Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jul 2012
Case ReportsSuccessful surgical repair of platypnea-orthodeoxia syndrome in a patient with cerebral infarction.
Platypnea-orthodeoxia syndrome is a rare condition characterized by hypoxaemia in the upright position and arterial hypoxaemia induced by the upright position, and the syndrome is relieved by recumbency. We encountered a cerebral infarction patient who presented with low SpO(2) levels in the upright position. ⋯ The surgical closure of the foramen and shortening of the ascending aorta improved the patient's clinical condition. To our knowledge, there have been few reports of clinical conditions of this kind.
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Interact Cardiovasc Thorac Surg · Jul 2012
Multicenter StudyConservative treatment of post-lobectomy bronchopleural fistula.
Post-lobectomy bronchopleural fistula is a rare complication of lung resection surgery, and proper management is essential for its successful resolution. Most published papers deal with endoscopic and surgical treatment. We report our experience with conservative management. ⋯ Two patients died due to causes unrelated to the treatment. The period of time elapsed for the resolution of this complication varied between 5 and 36 days. We conclude that conservative treatment of post-lobectomy bronchopleural fistula is a safe and simple option that must be taken into account in the management of this problem.
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Interact Cardiovasc Thorac Surg · Jul 2012
Randomized Controlled TrialRemote ischaemic preconditioning does not protect the heart in patients undergoing coronary artery bypass grafting.
Remote ischaemic preconditioning (RIPC) gained attention as a possibility to reduce myocardial injury after a subsequent sustained episode of myocardial ischaemia. This prospective randomized study was carried out to assess whether RIPC reduces myocardial injury in coronary artery bypass grafting patients. Eighty patients were assigned to remote preconditioning or control treatment. ⋯ There were no differences in other haemodynamic, troponin I and creatine kinase-MB concentrations at any time point between groups. Thus, short-term remote preconditioning improves haemodynamics and does not reduce myocardial injury after coronary artery bypass surgery. Further study of high-risk patients may be needed to fully evaluate the clinical effect of RIPC.
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Interact Cardiovasc Thorac Surg · Jul 2012
Surgical treatment for pulmonary aspergilloma: a 35-year experience in the Chinese population.
The surgical treatment of pulmonary aspergilloma is challenging and controversial. This study was designed to evaluate the clinical profile, indications and surgical outcomes of pulmonary aspergilloma operated on in our institute. A total of 256 patients with pulmonary aspergilloma underwent surgical treatment from 1975 to 2010. ⋯ The overall mortality within 30 days post-operation was 1.2%, occurring only in Group B. There was no statistically significant difference in the postoperative morbidity between Groups A and B (P = 0.27). With the good selection of patients, meticulous surgical techniques and good postoperative management, aggressive surgical treatment with anti-fungal therapy for pulmonary aspergilloma is safe and effective, and can achieve favourable outcomes.