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General Thoracic and Cardiovascular Surgery

Masaru Takenaka, Yoshinobu Ichiki, Akihiro Taira, Shinji Shinohara, Taiji Kuwata, Ayako Hirai, Naoko Imanishi, Kazue Yoneda, Noriaki Tsubota, Fumihiro Tanaka
We report the case of a 56-year-old woman who underwent pleural biopsy to identify the cause of the right pleural effusion. The pathological diagnosis was epithelial malignant pleural mesothelioma. The patient worked as a junior high school teacher and strongly hoped for continuing work. Thus, we performed pleurectomy/decortication (P/D) as a curative surgery. The operative findings showed pleural thickening that in the lower lobe of the lung. Thus, peeling of the lower lobe was performed. Pleural biopsy was only performed on the upper and middle lobes...
January 12, 2019: General Thoracic and Cardiovascular Surgery
Toshiro Ito, Takayuki Nobuoka, Hiroshi Sato, Akihito Ookawa, Ryosuke Numaguchi, Naomi Yasuda, Ayaka Arihara, Yousuke Yanase, Hirosato Doi, Nobuyoshi Kawaharada
We present two consecutive patients with secondary aortoesophageal fistula (AEF) who successfully underwent total repair including partial esophagectomy, removal of infected vascular prosthesis, graft replacement, and esophageal reconstruction using gastric tube concomitant to omental wrapping for staged operation in short phase. One 81-year-old male who had undergone thoracic endovascular aortic repair and another 69-year-old male who had undergone graft replacement of the descending thoracic aorta were referred to our hospital for treatment of AEF...
January 10, 2019: General Thoracic and Cardiovascular Surgery
Hiroyuki Kayata, Mitsuhiro Isaka, Yukihiro Terada, Kiyomichi Mizuno, Yoshiyuki Yasuura, Hideaki Kojima, Yasuhisa Ohde
OBJECTIVES: The indication of limited resection for radiographically pure-solid, small-sized lung adenocarcinoma is controversial. This study aimed to reveal the long-term outcome of standard surgical treatment and determine the predictive factors for pathological lymph node metastasis in optimal candidates undergoing limited surgical resection for pure-solid, small-sized lung adenocarcinoma. METHODS: The medical records of 107 consecutive patients were retrospectively reviewed at our hospital between December 2002 and December 2013...
January 9, 2019: General Thoracic and Cardiovascular Surgery
Takuma Tsukioka, Nobuhiro Izumi, Shinjiro Mizuguchi, Chung Kyukwang, Hiroaki Komatsu, Michihito Toda, Kantaro Hara, Hikaru Miyamoto, Noritoshi Nishiyama
In the original publication of the article, the title was incorrectly published as "Positive correlation between sarcopenia and elevation of neutrophil/lymphocyte ratio in pathological stage.
January 5, 2019: General Thoracic and Cardiovascular Surgery
Yukio Umeda, Tsutomu Marui, Shinji Murakawa, Shinsuke Matsumoto
Bronchial anastomosis is an important part of successful bronchoplasty, but it takes time to achieve stable results because of few opportunities to do it. To ensure a stable outcome, we have applied some tips for bronchial anastomosis. One of the tips is the use of a suture holder to obtain appropriate suture pitches, adjusting the discrepancy of the bronchial diameter, and another one is the use of a tourniquet to obtain an adequate tension upon tying the knots, ensuring good operative view.
January 4, 2019: General Thoracic and Cardiovascular Surgery
Fuat Sayir, Ilhan Ocakcioglu, Abidin Şehitoğulları, Ufuk Çobanoğlu
OBJECTIVE: Destroyed lung is whole lung destruction secondary to chronic or recurrent lung infections. This clinical condition can result in irreversible changes in the lung parenchyma. In this study, we aimed to evaluate patients undergoing pneumonectomy with a diagnosis of lung destruction in terms of surgical technique, post-operative morbidity and mortality, and long-term outcomes. METHODS: A total of 32 patients that underwent pneumonectomy due to a destroyed lung between 2005 and 2017 were retrospectively reviewed...
January 2, 2019: General Thoracic and Cardiovascular Surgery
Hiroaki Tsunezuka, Narumi Ishikawa, Tomoki Nishimura, Masayoshi Inoue
Pulmonary artery (PA) reconstruction has been accepted to avoid pneumonectomy in locally advanced lung cancer surgery because of its satisfactory outcomes with regard to long-term survival and its low postoperative morbidity and mortality rates. Several techniques of PA reconstruction have been documented. However, the availability of PA reconstruction using an autologous pulmonary vein (PV) patch is unclear. Here, we present a patient who successfully underwent PA reconstruction using an autologous PV patch during resection of a lung adenocarcinoma (cT2aN1M0: stage IIB) in the left upper lobe with hilar extension and left main PA invasion...
January 2, 2019: General Thoracic and Cardiovascular Surgery
Hidenori Kunou, Ryu Kanzaki, Tomohiro Kawamura, Takashi Kanou, Naoko Ose, Soichiro Funaki, Yasushi Shintani, Masato Minami, Meinoshin Okumura
Air leak syndrome (ALS) is a rare complication after bone marrow transplantation (BMT) and usually has a fatal outcome because of the high recurrence rate and treatment-refractory nature. A 32-year-old man with a history of BMT for acute lymphoblastic leukemia suffered from metachronous bilateral ALS. Bullectomy and the pleural covering procedure (PLC) were successfully performed for each side of the thorax. After surgery, no relapse of pneumothorax was seen for 2 years on the right side and for 1 year on the left side...
January 2, 2019: General Thoracic and Cardiovascular Surgery
Dai Une, Taichi Sakaguchi
Minimally invasive coronary artery bypass grafting (MICS CABG) via a small left thoracotomy has been proposed as an alternative to standard coronary artery bypass grafting. However, this technique is still limited to skillful surgeons. Off-pump multi-vessel bypass grafting and the use of bilateral internal thoracic arteries are particularly challenging via a small thoracotomy, while they are widely performed via a full median sternotomy. The purpose of this review is to serve as a guide for the proper introduction of MICS CABG in the current era...
December 19, 2018: General Thoracic and Cardiovascular Surgery
Emre Kubat, Malik Abacı, Celal Selçuk Ünal
OBJECTIVE: Sternal wound infections after sternotomy are associated with high morbidity, high mortality, and prolonged hospital stay. The recurrence rate of sternal wound infections after single-stage closure is greater than expected. The aim of the study is to present our results of a consecutive series of Z-plasty for the treatment of recurrent sternal wound infections. METHODS: Between March 2015 and March 2017, a total of 9 patients were referred to our clinic with a recurrent sternal wound infection due to sternotomy with or without osteomyelitis...
December 19, 2018: General Thoracic and Cardiovascular Surgery
Yuki Ikeno, Koki Yokawa, Soichiro Henmi, Hidekazu Nakai, Katsuhiro Yamanaka, Takeshi Inoue, Hidekazu Tanaka, Hiroshi Tanaka, Kenichi Hirata, Yutaka Okita
A 65 year-old man was diagnosed with congestive heart failure secondary to severe mitral regurgitation resulting from a parachute-like asymmetrical mitral valve. We performed mitral annuloplasty and triangular resection of the thick tissue. The postoperative course was uneventful with no recurrence of mitral regurgitation.
December 19, 2018: General Thoracic and Cardiovascular Surgery
Hiroyuki Itaya, Chikashi Aoki, Ryo Hatanaka, Ikuo Fukuda
Left atrial appendage aneurysm (LAAA) is a rare congenital heart anomaly that frequently becomes apparent after middle age. We report a case of LAAA in a 63-year-old woman with stroke. After stabilization of ischemic cerebral stroke, the patient underwent left atrial appendectomy with full maze procedure and tricuspid annuloplasty under cardiac arrest with cardiopulmonary bypasss. She has been living a healthy life without anticoagulants postoperatively. Resection and the full-maze procedure is an efficacious and durable procedure for LAAA with chronic atrial fibrillation...
December 18, 2018: General Thoracic and Cardiovascular Surgery
Reo Sakakura, Tohru Asai, Tomoaki Suzuki, Takeshi Kinoshita, Masahide Enomoto, Yasuo Kondo, Shoichiro Shiraishi
OBJECTIVES: To assess the effects of concomitant coronary artery bypass grafting (CABG), we analyzed the outcomes after aortic valve replacement (AVR) for aortic stenosis (AS) with and without coronary artery bypass grafting (CABG) at our institution. METHODS: Between 2002 and 2014, 605 consecutive patients underwent AVR for AS. Of these, the 275 who received isolated AVR (Group A) and the 122 who received both AVR and CABG (Group AC) patients were enrolled, after the exclusion of 8 patients who underwent reoperation and 200 who received other concomitant surgery...
December 17, 2018: General Thoracic and Cardiovascular Surgery
Kei Akiyoshi, Naoyuki Kimura, Kei Aizawa, Daijiro Hori, Homare Okamura, Hideki Morita, Koichi Adachi, Koichi Yuri, Koji Kawahito, Atsushi Yamaguchi
BACKGROUND: Acute type A aortic dissection (ATAAD) is relatively uncommon in dialysis patients, and characteristics and repair outcomes are not fully understood. PATIENTS AND METHODS: Patients with ATAAD (n = 960) were divided into a dialysis group (n = 19) and non-dialysis group (n = 941), depending on whether they required dialysis for preoperative end-stage renal disease (ESRD). Hospital charts and imaging data were reviewed, and characteristics and outcomes were compared between the groups...
December 14, 2018: General Thoracic and Cardiovascular Surgery
Takafumi Nakayama, Atsushi Okada, Takuya Hasegawa, Yoshiaki Morita, Hideaki Kanzaki, Kizuku Yamashita, Yusuke Shimahara, Tomoyuki Fujita, Satoshi Yasuda, Junjiro Kobayashi
OBJECTIVE: The standard treatment of prosthetic paravalvular leakage (PVL) accompanied by heart failure or hemolytic anemia is repeat open surgery. Although favorable outcomes for transcatheter prosthetic PVL closure in patients with a high surgical risk for repeat open surgery have been reported, procedural feasibility has not been examined in Japan. METHODS: From March 2015 to November 2015, transcatheter PVL closure in mitral position was performed in four patients (age range 41-78, three females) with high surgical risk due to history of repeated surgeries, chest radiation and reconstruction of the mitral annulus after debridement of abscess owing to infective endocarditis...
December 14, 2018: General Thoracic and Cardiovascular Surgery
Susumu Isoda, Ryo Izubuchi, Jun Kawashima, Ichiya Yamazaki, Yoshimi Yano, Munetaka Masuda
We have occasionally observed a bubble leaving the suture line of an open stent graft; hence, we hypothesized that de-airing an open stent graft could potentially reduce spinal cord injury. Postoperative computed tomography often showed residual air in thoracic aortic aneurysms, confirmed by the presence of a certain amount of air in an open stent graft in a dry lab. We filled CO2 in the sterilized package of an open stent graft and subsequently filled it with saline, which absorbed the CO2 and entered into the gap of the graft...
December 6, 2018: General Thoracic and Cardiovascular Surgery
Kenji Tsuboshima, Yasumi Matoba, Teppei Wakahara, Yoshimasa Maniwa
OBJECTIVE: For patients with recurrent primary spontaneous pneumothorax, surgery has been thought to be an acceptable treatment. However, even if bulla is completely resected, postoperative recurrence is relatively common due to bulla neogenesis. Bulla neogenesis seems to develop naturally in younger patients compared with the elderly, as theorized till date. If the complete development of bulla neogenesis is confirmed, surgical resection can be performed as the radical treatment. Then, we evaluated the relationship between bulla neogenesis and age...
December 6, 2018: General Thoracic and Cardiovascular Surgery
Go Yamashita, Naoki Kanemitsu, Yasuaki Nakashima, Takehiko Matsuo, Takeichiro Nakane, Masanori Honda, Hitoshi Okabayashi
Hypertrophic obstructive cardiomyopathy in Libman-Sacks endocarditis is quite rare and the correct etiological relationship between them is unknown. Some changes may cause a secondary disorganization of the ordinary muscle structure, making a disarray pattern with irregular interwoven myocyte fibers. This case report describes one of the first cases of ventricular septal myectomy and mitral valve replacement for hypertrophic obstructive cardiomyopathy and mitral valve regurgitation associated with Libman-Sacks endocarditis...
December 5, 2018: General Thoracic and Cardiovascular Surgery
Masaki Ikeda, Yuki Okada, Kiyohiko Hagiwara, Yoshitake Murata, Tomohiro Kanayama, Akira Hara, Takuji Fujinaga
Pulmonary sclerosing pneumocytoma (PSP) arising from the hilar lesion is extremely rare. We report an asymptomatic 70-year-old female with a thoracic tumor of unknown origin. Contrast-enhanced chest tomography showed a poorly and heterogeneously enhanced 40-mm tumor compressing the left upper lobe, bronchus, and pulmonary arteries. Positron-emission tomography did not detect abnormal integration in the tumor. Surgical resection was planned to confirm diagnosis and avoid further compression on the structures...
November 28, 2018: General Thoracic and Cardiovascular Surgery
Masanori Nakamura, Takeshi Uzuka, Hiroshi Sato, Mayo Kondo, Junichi Sakata, Fumihiro Kodama, Daisuke Murai, Hiroshi Komatsu, Takao Makino, Tetsuro Kohya
OBJECTIVES: We investigated the hypothesis that early surgery for infective endocarditis (IE) attenuates the rate of death or embolic events and does not increase the rate of relapse or postoperative valvular dysfunction (PVD) at 6 months. METHODS: 21 consecutive patients who underwent surgical treatment of IE were prospectively included. We assessed 6-month postoperative clinical outcomes by comparing early surgery (Group E, surgery within 72 h) and conventional treatment (Group C)...
November 27, 2018: General Thoracic and Cardiovascular Surgery
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