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General Thoracic and Cardiovascular Surgery

Katsuo Yamada, Yukio Seki, Taku Nakagawa, Yuta Hayashi, Mitsuaki Yagi, Kenji Ogawa
BACKGROUND: Limited information is currently available on the postoperative outcomes of Mycobacterium avium complex lung disease (MAC-LD). OBJECTIVE: To show the outcomes of pulmonary resection and identify risk factors after adjuvant surgical treatments for MAC-LD. METHODS: One hundred and eight patients underwent adjuvant lung resection for MAC-LD at two hospitals between January 2008 and July 2016. We retrospectively evaluated outcomes and risk factors...
November 2, 2018: General Thoracic and Cardiovascular Surgery
Hironobu Hoshino, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
OBJECTIVES: We encounter patients with mediastinal tumors invading the left innominate vein (LIV), and there is no evidence confirming whether the LIV should simply be ligated or reconstructed. The need for postoperative anticoagulant therapy after ligation of LIV is also controversial. METHODS: 3209 patients with thoracic malignant tumors underwent surgical resection between 1994 and 2014 in our institute. Nineteen (0.6%) patients had mediastinal malignant tumors invading the LIV and underwent LIV resection...
October 29, 2018: General Thoracic and Cardiovascular Surgery
Dimitrios E Magouliotis, Vasiliki S Tasiopoulou, Kalliopi Athanassiadi
OBJECTIVE: We reviewed the available literature on patients with MPM undergoing either extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D). METHODS: Original research studies that evaluated long-term outcomes of P/D versus EPP were identified, from January 1990 to July 2018. The 30 and 90 days mortality, along with the 1-, 2-, 3-, 5-year survival, the median overall survival and the complications were calculated according to both a fixed and a random effect model...
October 29, 2018: General Thoracic and Cardiovascular Surgery
Osamu Kinoshita, Haruo Yamauchi, Noboru Motomura, Minoru Ono
OBJECTIVES: Calcification is one of the major postoperative problems after aortic allograft implantation. We hypothesized that phosphate binders, lanthanum carbonate and calcium carbonate inhibit calcification of implanted aortic allografts and verified this hypothesis using a rat model. METHODS: Aortas were harvested from 4-week-old Brown Norway rats and implanted into the subdermal space of 4-week-old Lewis rats. Twenty-seven recipient Lewis rats were divided into Group N, Group L, and Group C (9 rats per group), which were fed a normal diet, a normal diet containing 3% lanthanum carbonate, and a normal diet containing 3% calcium carbonate, respectively...
October 29, 2018: General Thoracic and Cardiovascular Surgery
Daisuke Kimura, Ikuo Fukuda, Takao Tsushima, Takehiro Sakai, Satoko Umetsu, Yukari Ogasawara, Norihito Shimamura, Hiroki Ohkuma
OBJECTIVE: We analyzed acute ischemic stroke by thromboembolism in the early period after lung cancer surgery. METHODS: A retrospective review of the clinical records of patients who underwent lung resection for primary lung cancer was performed. Patients who underwent lobectomy, bilobectomy, and pneumonectomy were included. The clinical characteristics of the patients, the incidence of atrial fibrillation (Af) after surgery, and the incidence of acute ischemic stroke were analyzed...
October 26, 2018: General Thoracic and Cardiovascular Surgery
Alejandro Suarez-Pierre, Todd C Crawford, Charles D Fraser, Xun Zhou, Cecillia Lui, Bradley Taylor, Kurt Wehberg, John V Conte, Glenn J Whitman, Rawn Salenger
OBJECTIVES: Off-pump coronary artery bypass grafting (OPCAB) may have advantages in the elderly. Although proven safe, it remains unclear whether OPCAB provides a short-term survival benefit in octogenarians. We sought to compare outcomes using propensity matching between OPCAB and conventional surgery in a statewide database. METHODS: We identified all octogenarians (≥ 80 years) who underwent isolated coronary artery bypass grafting (CAB) at 10 different centers in the state of Maryland from July 2011 to June 2016...
October 19, 2018: General Thoracic and Cardiovascular Surgery
Masaki Yamamoto, Tadashi Isomura, Kazumasa Orihashi, Kohei Miyashita, Hiroaki Kitaoka, Kazuhiro Hanazaki, Naohito Yamasaki
A 79-year-old man underwent repair surgery for a left ventricular free wall rupture after an acute myocardial infarction. The surgical procedure followed for ventricular rupture was according to the rupture type. The patient showed slowly oozing bleeding through small holes. Epicardial echocardiography detected the color signals that crossed the left ventricular wall. Two channels were directly connected from the ventricular cavity to the epicardial hole. Although the bleeding hole was covered with collagen hemostats using a sutureless technique, the bleeding remained, probably because of the pressure exerted by the left ventricle on the channels connected to the epicardial hole...
October 17, 2018: General Thoracic and Cardiovascular Surgery
Shunsuke Endo, Norihiko Ikeda, Takashi Kondo, Jun Nakajima, Haruhiko Kondo, Yoshihisa Shimada, Masami Sato, Shinichi Toyooka, Yoshinori Okada, Yukio Sato, Ichiro Yoshino, Morihito Okada, Meinoshin Okumura, Masayuki Chida, Eriko Fukuchi, Hiroaki Miyata
BACKGROUND: Broncho-pleural fistula (BPF) and respiratory failure (RF) are life-threatening complications after lung cancer surgery and can result in long-term hospitalization and decreased quality of life. Risk assessments for BPF and RF in addition to mortality and major morbidities are indispensable in surgical decision-making and perioperative care. METHODS: The characteristics and operative data of 80,095 patients who had undergone lung cancer surgery were derived from the 2014 and 2015 National Clinical Database (NCD) of Japan datasets...
October 16, 2018: General Thoracic and Cardiovascular Surgery
Ryunosuke Maki, Masahiro Miyajima, Taijiro Mishina, Atsushi Watanabe
Persistent left superior vena cava (PLSVC) is the most common anomalous thoracic venous drainage. A PLSVC usually drains into the right atrium through a dilated coronary sinus. It is rare that a PLSVC flows directly into the left atrium, and even rarer that it connects to the left upper pulmonary vein (LUPV). We report a case, wherein the LUPV connected to both the PLSVC and the left atrium.
October 6, 2018: General Thoracic and Cardiovascular Surgery
Masaya Akashi, Nagisa Nanba, Junya Kusumoto, Takahide Komori
In brief, perioperative oral intervention consists of elimination of odontogenic foci and maintenance of oral hygiene in patients undergoing surgery. The importance of oral intervention before, during, and after medical treatments is well-known, especially in cancer patients, because odontogenic foci such as untreated deep dental caries or periodontitis can cause systemic infection in patients with myelosuppression resulting from chemotherapy. Although perioperative oral intervention is currently recommended for patients with cardiovascular disease, its efficacy in this population has not been established...
October 5, 2018: General Thoracic and Cardiovascular Surgery
Aritoshi Hattori, Kazuya Takamochi, Yoshitaka Kitamura, Takeshi Matsunaga, Kazuhiro Suzuki, Shiaki Oh, Kenji Suzuki
OBJECTIVE: We aimed to analyze the risk factors of postoperative cerebral infarction (CI) and thrombus formation in the left upper pulmonary vein (PV) stump after lobectomy. METHODS: We retrospectively investigated 1670 patients who underwent lobectomy or more intervention, and analyzed the risk factors of postoperative CI. Furthermore, postoperative contrast-enhanced computed tomography (CE-CT) were reviewed in patients who underwent left upper lobectomy (LUL), and risk factors of the thrombus formation in the left upper PV stump were evaluated...
September 24, 2018: General Thoracic and Cardiovascular Surgery
Shigeru Hattori, Kenichiro Noguchi, Yusuke Gunji, Motoki Nagatsuka, Tsuyoshi Yamabe, Hidemitsu Ogino, Ikuo Katayama
Conversion to open repair after thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection is rare, but inevitable. We present a case of an 86-year-old man with ruptured type B aortic dissection after TEVAR. He received a successful stent-graft implantation of the descending aorta without any type of endoleak. After the patient was transferred to the intensive care unit, he went into a shock state. Contrast-enhanced CT revealed a re-rupture of acute retrograde type B aortic dissection. The false lumen was patent and perforated to the left thorax...
September 22, 2018: General Thoracic and Cardiovascular Surgery
Hiroaki Komatsu, Nobuhiro Izumi, Takuma Tsukioka, Hidetoshi Inoue, Kantaro Hara, Hikaru Miyamoto, Noritoshi Nishiyama
A 68-year-old man was referred to our hospital because of mediastinal tumor on chest computed tomography (CT). Contrast-enhanced CT showed azygos continuation of the inferior vena cava (IVC). The retro-hepatic IVC was absent superior to the renal veins. The IVC continued into the dilated azygos vein, which joined the superior vena cava. The hepatic vein drained directly into the right atrium. The mediastinal tumor was close to the dilated azygos vein. Video-assisted thoracoscopic resection of the mediastinal tumor was performed, using four ports and CO2 insufflation...
September 18, 2018: General Thoracic and Cardiovascular Surgery
Takashi Kunihara
INTRODUCTION: The current guidelines for surgical intervention of aortic regurgitation were developed by assuming aortic valve replacement. However, when aortic valve repair is considered, earlier intervention may provide more durable repair. Standardization of the procedures may be required to achieve stable outcomes. The possibility of standardization of valve-sparing root replacement (VSRR) and annuloplasty will be discussed. METHODS AND RESULTS: The differences between the two VSRRs have decreased with technical modifications, reimplantation using a graft with sinuses, and remodeling with annuloplasty...
September 17, 2018: General Thoracic and Cardiovascular Surgery
Masanobu Nakajima, Hiroto Muroi, Maiko Kikuchi, Satoru Yamaguchi, Kinro Sasaki, Takashi Tsuchioka, Yusuke Takei, Ikuko Shibasaki, Hirotsugu Fukuda, Hiroyuki Kato
OBJECTIVE: Definitive chemoradiotherapy is useful for locally advanced esophageal cancer. However, salvage esophagectomy is required when residual or recurrent tumor is evident after chemoradiotherapy. We performed salvage esophagectomy combined with partial aortic wall resection after thoracic endovascular aortic repair for aortic invasion, and we evaluated the results. METHODS: Four patients underwent esophagectomy combined with aortic wall resection after thoracic endovascular aortic repair because the lesion was diagnosed as stage T4b...
September 15, 2018: General Thoracic and Cardiovascular Surgery
Keiji Uchida, Norihisa Karube, Tomoyuki Minami, Tomoki Cho, Yusuke Matsuki, Hiroko Nemoto, Naoto Yabu, Shota Yasuda, Shinichi Suzuki, Munetaka Masuda
Coronary malperfusion is one of the most dreadful complications of acute aortic dissection because it causes catastrophic acute myocardial infarction in patients who are already severely ill. Our strategy was as follows. After the administration of heparin, emergency percutaneous coronary intervention (PCI) was urgently performed at the same time as starting to prepare the operating room. A stent was then placed to cover the full length of dissected coronary artery. Patients whose cardiac function improved after successful coronary artery reperfusion were transferred to the operating room to undergo central repair surgery...
September 14, 2018: General Thoracic and Cardiovascular Surgery
Maziar Gholampour Dehaki, Alwaleed Al-Dairy, Yousef Rezaei, Gholamreza Omrani, Amir Hossein Jalali, Hoda Javadikasgari, Mahyar Gholampour Dehaki
OBJECTIVES: Previous small-sized studies have demonstrated the safety and efficacy of mechanical pulmonary valve replacement (mPVR) in patients with congenital heart disease; however, the predictors of major complications and reoperation remained unclear. METHODS: In a retrospective study, we reported the mid-term outcomes of a large-scaled series of patients, 396 patients, with congenital heart diseases who underwent mPVR in a single institution. RESULTS: The patients' mean age at mPVR was 24...
September 12, 2018: General Thoracic and Cardiovascular Surgery
Ibrahim Sultan, Keith A Dufendach, Arman Kilic, Valentino Bianco, Forozan Navid, Thomas G Gleason
BACKGROUND: Surgical implantation of a prosthetic aortic valve is typically done with multiple interrupted sutures. We adapted a running suture line technique for prostheses implantation to decrease the rate of complete heart block necessitating permanent pacemaker. METHODS: 374 patients undergoing isolated aortic valve replacements were identified between 2015 and 2017. Patients with preoperative heart block, patients undergoing concomitant MAZE procedure and those undergoing multivalve procedures were excluded...
September 12, 2018: General Thoracic and Cardiovascular Surgery
Kiyoshi Tamura, Toshiyuki Maruyama, Syogo Sakurai
OBJECTIVE: The aim of our study is to investigate that sternal reconstruction using bioresorbable plate in median sternotomy may reduce postoperative respiratory dysfunction when compared with wire cerclage only. METHODS: We reviewed 107 patients who were undergone coronary artery bypass grafting with median sternotomy. Patients were divided into two groups; patients underwent sternal reconstruction with bioresorbable plate and wire cerclage (S group, n = 56), patients with wire cerclage only (N group, n = 51), and perioperative respiratory function and postoperative pain score data were analyzed and compared between two groups...
September 11, 2018: General Thoracic and Cardiovascular Surgery
Mariko Fukui, Mikiko Suzuki, Izumi Kawagoe, Shunki Hirayama, Ryosuke Tachi, Yutaro Koike, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
Cardiac herniation is a complication that occurs after intrapericardial pneumonectomy. It is life-threatening unless promptly diagnosed and surgery performed. We report a case of cardiac herniation after right intrapericardial pneumonectomy following radiotherapy for lung cancer. The patient developed cardiac herniation with sudden hypotension following a switch to the spine position. An immediate switch to the lateral decubitus position improved the cardiocirculatory dynamics, and surgical patch closure was performed...
September 8, 2018: General Thoracic and Cardiovascular Surgery
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