General thoracic and cardiovascular surgery
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Gen Thorac Cardiovasc Surg · May 2016
Immediate and mid-term result of restrictive mitral annuloplasty using a small semi-rigid ring.
Though annuloplasty using a properly sized ring has been advocated in degenerative mitral regurgitation, restrictive annuloplasty using a down-sized ring is widely used in ischemic mitral regurgitation. We investigated the outcome of restrictive annuloplasty using a small (24- or 26-mm) ring in mitral regurgitation irrespective of the etiology. ⋯ Restrictive mitral annuloplasty using a small ring provided acceptable early and midterm results in patients with body surface area around 1.5 cm(2) without Barlow pathology. Restrictive annuloplasty may be another technical aspect to avoid valve replacement.
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Gen Thorac Cardiovasc Surg · Apr 2016
Case ReportsAdenoid cystic carcinoma of the lower trachea treated by resection of 11 of 18 rings of the total length: report of a case.
We report the case of a 63-year-old woman with adenoid cystic carcinoma of the lower trachea treated by resection of 11 of the 18 cartilaginous rings (61%) of the total length. The little remaining membranous portion of the carina was sewn up to create a margin for anastomosis. ⋯ Because both the proximal and distal margins showed microscopic tumors, radiation therapy was performed with 50 Gy 2 months after surgery. The patient has a good social life without recurrence 20 months after surgery.
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Gen Thorac Cardiovasc Surg · Feb 2016
ReviewCurrent status of brain protection during surgery for congenital cardiac defect.
The long-term neurodevelopmental outcome has been a great concern for cardiac surgeons although it is still unclear. There are some risks regarding the neurological and neuropsychological deficits before, during and after cardiovascular surgery. Current status of brain protection during congenital heart surgery could be reported. The incidence of neurologic outcome and the appropriate CPB strategy for brain protection are stated, and the latest data of neurodevelopmental outcome after pediatric cardiac surgery are clarified.
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Gen Thorac Cardiovasc Surg · Feb 2016
Case ReportsHybrid management of Paget-Schroetter syndrome due to thoracic outlet syndrome.
Paget-Schroetter syndrome due to thoracic outlet syndrome is a rare but potentially disabling condition that generally affects young patients otherwise healthy. The prompt diagnosis and treatment of Paget-Schroetter syndrome is necessary to avoid major morbidity and long-term disability. ⋯ Controversy exists partly because no randomised controlled studies are present in literature. We present a case of Paget-Schroetter syndrome due to thoracic outlet syndrome in a young male patient submitted to a multimodal procedure.
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Gen Thorac Cardiovasc Surg · Jan 2016
Novel paravertebral block during single-incision thoracoscopic surgery for primary spontaneous pneumothorax.
Recently, the use of paravertebral block (PVB) during thoracic surgery has been re-evaluated, as it is not inferior to epidural anaesthesia for postoperative pain control, and has been associated with fewer complications (e.g., hematoma of epidural, hypotension, urinary retention, postoperative nausea and vomiting). No reports have described intraoperative catheterization for PVB during single-incision thoracoscopic surgery (SITS) as distinct from thoracotomy or multi-ports video-assisted thoracoscopic surgery. ⋯ Our novel technique is both easy and safe. It is ideal to combine PVB with SITS because both methods are less invasive.