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General Thoracic and Cardiovascular Surgery

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https://www.readbyqxmd.com/read/30229437/thoracoscopic-resection-of-mediastinal-tumor-in-a-patient-with-azygos-continuation-of-the-inferior-vena-cava
#1
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
https://www.readbyqxmd.com/read/30225772/toward-standardization-of-valve-sparing-root-replacement-and-annuloplasty
#2
REVIEW
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
https://www.readbyqxmd.com/read/30220051/salvage-esophagectomy-combined-with-partial-aortic-wall-resection-following-thoracic-endovascular-aortic-repair
#3
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
https://www.readbyqxmd.com/read/30218209/treatment-of-coronary-malperfusion-in-type-a-acute-aortic-dissection
#4
REVIEW
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
https://www.readbyqxmd.com/read/30209777/mid-term-outcomes-of-mechanical-pulmonary-valve-replacement-a-single-institutional-experience-of-396-patients
#5
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
https://www.readbyqxmd.com/read/30209776/a-running-suture-line-for-aortic-valve-replacement-does-not-increase-the-rate-of-postoperative-complete-heart-block
#6
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
https://www.readbyqxmd.com/read/30206774/usefulness-of-sternal-closure-with-bioresorbable-plate-in-respiratory-function-after-coronary-artery-bypass-grafting
#7
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
https://www.readbyqxmd.com/read/30196391/case-report-of-cardiac-herniation-after-sleeve-pneumonectomy-with-superior-vena-cava-reconstruction
#8
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
https://www.readbyqxmd.com/read/30191531/living-donor-lung-transplantation-after-surgical-repair-of-transposition-of-the-great-arteries
#9
Daisuke Yoshinaga, Shiro Baba, Takuya Hirata, Hiroyuki Fukushima, Masatsugu Hamaji, Akihiro Aoyama, Toyofumi F Chen-Yoshikawa, Hiroyuki Yamagishi, Hiroshi Date, Toshio Heike
Pediatric pulmonary hypertension after surgery for congenital heart disease is a significant complication. We present a case of living-donor lung transplantation for a 12-year-old girl with pulmonary hypertension after surgical repair of transposition of great arteries. Despite repairing the transposition of great arteries, her growth was severely restricted because of progressive pulmonary hypertension; thus, lung transplantation was discussed. Standard bilateral lobar transplantation seemed unfeasible due to oversized grafts, so we performed a single lobar transplantation...
September 6, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30187260/differential-selective-hypothermic-intercostal-artery-perfusion-a-new-method-to-probe-spinal-cord-perfusion-during-thoracoabdominal-aortic-aneurysm-repair
#10
REVIEW
Yoshikatsu Saiki, Koyu Watanabe, Koki Ito, Keisuke Kanda, Goro Takahashi, Yukihiro Hayatsu, Ichiro Yoshioka, Naotaka Motoyoshi, Satoshi Kawatsu, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto
OBJECTIVE: To prevent paraplegia in patients undergoing thoracoabdominal aortic aneurysm repair, the importance of preoperative identification of the Adamkiewicz artery and reconstruction of critical intercostal artery have been advocated. Conversely, significance of collateral network for spinal cord perfusion has been recognized. We invented a new system consisting of a direct monitoring of cerebrospinal fluid temperature (CSFT) and differential selective hypothermic intercostal artery perfusion (D-HIAP)...
September 5, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30187259/clinicopathologic-characteristics-of-non-small-cell-lung-cancer-in-patients-with-smoking-related-chronic-obstructive-pulmonary-disease
#11
Ryo Maeda, Masaki Tomita, Katsuo Usuda, Hidetaka Uramoto
BACKGROUND: The purpose of this study was to clarify the clinicopathologic characteristics of non-small cell lung cancer (NSCLC) patients with smoking-related chronic obstructive pulmonary disease (COPD) and to evaluate the biological behavior of this disease. We investigated the association between smoking-related COPD, the recurrence-free proportion (RFP) and the clinicopathological features of clinical stage I NSCLC patients. METHODS: Between 2005 and 2014, 218 consecutive patients with clinical stage I NSCLC underwent complete resection with lobectomy or greater and systematic lymph node dissection...
September 5, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30182356/mitral-valve-repair-in-barlow-s-disease-by-chordal-reconstruction-using-the-adjustable-slip-knot-technique
#12
Mitsuhiro Yano, Masanori Nishimura, Atsuko Yokota, Kosuke Mori
The adjustable slip-knot technique-a procedure for facilitating repair of the mitral valve prolapse-was first performed and reported by us in 2015. This technique comprises six steps: anchor institution in the papillary muscle, flexible band positioning, saline injection to confirm the prolapsing site, neochorda setting between the anchor and leaflet, fine adjustment of the neochordal length, and knot-fixing to confirm repair. Here, we have described the first case of successful mitral valve repair using the adjustable slip-knot technique in a 51-year-old man with Barlow's disease...
September 4, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30178130/anatomical-variations-of-aortic-arch-vessels-in-japanese-patients-with-aortic-arch-disease
#13
Yuki Ikeno, Yutaka Koide, Takashi Matsueda, Katsuhiro Yamanaka, Takeshi Inoue, Satoshi Ishihara, Shinichi Nakayama, Hiroshi Tanaka, Koji Sugimoto, Yutaka Okita
OBJECTIVES: The present study analyzed the prevalence of variations of the aortic arch branching in Japanese population, comparing patients with aortic arch disease with healthy controls. METHODS: Between from October 1999 and December 2015, 815 Japanese patients with aortic arch disease defined as aortic arch aneurysm (diameter ≥ 45 mm) and aortic dissection (group A) underwent aortic arch surgery in our institution. As a control group, 1506 traumatic screened patients were enrolled (group C)...
September 3, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30173396/early-and-mid-term-outcomes-of-simultaneous-thoracic-endovascular-stent-grafting-and-combined-resection-of-thoracic-malignancies-and-the-aortic-wall
#14
Seijiro Sato, Atsuhiro Nakamura, Yuki Shimizu, Tatsuya Goto, Akihiko Kitahara, Terumoto Koike, Takeshi Okamoto, Masanori Tsuchida
OBJECTIVES: To aim of this study was to clarify the safety of simultaneous thoracic aortic endografting and combined resection of the aortic wall and thoracic malignancy in a one-stage procedure over the early and mid-term periods. METHODS: From March 2013 to December 2017, 6 patients underwent aortic endografting followed by one-stage en bloc resection of the tumor and aortic wall. Thoracic surgeons and cardiovascular surgeons discussed predicted tumor invasion range and resection site, stent placement position, stent length and size, and the surgical procedure, taking into account the safe margin...
September 1, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30171505/guillain-barr%C3%A3-syndrome-after-cardiac-surgery-diagnostic-dilemma
#15
Monish S Raut, Vijay Mohan Hanjoora, Murtaza A Chishti, Reshma Tewari
Guillain-Barré Syndrome after cardiac surgery is very uncommon. Mechanism remains elusive although immunological reaction post surgery has been postulated. This disease can potentially increase the morbidity of the postoperative patients and generally cannot be explained by the cardiac disease or interventions. It is very much essential to diagnose the condition as appropriate management can substantially and profoundly change the course of treatment.
August 31, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30167925/influence-of-intersegmental-plane-size-and-segment-division-methods-on-preserved-lung-volume-and-function-after-pulmonary-segmentectomy
#16
Hiroyuki Tao, Masataro Hayashi, Masashi Furukawa, Ryohei Miyazaki, Shintaro Yokoyama, Akio Hara, Kazunori Okabe
OBJECTIVES: We previously reported that the use of a stapler to divide intersegmental planes did not decrease preserved pulmonary volume or function relative to electrocautery. However, preservation of pulmonary volume or function can be compromised when a stapler is used with larger intersegmental planes. Here, we assessed the correlations between preserved lung volume and pulmonary function after segmentectomy and the size of the intersegmental planes, based on the division method. METHODS: Intersegmental plane sizes in 56 patients were semi-automatically calculated using image analysis software on computed tomography images...
August 30, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30145737/mid-term-results-of-mitral-valve-repair-for-ischemic-mitral-regurgitation-adjusted-according-to-the-degree-of-remodeling-progression
#17
Koji Furukawa, Mitsuhiro Yano, Eisaku Nakamura, Masanori Nishimura, Kunihide Nakamura
OBJECTIVES: Mitral annuloplasty (MAP) for ischemic mitral regurgitation (IMR) with advanced remodeling is often associated with recurrent mitral regurgitation (MR). We performed surgeries adjusted according to the degree of remodeling; i.e., for advanced remodeling cases, we added subvalvular repair (SVR) to MAP. This study aimed to evaluate our experience with patients with IMR. METHODS AND RESULTS: Thirty patients with IMR (MR grade ≥ 2) were retrospectively analyzed...
August 25, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30143959/analysis-of-the-perioperative-change-in-cognitive-function-of-patients-with-risk-factors-for-cognitive-impairment-in-cardiovascular-surgery
#18
Akihiro Yoshimoto, Takafumi Inoue, Sei Morizumi, Satoshi Nishi, Takaharu Shimizu, Kanan Kurahashi, Yoshihiro Suematsu
OBJECTIVE: The purpose of the present study is to assess the perioperative changes in the cognitive function of patients after cardiovascular surgery (CVS) and to find out risk factors for early postoperative cognitive decline. MATERIALS AND METHODS: From December 2013 to March 2017, 291 patients underwent elective or urgent CVS with cardiopulmonary bypass in our institution. One hundred and fifteen patients, who agreed to an evaluation of their cognitive function, were included in this study...
August 24, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30141079/resection-of-mediastinal-goiter-extending-to-the-carina-with-use-of-artificial-pneumothorax-two-lung-ventilation-and-thoracoscopy-with-the-patient-in-a-prone-position
#19
Satoshi Hayashi, Masaya Kawada, Naoki Hyakushima, Daisuke Saikawa, Yoshitomo Ashitate, Yoshinori Suzuki, Yo Kawarada, Shuji Kitashiro, Hiroshi Tsubota, Shunichi Okushiba
A 67-year-old woman was presented with a mediastinal tumor extending from the left lobe of the thyroid and passing through the posterior trachea, causing displacement of the esophagus to the left side of the patient and then descending into the right side of the mediastinum to below the carina. Surgery was performed under two-lung ventilation with the patient in a prone position; general anesthesia was performed with a single-lumen tube combined with artificial pneumothorax. In thoracoscopic surgery, we were able to confirm and preserve anatomical structures...
August 24, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30136032/initial-clinical-evaluation-of-preoperative-frailty-in-surgical-patients-with-stanford-type-a-acute-aortic-dissection
#20
Hiroshi Furukawa, Naoki Yamane, Takeshi Honda, Takahiko Yamasawa, Yuji Kanaoka, Kazuo Tanemoto
BACKGROUND: We retrospectively assessed the initial clinical role of preoperative frailty in surgical patients with Stanford type A acute aortic dissection (AAAD). METHODS: One hundred and fourteen consecutive patients who underwent emergent or urgent surgical interventions for AAAD in our institute between April 2000 and March 2016 participated in this retrospective study. Patients with more than three of the following six modalities were defined as being frail: age older than 75 years, preoperative requirement of assistance in daily living, body mass index less than 18...
August 22, 2018: General Thoracic and Cardiovascular Surgery
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