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https://www.readbyqxmd.com/read/28790290/-postoperative-intrathoracic-hemorrhage-perioperative-prevention-and-management
#1
Yoshimasa Maniwa
Postoperative intrathoracic hemorrhage is sometimes diagnosed in the thoracic cavity, while the patient is in the recovery room after undergoing thoracic surgery such as lung resection with thoracotomy or mediastinal surgery with a median sternotomy. The information from the chest tube is important to identify this kind of postoperative complication. When the condition becomes severe, the patient may develop hemorrhagic shock due to hemothorax and re-exploration to assess for bleeding and hemostasis may be required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790248/-concomitant-operations-for-thoracic-aortic-aneurysm-and-myasthenia-gravis-report-of-a-case
#2
Hayato Konishi, Takahiro Katsumata, Yoshikazu Motohashi, Hiroaki Uchida, Eiki Woo, Tomoyasu Sasaki, Shigetoshi Mieno, Hideki Ozawa, Masahiro Daimon, Shintaro Nemoto
A 77-year-old man, who had been under medical treatment for myasthenia gravis without thymoma, was diagnosed with aortic arch aneurysm. He underwent total aortic arch replacement and total resection of the thymus through median sternotomy. His symptoms relating to myasthenia gravis dramatically disappeared after the surgery. The serum anti-acetyl chorine receptor antibody decreased from 2.7 to 0.7 nmol/l (N<0.2) with the reduction of oral predonisolone from 12.5 to 5 mg/day at 4 years after the surgery. The concomitant operations significantly improved his quality of life...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790244/-effectiveness-of-the-waffle-procedure-for-constrictive-pericarditis
#3
Naoki Hashiyama, Hiroko Nemoto, Aya Kato, Masanobu Hashimoto, Makoto Mo, Munetaka Masuda
A 66-year-old woman was referred to our hospital with dyspnea. Right-sided congestive pleural effusion of an unknown etiology was detected and she was diagnosed with constrictive pericarditis. Pericardiectomy was performed via median sternotomy under extracorporeal circulation because severe adhesion was observed. However, hemodynamics did not improve after pericardial resection because of thickend epicardium in front of the right ventricle. Hence, the waffle procedure was additionally performed on the anterior surface of the right ventricle after coming-off the extracorporeal circulation...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790237/-prophylactic-effectiveness-of-vacuum-assisted-closure-for-high-risk-patients-undergoing-cardiovascular-surgery-through-median-sternotomy
#4
Ippei Takazawa, Yoshio Misawa, Satoshi Uesugi, Akira Sugaya, Hirohiko Akutsu, Souki Kurumisawa, Hirotaka Satoh, Arata Muraoka, Kei Aizawa, Shinichi Ohki, Koji Kawahito
Vacuum-assisted closure(VAC) therapy is mainly used for tissue defects. VAC therapy can remove exudate that could impair the healing process. We applied VAC therapy in patients considered at high risk of surgical site infection who underwent cardiovascular surgery via standard median sternotomy. Risk factors included advanced heart failure, obesity, diabetes mellitus, steroid administration, immunosuppressant administration, and chronic renal failure, etc. VAC therapy was used in 134 patients. Only 3 of these patients (2...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28780761/microthymoma-and-microscopic-thymomas-associated-with-a-thymic-cyst-without-solid-component
#5
Tatsuo Furuya, Daishiro Kato, Sanae Yamazaki, Naoko Miyata, Hiroaki Tsunezuka, Satoru Okada, Junichi Shimada, Akio Yanagisawa, Masayoshi Inoue
A 75-year-old asymptomatic man presented with an anterior mediastinal cyst without a solid component on computed tomography. Pathologic examination of the specimens obtained by thoracoscopic resection showed a thymic cyst with a 1.6-mm type A microthymoma in the surrounding thymic tissue. In addition, there were multiple hyperplastic nodules smaller than 1 mm histologically corresponded to microscopic thymomas. The patient underwent completion thymectomy through median sternotomy; thereafter, there was no residual thymic neoplasm detected...
August 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28760470/improved-approach-with-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-difference-in-on-and-off-pump
#6
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Emily Phillips, Joyce Wald, Matthew L Williams, David W Low, Michael A Acker, Pavan Atluri
BACKGROUND: The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. METHODS: This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC)...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28759544/minimally-invasive-access-aortic-arch-surgery
#7
Nora Goebel, Daniel Bonte, Schahriar Salehi-Gilani, Ragi Nagib, Adrian Ursulescu, Ulrich F W Franke
OBJECTIVE: Median sternotomy is still the standard approach for aortic arch surgery. Minimally invasive techniques promise faster recovery with shorter hospital stay due to thoracic stability, reduced pain, and superior cosmetic results. However, safety is a concern in complex aortic surgery. The aim of our study was to demonstrate that aortic arch surgery via partial upper sternotomy is viable, safe, and equivalent to standard procedure both in terms of its safety and the risk of major adverse cardiac and cerebrovascular events...
July 28, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#8
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740713/outcomes-of-minimally-invasive-double-valve-surgery
#9
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Frederick Hasty, Esteban Escolar, Christos G Mihos
BACKGROUND: Double valve surgery is associated with an increased peri-operative morbidity and mortality. A less invasive right thoracotomy approach may be a viable alternative to median sternotomy surgery in these higher-risk patients. METHODS: We retrospectively analyzed the baseline demographics, operative characteristics, and post-operative outcomes of patients who underwent minimally invasive double valve surgery between January 2009 and December 2011 at our institution...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#10
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740633/papillary-fibroelastoma-arising-from-the-coumadin-ridge
#11
Mahim Malik, Konstantin Shilo, Ahmet Kilic
Cardiac papillary fibroelastomas (CPF) are rare cardiac tumors, mostly found on the valvular surfaces in the heart. These tumors are frond like in nature and are benign, intracardiac masses, rarely causing any hemodynamic disturbances. However, excision of these masses is indicated due to their propensity to embolize. We present a case report of the tumor found on the coumadin ridge, causing transient ischemic attacks in a patient. We performed complete excision of the tumor via median sternotomy on cardiopulmonary bypass support with cardiac arrest...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28736841/outcomes-of-blalock-taussig-shunts-in-current-era-a-single-center-experience
#12
Navaneetha Sasikumar, Antony Hermuzi, Chun-Po Steve Fan, Kyong-Jin Lee, Rajiv Chaturvedi, Edward Hickey, Osami Honjo, Glen S Van Arsdell, Christopher A Caldarone, Arnav Agarwal, Lee Benson
OBJECTIVES: Mortality associated with the modified Blalock-Taussig shunt (MBTS) remains high despite advanced perioperative management. This study was formulated to provide data on (1) current indications, (2) outcomes, and (3) factors affecting mortality and morbidity. DESIGN: A retrospective single center chart review identified 95 children (excluding hypoplastic left heart lesions) requiring a MBTS. Mortality and major morbidity were analyzed using the Kaplan Meier method and risk factor analysis using Cox's proportional hazard regression...
July 24, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28711822/extended-thymectomy-left-pneumonectomy-pericardiectomy-and-partial-pleurectomy-for-a-large-thymoma-using-only-a-median-sternotomy
#13
Jorge Cruz, André Sena, Catarina Carvalheiro, Ricardo Ferreira
We present a case of a large thymoma with invasion to the hilum of the lung and pleural dissemination. A 58-year-old woman was diagnosed with a type B2 thymoma, with suspected pericardium, pulmonary artery and left lung invasion and pleural metastasis (Masaoka-Koga stage IVb). A radical resection was planned after systemic chemotherapy. Through a median sternotomy, we resected the tumour, and after confirmation of pericardium and left lung invasion, we also performed resection of the pericardium, of the lung and of the pleural metastasis...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28698429/-thymoma-with-multilocular-cystic-change-report-of-a-case
#14
Masanobu Hayakawa, Kazuyuki Oda
A 21-year-old male was pointed out an abnormal shadow on chest X-ray. Chest computed tomography showed a multilocular cystic mass of 10×4×4 cm in size in the anterior mediastinum. The tumor and the left lobe of the thymus was resected by median sternotomy. Pathologically, type AB thymoma as found in the wall of the cyst.
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28698426/-seminoma-of-the-mediastinum-with-cystic-change-report-of-a-case
#15
Atsushi Kagimoto, Koichi Akayama, Satoshi Shibata
The patient was a 25-year-old man. He was diagnosed as having a mediastinal tumor based on chest radiography. Chest computed tomography and magnetic resonance imaging revealed a cystic tumor in the anterior mediastinum. Total resection of the tumor with median sternotomy was performed. We anticipated that the tumor was a thymic cyst or teratoma, but pathological findings indicated a seminoma. The patient was discharged without any complication, and no recurrence of the lesion has been observed for 8 years after surgery without adjuvant therapy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28696882/risk-factors-for-mortality-in-reoperations-for-pediatric-and-congenital-heart-surgery-in-a-developing-country
#16
Carlos A Villa-Hincapie, Marisol Carreno-Jaimes, Carlos E Obando-Lopez, Jaime Camacho-Mackenzie, Juan P Umaña-Mallarino, Nestor F Sandoval-Reyes
BACKGROUND: The survival of patients with congenital heart disease has increased in the recent years, because of enhanced diagnostic capabilities, better surgical techniques, and improved perioperative care. Many patients will require reoperation as part of staged procedures or to treat grafts deterioration and residual or recurrent lesions. Reoperations favor the formation of cardiac adhesions and consequently increase surgery time; however, the impact on morbidity and operative mortality is certain...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28671862/median-sternotomy-for-lung-transplantation-techniques-and-advantages
#17
Nicholas R Teman, Jianzhou T Xiao, Curtis G Tribble, Patrick E Parrino
Lung transplantation is traditionally performed with a clamshell thoracotomy or bilateral anterior thoracotomy incisions. We have performed 121 lung transplants with a median sternotomy incision from 2013-2017. We present our technique for lung transplantation utilizing cardiopulmonary bypass with a median sternotomy, and discuss the potential advantages of this technique.
June 19, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28667440/-surgical-treatment-of-aortic-valve-stenosis
#18
O J Liakopoulos, J Merkle, T Wahlers, Y-H Choi
Surgical aortic valve replacement still represents the gold standard in patients with severe symptomatic aortic valve stenosis. In addition to conventional aortic valve replacement by mechanical or biological prostheses via a median sternotomy, novel approaches including minimally invasive strategies and new devices, such as so-called rapid deployment prostheses, are becoming increasingly more established. Autologous replacement strategies including the Ross and the Ozaki procedures have evolved into reliable options at selected centers of excellence...
June 30, 2017: Herz
https://www.readbyqxmd.com/read/28651347/minimally-invasive-centrimag-ventricular-assist-device-support-integrated-with-extracorporeal-membrane-oxygenation-in-cardiogenic-shock-patients-a-comparison-with-conventional-centrimag-biventricular-support-configuration
#19
Koji Takeda, Arthur R Garan, Masahiko Ando, Jiho Han, Veli K Topkara, Paul Kurlansky, Melana Yuzefpolskaya, Maryjane A Farr, Paolo C Colombo, Yoshifumi Naka, Hiroo Takayama
OBJECTIVES: We recently developed a novel minimally invasive surgical approach that combines extracorporeal membrane oxygenation and CentriMag ventricular assist device (Ec-VAD) for the treatment of cardiogenic shock as a short-term circulatory support. We compared the outcomes of this new approach to conventional CentriMag biventricular assist device (BiVAD) support through a median sternotomy. METHODS: Between July 2015 and August 2016, 22 patients were implanted with CentriMag Ec-VAD and 90 patients were implanted with conventional CentriMag BiVAD...
June 22, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28645301/the-sternal-management-accelerated-recovery-trial-s-m-a-r-t-standard-restrictive-versus-an-intervention-of-modified-sternal-precautions-following-cardiac-surgery-via-median-sternotomy-study-protocol-for-a-randomised-controlled-trial
#20
Md Ali Katijjahbe, Linda Denehy, Catherine L Granger, Alistair Royse, Colin Royse, Rebecca Bates, Sarah Logie, Sandy Clarke, Doa El-Ansary
BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post-operative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound...
June 23, 2017: Trials
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