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General Thoracic and Cardiovascular Surgery

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https://www.readbyqxmd.com/read/28540630/surgery-for-malignant-lesions-of-the-chest-which-extensively-involved-the-mediastinum-lung-and-heart
#1
REVIEW
Yugo Tanaka, Daisuke Hokka, Hiroyuki Ogawa, Nahoko Shimizu, Takeshi Inoue, Hiroshi Tanaka, Yutaka Okita, Yoshimasa Maniwa
OBJECTIVE: Radical resection for thoracic malignancies that invade the great vessels or heart structure is an uncommon, high-risk operation. To help surgeons determine therapeutic strategy, we reviewed the patient characteristics and outcomes of combined thoracic and cardiovascular surgery for thoracic malignancies. METHODS: Surgical resections of lung cancer, mediastinal tumor and pulmonary artery sarcoma invading great vessels or heart structures were reviewed from the literature...
May 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28536917/comparison-of-early-outcomes-of-surgical-ablation-procedures-for-atrial-fibrillation-concomitant-to-non-mitral-cardiac-surgery-a-japan-adult-cardiovascular-surgery-database-study
#2
Hideaki Takai, Hiroaki Miyata, Noboru Motomura, Kenichi Sasaki, Takashi Kunihara, Shinichi Takamoto
OBJECTIVE: Although the benefit of surgical ablation for atrial fibrillation (AF) performed concomitant to mitral valve surgery is established, whether that performed concomitant to non-mitral cardiac surgery is beneficial remains unclear. In non-mitral, non-left-atriotomy cardiac surgery, the optimal surgical approach for AF remains to be established. Therefore, using the Japan Adult Cardiovascular Surgery Database (JACVSD), we compared 2 surgical ablation procedures [the maze procedure and pulmonary vein isolation (PVI)] performed concomitant to non-mitral cardiac surgery...
May 23, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28523430/long-term-durability-of-preserved-aortic-root-after-repair-of-acute-type-a-aortic-dissection
#3
Keiji Kamohara, Shugo Koga, Jun Takaki, Nozomi Yoshida, Kojiro Furukawa, Shigeki Morita
BACKGROUND: Optimal management of aortic root in type A aortic dissection (AAD) is controversial. To determine the most appropriate strategy, we studied the late outcomes after conservative repair of aortic root. METHODS: 234 AAD patients (mean age 68 ± 12 years) underwent surgical repair using supracommissural replacement (SCR) for aortic root reconstruction from 1989 to 2014. Ascending aortic replacement or hemi-arch replacement was performed in 180 patients (non-arch group), whereas total arch replacement (TAR) was performed in 54 patients...
May 18, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28516395/thoracoscopic-partial-resection-without-using-a-stapler-complete-republication
#4
Toshiya Toyazaki, Yasuaki Tomioka, Naohisa Chiba, Yuichiro Ueda, Yasuto Sakaguchi, Masashi Gotoh, Shinya Ishikawa, Tatsuo Nakagawa
Thoracoscopic partial pulmonary resection for small peripheral nodules without using a stapler has been introduced to our hospital. After partial resection was performed with electrocautery, two different methods of surface sealing were used: a coagulation method (C method) with Soft Coagulation alone, and a coagulation-suturing method (CS method) with Soft Coagulation combined with continuous suturing. The clinical outcomes of the two methods were retrospectively compared in this study. The C method was used in 19 lesions of 18 cases, and the CS method was used in 20 lesions of 19 cases...
May 17, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28493094/new-minimally-invasive-surgical-approach-for-excision-of-left-atrial-myxoma
#5
Cristiano Spadaccio, Karim Elkasrawy, Fraser W H Sutherland
A novel minimally invasive technique for left atrial myxoma surgery involving a combination of mini-sternotomy and restricted left atrial dome incision is described. Surgery is performed through a mini-J sternotomy at third intercostal space and a standard aorto-right atrial cannulation. Exposure of cardiac mass is obtained by a restricted incision of the left atrial dome which provides excellent view of the entire interatrial septum. Base of the tumor base is clearly visualized making the en-bloc excision extremely easy...
May 10, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28474330/mucinous-adenocarcinoma-of-the-thymus-report-of-a-case
#6
Fumihiko Kinoshita, Fumihiro Shoji, Kazuki Takada, Gouji Toyokawa, Tatsuro Okamoto, Tokujiro Yano, Yoshinao Oda, Yoshihiko Maehara
Thymic mucinous adenocarcinoma is a very rare neoplasm. This tumor has a poor prognosis and its treatment is not established. In addition, the existence of KRAS mutations of thymic mucinous adenocarcinoma is still unknown, despite these mutations are common in lung mucinous adenocarcinoma. We present the case of a 79-year-old woman with primary thymic mucinous adenocarcinoma. Therefore, we reviewed clinico-pathological features of thymic mucinous adenocarcinoma in details and analyzed KRAS gene mutations of the present case...
May 4, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28466245/pulmonary-artery-hypoplasia-associated-with-posterior-mediastinal-hematoma-accompanied-by-a-ruptured-pseudoaneurysm-of-the-esophageal-branch-of-the-left-gastric-artery
#7
Miho Nitta, Soji Ozawa, Junya Oguma, Akihito Kazuno, Yamato Ninomiya, Takayuki Nishi, Hideo Shimada, Kazunori Myojin
A 65-year-old woman with no significant medical history visited the emergency department complaining of epigastric discomfort. A computed tomography of the thorax and abdomen showed the attenuation of the pulmonary artery and a posterior mediastinal hematoma. Angiography showed a tortuous esophageal branch of the left gastric artery and a pseudoaneurysm, and during the later phase, the left lower lobe of the lung was enhanced, and finally, the left pulmonary vein was enhanced. We considered that the patient was exhibiting hypoperfusion of the left pulmonary artery arising from left pulmonary artery hypoplasia, since the left lung was supplying the systemic circulation...
May 2, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28439697/heart-transplantation-for-adults-with-congenital-heart-disease-current-status-and-future-prospects
#8
REVIEW
Hikaru Matsuda, Hajime Ichikawa, Takayoshi Ueno, Yoshiki Sawa
Increased survival rates after corrective or palliative surgery for complex congenital heart disease (CHD) in infancy and childhood are now being coupled with increased numbers of patients who survive to adulthood with various residual lesions or sequelae. These patients are likely to deteriorate in cardiac function or end-organ function, eventually requiring lifesaving treatment including heart transplantation. Although early and late outcomes of heart transplantation have been improving for adult survivors of CHD, outcomes and pretransplant management could still be improved...
April 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28434140/radiation-therapy-for-recurrent-cardiac-undifferentiated-pleomorphic-sarcoma-after-three-operations
#9
Kazunobu Hirooka, Masahiro Oonuki, Susumu Manabe, Daisuke Hiraoka, Takashi Yasukawa, Keiko Suzuki
We report the case of a 57-year-old female suffering from recurrent malignant undifferentiated pleomorphic sarcoma of the left atrium. Metastasis to the posterior mediastinum was detected upon first presentation. Incomplete resections were carried out twice before mitral valve replacement was finally performed. The tumor recurred 16 months later and was treated with radiation therapy, which has proved to be effective in bringing about tumor regression for 2 years, to date. The patient has survived for 7 years since the first surgery...
April 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432576/clinical-benefit-of-neoadjuvant-chemoradiotherapy-for-the-avoidance-of-pneumonectomy-assessment-in-12-consecutive-centrally-located-non-small-cell-lung-cancers
#10
Keizo Misumi, Hiroaki Harada, Norifumi Tsubokawa, Yasuhiro Tsutani, Kotaro Matsumoto, Yoshihiro Miyata, Yoshinori Yamashita, Morihito Okada
BACKGROUND: Considering that pneumonectomy itself is a disease, avoidance of pneumonectomy needs to be deliberated. Herein, we evaluated the role of neoadjuvant chemoradiotherapy for avoidance of pneumonectomy in patients with centrally located locally advanced non-small cell lung cancer. METHODS: Patients who underwent neoadjuvant chemoradiotherapy after being judged to require pneumonectomy by cancer board between 1997 and 2011 were retrospectively evaluated. RESULTS: Twelve patients, including 10 males and 2 females with median age 63...
April 21, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28425027/10-year-results-of-on-x-bileaflet-mechanical-heart-valve-in-the-aortic-position-low-target-inr-regimen-in-japanese
#11
Hideki Teshima, Masahiko Ikebuchi, Yosuke Miyamoto, Ryuta Tai, Toshikazu Sano, Yusuke Kinugasa, Hiroyuki Irie
OBJECTIVES: This study was designed to establish clinical outcomes after aortic valve replacement (AVR) with On-X bileaflet mechanical heart valve. METHODS: Between 2006 and 2014, AVR was performed to 686 patients. Of them, 78 patients using On-X valve were enrolled. The mean age was 65 ± 11 years (ranged 33-85); 65% were men; and 81% were in sinus rhythm preoperatively. Calcific or degenerative tricuspid aortic valve was present in 73%. Concomitant procedures included coronary artery bypass grafting (22%), Bentall (8%), mitral valve procedure (3%) and other (9%)...
April 19, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28391520/neonatal-repair-of-left-atrial-diverticulum-with-gigantic-thrombus-without-cardiopulmonary-bypass
#12
Akihiko Higashida, Takaya Hoashi, Heima Sakaguchi, Hajime Ichikawa
A 5-day-old neonate with coarctation of the aorta, hypoplastic aortic arch, large apical muscular ventricular septal defect, and patent ductus arteriosus developed pulmonary over-circulation and systemic hypoperfusion underwent bilateral pulmonary artery banding through median sternotomy as a part of hybrid stage I palliation. At operation, left atrial diverticulum with gigantic thrombus formation at the base of the left atrial appendage was incidentally detected by intraoperative direct echocardiography, and therefore, was successfully resected with the whole thrombus inside it without use of cardiopulmonary bypass...
April 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28386812/a-novel-technique-of-total-debranching-tevar-with-inflow-from-the-descending-aorta
#13
Saiki Munehiro, Yunoki Keiji, Sakoda Naoya, Hattori Shigeru, Uchino Gaku, Kawabata Takuya, Fujita Yasufumi, Hisamochi Kunikazu, Yoshida Hideo
An 82-year-old male with TAA was considered high risk for conventional surgery because of previous CABG. Therefore, a hybrid repair was performed. First, the arch vessels were debranched extra-anatomical bypass. Second, left thoracotomy was performed. The proximal side of a bifurcated graft was anastomosed to the descending aorta. To arch vessels' debranch graft, two bifurcated graft distal limbs were anastomosed with a 10-mm distance. Two stentgrafts were deployed from the ascending to descending aorta. Postoperative CT did not reveal any endoleak, and all debranch grafts were patent...
April 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28386811/left-main-coronary-malperfusion-from-acute-non-communicating-aortic-dissection
#14
Mototsugu Tamaki, Hideki Kitamura, Yutaka Koyama, Arishige Kimura, Yasuhide Okawa
A 64-year-old man was admitted with sudden back and chest pain. He had undergone aortic valve replacement 5 years earlier. Enhanced computed tomography showed acute type A non-communicating aortic dissection. He was initially treated with supportive medical therapy. Since he was restless, he was placed on a respirator. He went into sudden shock 6 h after onset. Percutaneous cardiopulmonary support was administered, and coronary arteriography showed progression of the dissection to the left main trunk. Percutaneous coronary intervention was performed...
April 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28374271/effect-of-preoperative-left-ventricular-diastolic-dysfunction-on-mid-term-outcomes-after-surgical-ventricular-restoration-for-ischemic-cardiomyopathy
#15
Koji Furukawa, Mitsuhiro Yano, Eisaku Nakamura, Masakazu Matsuyama, Masanori Nishimura, Katsuya Kawagoe, Kunihide Nakamura
OBJECTIVES: The impact of surgical ventricular restoration (SVR) on survival and major adverse cardiac events (MACEs) is still controversial. The purposes of this study were to analyze our surgical experience with SVR for ischemic cardiomyopathy and to determine the effect of preoperative left ventricular diastolic dysfunction on mid-term outcomes after SVR. METHODS AND RESULTS: Between April 2010 and May 2016, 19 patients underwent SVR. The mean age was 60 ± 11 years and the mean New York Heart Association functional class was 2...
April 4, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28349384/extended-surgery-for-t4-lung-cancer-a-30-years-experience
#16
P G Dartevelle, D Mitilian, E Fadel
T4 non-small cell lung carcinomas (NSCLC) were deemed unresectable. Advances in surgery have challenged this dogma. We describe technical aspects and result on superior vena cava (SVC), carinal, thoracic inlet tumor surgeries, and resection under cardiopulmonary bypass (CPB). SVC reconstruction requires hemodynamic control to reverse SVC clamping cerebral effects and excellent cephalic venous bed patency. Among 50 SVC resections, including 25 carinal pneumonectomies, post-operative mortality rate was 8%. In the N0-N1 group, 5- and 10-year survival rates were 46...
March 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28332088/simple-technique-of-repair-for-barlow-syndrome-with-posterior-resection-and-chordal-transfer-via-minimally-invasive-approach-primary-experience-in-a-consecutive-series-of-22-patients
#17
H Kamiya, Payam Akhyari, J-P Minol, A C Ites, T Weinreich, S Sixt, P Rellecke, U Boeken, A Albert, A Lichtenberg
OBJECTIVE: Current techniques for mitral valve repair (MVR) in Barlow's disease require high level of surgical expertise due to a complex anatomy. A novel and simple standardized technique that particularly considers the pathological changes of the mitral valve in Barlow's disease has been developed. METHODS: Between 2009 and 2013, 22 patients underwent minimally invasive MVR for Barlow's disease and severe mitral regurgitation (MR). A simple, standardized technique was applied, including resection of P2 segment of posterior mitral leaflet (PML) with preservation of the shortest chordae, transfer of the preserved chordae to A2, and implantation of a semi-rigid open ring...
March 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28315045/late-onset-chest-wall-abscess-due-to-a-biodegradable-rib-pin-infection-after-lung-transplantation
#18
Yasufumi Goda, Toyofumi F Chen-Yoshikawa, Masaaki Kusunose, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hiroshi Date
A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space...
March 17, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28281043/preoperative-management-using-inhalation-therapy-for-pulmonary-complications-in-lung-cancer-patients-with-chronic-obstructive-pulmonary-disease
#19
Kyoshiro Takegahara, Jitsuo Usuda, Tatsuya Inoue, Takayuki Ibi, Akira Sato
OBJECTIVE: This study aimed to investigate whether perioperative inhalations of long-acting beta-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs) might decrease the incidence of postoperative complications in lung cancer patients with chronic obstructive pulmonary disease (COPD). METHODS: We retrospectively analyzed 108 patients with COPD who underwent pulmonary resections for primary lung cancer at our hospital between January 2013 and January 2016 to determine the association between the incidence of postoperative complications (e...
March 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28281042/valve-sparing-aortic-root-re-implantation-for-commissural-detachment-with-fibrous-strand
#20
Seiji Matsukuma, Taku Inoue, Kazuyoshi Tanigawa, Takashi Miura, Ichiro Matsumaru, Mizuki Sumi, Takeshi Murakami, Kikuko Obase, Kiyoyuki Eishi
Both aortic valve commissural detachment and commissural fenestration are rare causes of aortic regurgitation. In general, aortic valve replacement is the mainstay treatment for aortic regurgitation caused by commissural detachment or commissural fenestration. We herein describe valve-sparing aortic root re-implantation and aortic valve repair for aortic regurgitation and aortic root dilatation in an extremely rare case accompanied by both commissural detachment and commissural fibrous strand of fenestrated cusp...
March 9, 2017: General Thoracic and Cardiovascular Surgery
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