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Thoracic dissection

Kouhei Tajima, Nobuyuki Uchida, Hajime Sasamoto, Toshiyuki Okada, Takayuki Kohri, Akira Mogi, Hiroyuki Kuwano
A 69-year-old woman visited our hospital complaining of right chest pain. Chest computed tomography showed a 55 × 45 mm tumor in the right upper lobe. Bronchoscopy revealed displaced anomalous B (1) and B (2)(+3) arising from the right main bronchus, and the patient was diagnosed with lung adenocarcinoma by transbronchial lung biopsy from the displaced B (2)(+3) . Three-dimensional computed tomography with multiplanar reconstruction revealed a displaced anomalous B (1) and B (2)(+3) branching directly from the right main bronchus, respectively, and abnormal distribution of the aberrant pulmonary vein (V (2) ) descended dorsally to the right main bronchus and emptied into the left atrium...
September 2016: Thoracic Cancer
Sasha C Voss, Paola Magni, Ian Dadour, Christian Nansen
Forensic entomology is primarily concerned with the estimation of time since death and involves determination of the age of immature insects colonising decomposing remains. Accurate age determination of puparia is usually accomplished by dissection, which means destructive sampling of evidence. As part of improving abilities to correctly identify species and developmental age, it is highly desirable to have available non-destructive methods. In this study, we acquired external hyperspectral imaging (HSI) data (77 spectral bands, 389-892 nm) from the dorsal and ventral sides of individual puparia of two species of blowfly (Diptera: Calliphoridae), Calliphora dubia Macquart 1855 and Chrysomya rufifacies Macquart 1842...
October 21, 2016: International Journal of Legal Medicine
Moussa Abi Ghanem, Mario Gomez-Sanchez, Xavier Chaufour, Bertrand Marcheix
Thoracic endovascular aortic repair (TEVAR) is recognized as an attractive option to treat complicated Type B aortic dissection. Nevertheless, TEVAR is not always technically possible. We report the case of a 53-year-old male with complicated Type B aortic dissection, in the setting of a complex anomalous aortic arch anatomy with an aneurysmal aberrant right subclavian artery. He was successfully treated by the frozen elephant trunk technique using the Thoraflex hybrid graft.
February 2016: Aorta (Stamford, Conn.)
Kyle Arsenault, Darren Klass, Joel Price, Michael Janusz, Joel Gagnon, Jerry Chen, Jason Faulds
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Shigemitsu Shirai, Keisuke Hirano, Norihiro Kobayashi
It is difficult to treat a thrombotic embolism in the common femoral artery or popliteal artery (POP A), i.e., the non-stenting zone. We report a new technique for the treatment of thrombotic embolism in the non-stenting zone using a self-expandable nitinol stent. Case 1 had an external iliac artery (EIA) occlusion that occurred over several months. A self-expandable nitinol stent was placed in the right EIA lesion via a retrograde approach using a distal 9-Fr balloon protection guide catheter in the right femoral artery...
October 19, 2016: Catheterization and Cardiovascular Interventions
Alan S Chou, Bulat A Ziganshin, John A Elefteriades
Contrast-enhanced computed tomography (CT) is an effective tool for assessment of thoracic aortic disease in the modern era. Here, we describe a case of Type A aortic dissection incidentally detected by CT in a 63-year old man. Upon more precise imaging with electrocardiography (ECG)-gated CT, the dissection vanished, revealing it to be an aortic motion artifact. This report highlights the importance of motion artifacts mimicking a dissection flap. CT imaging gated with ECG can distinguish a dissection flap from an artifact...
April 2016: Aorta (Stamford, Conn.)
Tyler M Gunn, Sotiris C Stamou, Nicholas T Kouchoukos, Kevin W Lobdell, Kamal Khabbaz, Lawrence H Patzelt, Robert C Hagberg
BACKGROUND: The goal of this study was to compare the early and late outcomes of different techniques of proximal root reconstruction during the repair of acute Type A aortic dissection, including aortic valve (AV) resuspension, aortic valve replacement (AVR), and a root replacement procedure. METHODS: All patients who underwent acute Type A aortic dissection repair between January 2000 and October 2010 at four academic institutions were compiled from each institution's Society of Thoracic Surgeons Database...
April 2016: Aorta (Stamford, Conn.)
Verena Merki, Juliane Pichler, Roland Giger, Georgios Mantokoudis
BACKGROUND: Chylothorax is a very rare but major complication in thyroid surgery and should be apparent to clinicians in this field. CASE PRESENTATION: We report a case with chylothrax after thyroid surgery in our department that drew our attention. METHODS: Systematic review of the literature to evaluate the incidence and the contributing factors of chylothorax after thyroid surgery. Database (PubMed) and hand searches to identify patients with thyroid surgery and postoperative chylothorax...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
Rongjie Zhang, Jian Zhou, Jiaxuan Feng, Zhiqing Zhao, Junjun Liu, Zhenjiang Li, Rui Feng, Zaiping Jing
BACKGROUND: How to choose the proximal landing zone in endovascular interventions for a patient with a patent retrograde false lumen in dissection of the ascending aorta and aortic arch remains unclear. This study sought to report the safety and efficiency of inducing thrombosis of the retrograde false lumen to enhance a proximal landing zone to treat retrograde type A aortic dissection. METHODS: This study included 9 patients with retrograde type A aortic dissection treated with a 2-stage operation strategy between January 2015 and January 2016...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Jagdish C Mohan, Madhu Shukla, Vishwas Mohan, Arvind Sethi
Left atrial dissection is a very uncommon complication of cardiac surgery and usually causes significant hemodynamic compromise. Little is known about spontaneous dissection of the left atrium. Two patients, one middle-aged man and another elderly woman were evaluated following stroke. Routine trans-thoracic echocardiogram showed vertical division of the left atrium with both chambers communicating with each other through an orifice. Detailed trans-oesophageal echocardiographic study revealed dissection of the left atrium producing an additional false chamber (pseudo-aneurysm) placed posterior to the left atrial appendage and above the postero-lateral aspect of mitral annulus...
September 2016: Indian Heart Journal
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Giacomo Murana, Antonio Pantaleo, Alessandro Parolari, Roberto Di Bartolomeo, Davide Pacini
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Mitsuaki Sakai, Yuichiro Ozawa, Tomomi Nakajima, Akihiko Ikeda, Taisuke Konishi, Kanji Matsuzaki
Massive hemoptysis from an aortobronchial fistula due to thoracic aortic dissection is an extremely rare symptom, but is a potentially life-threatening condition. We report a case of acute massive hemoptysis due to aortobronchial fistula that was successfully controlled by a simple and rapid thick wedge resection of the lung with hematoma by using the black cartilage stapler. A 65-year-old man was admitted to our hospital with acute massive hemoptysis. After tracheal intubation, chest computed tomography revealed hematoma in the left lung and ruptured aortic dissection from the distal arch to the descending aorta...
September 2016: Journal of Thoracic Disease
Antonio Mazzella, Anne Olland, Pierre Emmanuel Falcoz, Stephane Renaud, Nicola Santelmo, Gilbert Massard
BACKGROUND: This study evaluates the number of video-assisted thoracic surgery-lobectomies (VATS-lobectomies) required for an experienced consultant thoracic surgeon to obtain competence and to perform standard quality surgery. METHODS: We have analysed the initial VATS-experience (January 2012 to September 2014) of a confirmed senior consultant who has performed 145 consecutive anatomic resections by thoracoscopy. After excluding bilobectomies, segmentectomies, and lobectomies for infectious disease, we have focused into 119 consecutive lobectomies, classified into 4 chronologic groups of 30 each...
September 2016: Journal of Thoracic Disease
Yu Kigasawa, Hiroya Takeuchi, Hirofumi Kawakubo, Kazumasa Fukuda, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Yuko Kitagawa
Situs inversus totalis (SIT) is a rare congenital condition in which abdominal and thoracic organs are transposed from normal positions. Laparoscopy-assisted distal gastrectomy for situs inversus totalis is technically difficult and has rarely been reported. Here, we report the case of man in his 40s with situs inversus totalis and a preoperative diagnosis of stage IA gastric cancer (cT1b, cN0, cM0). We successfully performed laparoscopy-assisted distal gastrectomy with D1+ lymph node dissection and Billroth I reconstruction...
October 13, 2016: Asian Journal of Endoscopic Surgery
Norikazu Kawai, Takeshi Kawaguchi, Motoaki Yasukawa, Takashi Tojo
Anatomical variations of the pulmonary artery increase the risks for vessel injury and critical mistakes during pulmonary artery resection. The mediastinal basal pulmonary artery is a rare branch abnormality and is the first branch of the pulmonary artery to flow into the basal segment. We report a patient who underwent video-assisted thoracic surgery (VATS) right lower lobectomy for lung cancer with a mediastinal basal pulmonary artery. The mediastinal basal pulmonary artery was detected preoperatively by computed tomography...
October 13, 2016: General Thoracic and Cardiovascular Surgery
Yasunori Iida, Tsutomu Ito, Yu Inaba, Sachiko Hayashi, Takahiko Misumi, Hideyuki Shimizu
A 43-year-old woman with abdominal and back pain during childbirth consulted us 1 day postdelivery. Contrast-enhanced computed tomography (CT) revealed partially thrombosed type A aortic dissection with intimal tear in the proximal descending thoracic aorta. Conservative antihypertensive treatment was started. However, her abdominal pain progressively deteriorated. Repeat CT revealed narrowing of the descending aorta true lumen and progressive bowel malperfusion. Total arch replacement was urgently performed using the frozen elephant trunk technique...
2016: Annals of Vascular Diseases
V Pompa, P Papi, M Coletti, L Bresadola
OBJECTIVE: Acute aortic dissection (AAD) is one of the most frequent aortic emergencies, which occurs to the vascular specialist. Endovascular reconstruction of the true lumen using minimally invasive stent grafting or stenting has become increasingly popular and widespread among institutions. The aim of this paper is to report a case series composed by twenty-eight patients, who underwent endovascular intervention for acute type B aortic dissections complicated by rupture using thoracic endovascular aortic repair (TEVAR)...
September 2016: European Review for Medical and Pharmacological Sciences
Atsushi Yamamoto, Yoshiaki Miyasaka, Kazushige Furuya, Hideki Watanabe, Masahiro Maruyama, Haruka Nakada, Atsushi Takano, Masao Hada, Hiroshi Nakagomi, Masao Omata, Toshio Oyama
We herein experienced a case with pseudo-Meigs' syndrome that developed both synchronous and metachronous metastases to the ovary from ascending colon cancer. A 57-year-old female visited a hospital for a 2-month history of abdominal distension and voiding difficulty. Massive pleural effusion on the right side and a small amount of left-sided pleural effusion were detected on CT. She underwent emergent laparotomy due to the severe symptom of abdominal distention. The tumor originated from the left ovary, and left-sided oophorectomy was performed...
December 2016: Surgical Case Reports
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