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General Thoracic and Cardiovascular Surgery

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https://www.readbyqxmd.com/read/28940166/thoracoscopic-left-atrial-appendectomy-and-thoracic-endovascular-aortic-repair-tevar-in-a-patient-with-cardiogenic-stroke-combined-with-acute-aortic-dissection
#1
Takafumi Inoue, Kanan Kurahashi, Satoshi Nishi, Akihiro Yoshimoto, Masayuki Fujisaki, Sei Morizumi, Yoshihiro Suematsu
The simultaneous occurrence of cardiogenic stroke and acute aortic dissection is rare, and its treatment remains unclear. Although anticoagulation therapy is usually chosen for cardiogenic stroke due to atrial fibrillation, it is inappropriate for acute aortic dissection. Recently, thoracoscopic left atrial appendectomy (TLAA) has been suggested as an alternative for anticoagulation. We herein report a case of a 78-year-old man with combined cardiogenic stroke and acute aortic dissection in whom thoracic endovascular aortic repair (TEVAR) was performed after TLAA...
September 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932974/japanese-perspective-in-surgery-for-thoracoabdominal-aortic-aneurysms
#2
Norihiko Shiiya, Naoki Washiyama, Kazumasa Tsuda, Ken Yamanaka, Daisuke Takahashi, Katsushi Yamashita, Kayoko Natsume, Yuki Takeuchi, Suguru Kubota, Yoshiro Matsui
OBJECTIVE: Operative mortality and morbidity after thoracoabdominal aortic surgery remain high. We report our strategy and outcomes, especially those of spinal cord protection. METHODS: Outcomes of 178 patients (age: 26-88 years) who underwent thoracoabdominal aortic replacement were retrospectively analyzed. 65 had aortic dissection, 14 had infected aneurysms, and 22 presented with rupture. Operations were non-elective in 24 and redo through re-thoracotomy in 21...
September 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28929446/new-imaging-tools-in-cardiovascular-medicine-computational-fluid-dynamics-and-4d-flow-mri
#3
Keiichi Itatani, Shohei Miyazaki, Tokoki Furusawa, Satoshi Numata, Sachiko Yamazaki, Kazuki Morimoto, Rina Makino, Hiroko Morichi, Teruyasu Nishino, Hitoshi Yaku
Blood flow imaging is a novel technology in cardiovascular medicine and surgery. Today, two types of blood flow imaging tools are available: measurement-based flow visualization including 4D flow MRI (or 3D cine phase-contrast magnetic resonance imaging), or echocardiography flow visualization software, and computer flow simulation modeling based on computational fluid dynamics (CFD). MRI and echocardiography flow visualization provide measured blood flow but have limitations in temporal and spatial resolution, whereas CFD flow calculates the flow according to assumptions instead of flow measurement, and it has sufficiently fine resolution up to the computer memory limit, and it enables even virtual surgery when combined with computer graphics...
September 19, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28918516/valve-sparing-aortic-root-surgery-con-remodeling
#4
Takashi Kunihara
The two major valve-sparing root replacement procedures, aortic valve reimplantation (reimplantation) and aortic root remodeling (remodeling), have advantages and disadvantages, which are reviewed herein. The main advantage of reimplantation is the resulting annular support, and the disadvantages are the unfavorable hemodynamics and relatively long procedure time. The main advantages of remodeling are the physiological hemodynamics and decreased procedure time, and the disadvantage is the lack of annular support...
September 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28918471/extracorporeal-membrane-oxygenation-versus-cardiopulmonary-bypass-during-lung-transplantation-a-meta-analysis
#5
Dimitrios E Magouliotis, Vasiliki S Tasiopoulou, Alexis A Svokos, Konstantina A Svokos, Dimitris Zacharoulis
BACKGROUND: We reviewed the available literature on patients undergoing lung transplantation supported by cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO). METHODS: A systematic literature search was performed in three databases, in accordance with the PRISMA guidelines. Meta-analyses were used to compare the outcomes of ECMO and CPB procedures. RESULTS: Seven observational studies met the inclusion criteria incorporating 785 patients...
September 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28905303/measuring-what-matters-to-the-patient-health-related-quality-of-life-after-aortic-valve-and-thoracic-aortic-surgery
#6
Frederiek de Heer, Arjen L Gökalp, Jolanda Kluin, Johanna J M Takkenberg
With improved outcomes following cardiac surgery, health related quality of life (HRQoL) gains increasing importance for the better judgement of choosing the preferred treatment strategy in the individual patient. The physician perception of patient preferences can differ considerably from actual patient preferences, underlining the importance of gathering evidence of actual patient preferences before and quality of life after cardiac surgery. The objective of the current review is to provide an overview of current insights into the quality of life measurements after aortic valve and thoracic aortic surgery and to provide starting points for the application of HRQoL measurements toward the future...
September 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28905190/primary-synovial-sarcoma-of-the-left-heart-with-large-amount-of-necrotic-tissue
#7
Shusaku Maeda, Hiroshi Takano, Takashi Yamauchi, Kenji Tanaka, Kohta Suzuki, Hiroaki Fushimi, Kohki Shimazu, Yukitoshi Shirakawa
We present a case of primary synovial sarcoma arising from the left heart, an extremely rare occurrence, with a large amount of necrotic tissue, which suggested a poor prognosis. After incomplete tumor resection, chemotherapy and radiation therapy were performed; however, PET/CT findings at 26 months after the operation revealed local recurrence. Although we performed two additional operations following chemotherapy, the patient died from local recurrence at 36 months after the initial operation. In this case of synovial sarcoma arising from the left heart, even though aggressive multimodality therapy was performed, the prognosis was still poor...
September 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28887727/predictors-of-primary-lung-cancer-in-a-solitary-pulmonary-lesion-after-a-previous-malignancy
#8
Akie Nakadate, Masashi Nakadate, Yasunori Sato, Tassei Nakagawa, Katsuya Yoshida, Yoshio Suzuki, Yukihiro Yoshida
OBJECTIVE: A solitary pulmonary lesion in patients with a history of malignancy may be either primary lung cancer or a metastatic lung tumor or benign nodule. We retrospectively examined the preoperative predictive factors for determining the type of pathology. METHODS: We used an exact logistic regression analysis to identify radiological and clinical predictors of primary lung cancer. The study included 187 patients who underwent pulmonary resection for a solitary pulmonary lesion and had received previous treatment for a malignancy...
September 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28884283/clinical-outcomes-of-early-scheduled-fontan-completion-following-kawashima-operation
#9
Takashi Kido, Takaya Hoashi, Masatoshi Shimada, Hideo Ohuchi, Kenichi Kurosaki, Hajime Ichikawa
OBJECTIVES: This study reviewed late clinical features after Kawashima operation to confirm the impact of scheduled subsequent early Fontan completion. METHODS: Of the 17 consecutive patients who underwent the Kawashima operation between 1987 and 2010, 11 underwent the procedure as inter-stage palliation (scheduled Fontan group). Ten of these patients underwent subsequent early Fontan completion after a median interval of 0.6 years. The remaining 6 patients underwent the Kawashima operation initially as definitive surgery (non-scheduled group)...
September 7, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28879585/the-irad-and-beyond-what-have-we-unravelled-so-far
#10
REVIEW
Xun Yuan, Andreas Mitsis, Yida Tang, Christoph A Nienaber
Acute aortic dissection is a life-threatening condition associated with high morbidity and mortality rates and a long history of challenges to both diagnose and manage this condition successfully. The International Registry of Acute Aortic Dissection (IRAD) was established in 1996 as a global database to understand this old disease better and improve care for dissection. IRAD initially targeted various areas including etiological factors of dissection, modes of presentation, clinical features, physical findings, imaging, management, and outcomes, and is currently branching out in more specific fields such as endovascular intervention, genetic profiling, and functional imaging...
September 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28875285/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-5-thoracic-aortic-surgery
#11
REVIEW
Hideyuki Shimizu, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
BACKGROUND: Although open aortic repair (OAR) is still considered to be a standard treatment for thoracic aortic diseases, the indications for thoracic endovascular treatment (TEVAR)/hybrid aortic repair (HAR) have expanded in recent years. The purpose of this study was to review the current status of treatment of thoracic aortic diseases in Japan. METHODS: Data for 2013 and 2014 concerning surgery for diseases of the thoracic/thoracoabdominal aorta were extracted from the Japan Cardiovascular Surgery Database (JCVSD)...
September 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28866847/successful-conservative-management-of-an-anastomotic-airway-dehiscence-at-the-left-main-bronchus-following-bilateral-cadaveric-lung-transplantation
#12
Ryo Miyata, Toyofumi F Chen-Yoshikawa, Masatsugu Hamaji, Fumiaki Gochi, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toshihiko Sato, Makoto Sonobe, Hiroshi Date
There is a dearth of data on management of anastomotic airway dehiscence following lung transplantation. Herein we report a case of successful conservative management of an anastomotic airway dehiscence after cadaveric donor lung transplantation. A 41-year-old woman with primary ciliary dyskinesia underwent cadaveric bilateral lung transplantation without cardiopulmonary bypass. On the postoperative day 25, left pneumothorax developed and bronchoscopy demonstrated a localized anastomotic dehiscence at the left main bronchus...
September 2, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28866794/predictors-for-hilar-intrapulmonary-lymph-node-metastasis-in-discrete-type-of-clinical-n1-non-small-cell-lung-cancer
#13
Takayuki Fukui, Katsuhiko Kato, Toshiki Okasaka, Koji Kawaguchi, Koichi Fukumoto, Shota Nakamura, Shuhei Hakiri, Naoki Ozeki, Kohei Yokoi
OBJECTIVE: Accurate preoperative evaluation of lymph nodes can provide optimal treatment for patients. However, in patients with clinical N1 disease (cN1) non-small cell lung cancer (NSCLC), no suitable predictor has been identified for hilar/intrapulmonary lymph node metastasis (pathological N1 disease; pN1). The purpose of this study was to identify pN1 in cN1 NSCLC patients. METHODS: We retrospectively reviewed the clinicoradiological features of 109 patients with a discrete type of cN1 NSCLC who had undergone complete resection at our institution from 2004 to 2015...
September 2, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28856583/thoracoabdominal-aortic-aneurysm-repair-open-endovascular-or-hybrid
#14
REVIEW
Joshua M Rosenblum, Edward P Chen
Successful repair of complex thoracoabdominal aortic aneurysms requires careful surgical planning based on anatomic and patient considerations. Not only are surgical considerations key, but also post-operative care, regardless of surgical approach, can dramatically impact both short- and long-term outcomes. While open repair has been the gold standard for decades, the technical challenges associated with operative repair, a specialty approach requisite for good outcomes, and the unique challenges in the post-operative care of these patients have given providers pause when considering operative intervention...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28856517/bicuspid-aortic-valve-related-aortopathy
#15
REVIEW
Sina Stock, Salah A Mohamed, Hans-Hinrich Sievers
Bicuspid aortic valve related aortopathy is known to significantly increase the risk for catastrophic aortic events and, therefore, represents a considerable health burden. Albeit of ongoing research in this field including genetic, molecular, hemodynamic and morphologic aspects, bicuspid aortic valve related aortopathy still represents an imperfectly understood disorder. This lack in knowledge results in a lack of consistency considering different therapeutic approaches. Recent studies have provided new insights into the etiology and clinical impacts of bicuspid aortic valve related aortopathy in different clinical settings, leading to a growing body of opinion towards a more individualized surgical approach than currently provided by the guidelines...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28852969/recovery-from-very-long-aortic-cross-clamping-in-redo-complex-aortic-surgery
#16
Shoichi Suehiro, Koji Shimizu, Megumi Ito, Hayato Nakata, Kazuhiro Akeho, Teiji Oda
A 68-year-old man had undergone ascending aortic replacement for acute type A aortic dissection. Three months later, he had a new aortic dissection with an ulcer-like projection located in the aortic arch with suspected graft infection. An emergent redo total aortic arch and root replacement was performed because of the coexistence of a fragile aortic root wall. The extensive redo procedure necessitated a very long aortic cross-clamping time (516 min). After 25 min of assisted circulation, he was easily weaned from the cardiopulmonary bypass...
August 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28852959/how-should-we-manage-type-b-aortic-dissections
#17
REVIEW
J Fleerakkers, M Schepens
Dissection of the descending aorta is a serious and potentially lethal event. Treatment options consist of medical therapy, open surgical replacement of the affected aorta and thoracic endovascular repair. In acute cases, medical treatment is started initially. When complicated, endovascular repair is generally considered as first choice treatment, except for connective tissue disorders where open surgery remains the standard. In stable, uncomplicated patients with risk factors for future aortic growth pre-emptive endovascular repair should be considered in the sub-acute phase of the dissection...
August 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28849328/tirone-on-tirone-david-operation-and-types
#18
REVIEW
Tirone E David
No abstract text is available yet for this article.
August 28, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28828590/direct-reopening-of-the-occluded-hepatic-veins-of-budd-chiari-syndrome-verification-of-our-operative-method-by-the-perioperative-course-of-esophageal-varices
#19
Yukio Kuniyoshi, Hitoshi Inafuku, Satoshi Yamashiro, Yuya Kise, Takaaki Nagano, Ryoko Arakaki, Tatsuya Maeda, Mizuki Ando, Shotaro Higa
OBJECTIVE: A total of 69 patients with Budd-Chiari syndrome (BCS) were operated by direct approach under cardiopulmonary bypass (CPB). To assess the operative procedure, the perioperative course of esophageal varices (EVs) was evaluated. PATIENTS AND METHODS: Of the 69 patients, 59 (22 females) were enrolled in this study because they had complete follow-up data for endoscopic evaluation of EVs. Their mean age was 46.3 ± 13.0 years (range 21-73.3 years). EVs were found in 52 patients...
August 21, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28828555/efficacy-of-co2-insufflation-during-thoracoscopic-esophagectomy-in-the-left-lateral-position
#20
Itasu Ninomiya, Koichi Okamoto, Sachio Fushida, Katsunobu Oyama, Jun Kinoshita, Hiroyuki Takamura, Hidehiro Tajima, Isamu Makino, Tomoharu Miyashita, Tetsuo Ohta
OBJECTIVE: Thoracoscopic esophagectomy (TE) is widely performed as a minimally invasive technique in the management of esophageal cancer. The aim of this study was to estimate the efficacy of intrathoracic carbon dioxide (CO2) insufflation during TE in the left lateral position. METHODS: From January 2010 to April 2016, 58 patients with esophageal cancer underwent TE without intrathoracic CO2 insufflation (Group N) and 37 patients with esophageal cancer underwent TE with intrathoracic CO2 insufflation (Group C)...
August 21, 2017: General Thoracic and Cardiovascular Surgery
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