choi, Young Ho So, Jae-Sung Choi
Pseudoaneurysms are vascular spaces vulnerable to pressure, and expansion or rupture of these spaces may occur during embolization. Here, we describe the case of a transcatheter embolization of a spontaneous aortic pseudoaneurysm, which showed gradual expansion during n-butyl cyanoacrylate embolization. This pseudoaneurysm was successfully embolized with an adjuvant coil.
January 16, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29332925/pulmonary-artery-pseudoaneurysm-secondary-to-lung-inf-lammation
#4
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29332924/multiple-recurrent-pseudoaneurysms-after-endovascular-repair-of-abdominal-aortic-aneurysm-in-a-patient-with-beh%C3%A3-et-s-disease
#5
Yohei Yamamoto, Yoshinori Inoue, Tsuyoshi Ichinose, Masato Nishizawa, Kimihiro Igari, Takahiro Toyofuku, Toshifumi Kudo
In Behçet's disease (BD) patients, endovascular repair is a reasonable alternative treatment for aortic aneurysms to avoid postoperative anastomotic pseudoaneurysms. However, there are some complications that may occur after endovascular repair. We herein report the case of a 40-year-old man with active BD developed recurrent aortic pseudoaneurysms at the proximal and distal margins of the stent graft and a femoral puncture site pseudoaneurysm 3 months after endovascular abdominal aortic aneurysm (AAA) repair...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29321385/severe-compression-of-the-left-main-coronary-artery-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension
#6
Kayo Sugiyama, Nobusato Koizumi, Hitoshi Ogino
Extrinsic compression of the left main coronary artery (LMCA) can occur in patients with an enlarged pulmonary artery trunk secondary to severe pulmonary hypertension (PH). This phenomenon rarely occurs in PH; moreover, few reports have shown that chronic thromboembolic PH can be a triggering factor for this syndrome. Herein, we describe a patient with extrinsic compression of the LMCA with chronic thromboembolic PH who underwent pulmonary endarterectomy and coronary artery bypass grafting successfully. Intravenous ultrasonography (IVUS) was effective for detecting and assessing the compression...
January 10, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29311500/thoracoscopic-thymectomy-using-a-subxiphoid-approach-for-anterior-mediastinal-tumors
#7
Hiroki Numanami, Motoki Yano, Masayuki Yamaji, Rumiko Taguchi, Chihiro Furuta, Ryoichi Nakanishi, Masayuki Haniuda
PURPOSE: Video-assisted thoracic surgery (VATS) techniques have been widely used for resection of mediastinal tumors. This study investigated the usefulness of the subxiphoid approach in thoracoscopic thymectomy. METHODS: In all, 36 patients with anterior mediastinal tumor underwent thymectomy using the subxiphoid approach in two Japanese institutions. These patients were retrospectively reviewed and analyzed. RESULTS: There were 16 females and 20 males with a mean age of 57 years...
January 9, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29279462/recurrence-of-spontaneous-pneumothorax-is-not-associated-with-allegedly-risk-prone-lifestyle-conduct
#8
Volker Steger, Ulrike Sostheim, Marcus Leistner, Thorsten Walles
PURPOSE: Spontaneous pneumothorax (PNTX) is a common disease frequently operated at specialized thoracic surgery units. Videothoracoscopic surgery (VATS) has become the standard for treatment and recurrence prevention. While there is broad consensus regarding indications and techniques of PNTX surgery, postoperative risks and consecutive patient behavioral advice have not been sufficiently elucidated. METHODS: Single-center cohort analysis of 641 patients operated for primary PNTX by VATS over 10 years...
December 27, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29279461/immunoglobulin-g-subclass-4-related-lymphoplasmacytic-thoracic-aortitis-in-a-patient-with-acute-type-a-aortic-dissection
#9
Tetsuro Uchida, Azumi Hamasaki, Yoshinori Kuroda, Mitsuaki Sadahiro, Nobuyuki Tamazawa, Rintaro Ohe, Mitsunori Yamakawa
Immunoglobulin G subclass 4-related disease (IgG4-RD) is a recently recognized systemic inflammatory disease characterized by an elevated serum IgG4 level and an IgG4-positive lymphocyte infiltrate mainly in exocrine tissues. Previous reports documented IgG4-RD in several cardiovascular disorders. We present a case of type A aortic dissection associated with IgG4-RD. A 52-year-old man diagnosed with a type A aortic dissection was referred for surgical treatment. He underwent emergency hemiarch reconstruction with a prosthetic graft...
December 27, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29269707/a-case-of-paraneoplastic-limbic-encephalitis-in-a-patient-with-invasive-thymoma-with-anti-glutamate-receptor-antibody-positive-cerebrospinal-fluid-a-case-report
#10
Takuya Inoue, Ryuzo Kanno, Arata Moriya, Koichiro Nakamura, Yuzuru Watanabe, Yuki Matsumura, Hiroyuki Suzuki
BACKGROUND: Thymoma is known to cause autoimmune neuromuscular disease. However, anti-glutamate receptor antibody limbic encephalitis (LE) with thymoma is relatively rare. CASE PRESENTATION: A 68-year-old woman was admitted with progressive memory impairment and personality change. Brain magnetic resonance imaging (MRI) revealed high intensity in the bilateral limbic areas on T2-weighted fluid-attenuation inversion recovery (FLAIR) images. Chest computed tomography revealed a mass in the anterior mediastinum...
December 20, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29249769/open-conversion-for-type-a-ascending-aortic-dissection-after-thoracic-endovascular-aortic-repair-by-the-chimney-graft-technique
#11
Hirofumi Kasahara, Yoshito Inoue, Takashi Hachiya
An 83-year-old man with aortic arch aneurysm underwent zone 0 thoracic endovascular aortic repair (TEVAR) by the chimney graft technique with two supra-aortic arch debranching grafts and developed subacute type A ascending aortic dissection. We performed emergency open conversion with circulatory arrest under deep hypothermia. The tip of the chimney graft (around the sino-tubular junction in the ascending aorta) was stiff, making it difficult to inspect the lumen and perform anastomosis. Deep hypothermic circulatory arrest and cutting the endograft stents to mobilize the graft were necessary for secure anastomosis...
December 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29249770/elevation-of-serum-carcinoembryonic-antigen-concentration-caused-by-everolimus-induced-lung-injury-a-case-report
#12
Hiroaki Komatsu, Nobuhiro Izumi, Takuma Tsukioka, Michihito Toda, Kantaro Hara, Hikaru Miyamoto, Noritoshi Nishiyama
A 66-year-old woman underwent right nephrectomy for treatment of renal cell carcinoma (RCC). Two years later, she underwent wedge resection of the right lung for treatment of metastatic RCC and primary adenocarcinoma of the lung. She began oral sorafenib for the remaining nodules of the left lung, which were suspected to be metastatic RCC. Two years later, the sorafenib was changed to everolimus because of slight enlargement of the left pulmonary nodules. The carcinoembryonic antigen (CEA) concentration then increased to 25...
December 15, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29225302/role-of-surgery-in-the-treatment-of-masaoka-stage-iva-thymoma
#13
Erkan Kaba, Berker Ozkan, Suat Erus, Salih Duman, Berk Cimenoglu, Alper Toker
PURPOSE: To analyze the role of surgery in patients with Masaoka stage IVa thymoma treated with multimodality therapy. METHODS: Of 191 patients undergoing surgery for thymoma in our department between January 2002 and December 2015, 39 (20.4%) had Masaoka stage IVa. Histopathological tumor type, myasthenic status of the Osserman-Genkins score, Masaoka stage at the first surgery, neoadjuvant treatment, number and type of surgeries, and survival rates were recorded...
December 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29225301/paralysis-of-the-rectus-abdominis-muscle-after-a-video-assisted-thoracoscopic-surgery
#14
Hyun Min Cho, Hee Je Sim, Do Hyung Kim, Mi Hee Lim, Sang Kwon Lee
The rectus abdominis muscle is innervated by intercostal nerves T7-T12, and most thoracotomies are performed through the fourth to sixth intercostal spaces, so direct nerve damage to the rectus abdominis seems unlikely. However, at least one trocar is inserted below the seventh intercostal space in most multi-port video-assisted thoracoscopic surgeries (VATSs), and injury of the seventh or lower intercostal nerve with related paralysis of the rectus abdominis is possible, albeit rare. Only two cases of rectus abdominis paralysis caused by after VATSs have been reported, and these cases were not permanent injuries...
December 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29187677/prevention-of-kinked-stent-graft-limb-due-to-severe-angulated-proximal-neck-during-endovascular-repair-for-abdominal-aortic-aneurysm
#15
Pyung Chun Oh, Minsu Kim, Eak Kyun Shin, Woong Chol Kang
Although the technology of endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) is evolving that make it appealing for challenging anatomy, proximal aortic neck morphology, especially severe angulation, is still one of the most determinants for a successful procedure. We describe a patient of AAA with severely angulated proximal neck, in whom kinked stent graft limb occurred against severe angulation of proximal neck. Then, we suggested how to prevent this complication in the second patient...
November 29, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29187676/three-channeled-aortic-dissection-in-a-patient-without-marfan-syndrome
#16
Yoshie Inoue Arita, Koichi Akutsu, Takeshi Yamamoto, Yusuke Hosokawa, Masahiro Fujii, Takashi Nitta, Wataru Shimizu
A 64-year-old man was admitted for evaluation of back pain. He did not have a Marfan syndrome (MFS)-like appearance, and had a history of a type B aortic dissection and total arch replacement. A connective tissue disorder had been suspected because of the histologic findings of the resected aortic wall. On admission, a computed tomography (CT) scan demonstrated a three-channeled aortic dissection (3ch-AD) measuring 63 mm in diameter. We planned to perform elective surgery during his hospitalization. On the fourth hospital day, he complained of severe back pain, and enhanced CT scan revealed an aortic rupture...
November 29, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29176270/an-unusual-foreign-body-in-the-heart-a-case-report
#17
Handy Darmawan
Penetrating foreign bodies in the heart is rare and may lead to life-threatening complications. Early diagnosis and removal are crucial for these rare cases. We report a case of accidental penetrating sewing needle in the right ventricle. The needle was successfully removed without open heart surgery and cardiopulmonary bypass (CPB), after accurate localization using transthoracic echocardiography (TTE).
November 24, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29129842/association-of-perioperative-redox-balance-on-long-term-outcome-in-patients-undergoing-lung-resection
#18
Osamu Araki, Yuji Matsumura, Takashi Inoue, Yoko Karube, Sumiko Maeda, Satoru Kobayashi, Masayuki Chida
PURPOSE: We examined whether redox balance during the perioperative period is associated with long-term survival of patients after undergoing lung resection. METHODS: Patients who underwent surgery for lung cancer from January to June 2013 at our institution were investigated. Serum was collected during the operation, and on postoperative day (POD) 3 and 7, and the levels of derivatives of reactive oxygen metabolites (d-ROMs) and biologic antioxidant potential (BAP) were measured...
November 10, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#19
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29093430/epidermal-growth-factor-receptor-gene-mutation-in-pleural-lavage-cytology-findings-of-primary-lung-adenocarcinoma-cases
#20
Takashi Inoue, Yuji Matsumura, Osamu Araki, Yoko Karube, Sumiko Maeda, Satoru Kobayashi, Masayuki Chida
PURPOSE: In the present study, we examined the relationship between intraoperative pleural lavage cytology findings and presence of epidermal growth factor receptor (EGFR) gene mutations. METHODS: We investigated 160 patients who underwent surgical treatment for primary lung adenocarcinoma at our hospital from January 2011 to December 2013 to determine the presence of EGFR gene mutations and pleural lavage cytology. RESULTS: In all, 52 subjects (31...
October 31, 2017: Annals of Thoracic and Cardiovascular Surgery
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