The Annals of thoracic surgery
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Thoracoscopic sympathectomy has been used for the treatment of sympathetic dysfunction since it was first described in the 1940s. With the advent of video-assisted thoracic surgery, the procedure has become more widely applied. ⋯ This article presents a review of existing approaches and techniques as well as the author's summary and preferences. The review of the articles on thoracoscopic sympathectomy only included those from the English literature.
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Spasm of the left internal thoracic artery in the perioperative period represents a life-threatening complication after coronary artery bypass grafting. We present a case in which graft spasm was treated with the administration of intra-arterial nitroglycerin and verapamil. Although vasospasm is more often seen in radial artery grafts, this case demonstrates that left internal thoracic artery grafts are also prone to spasm.
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It is not obvious to visualize and expose the main trunk of the pulmonary artery through a port access approach. We describe surgical and anesthesiology measures necessary to perform the removal of an atrial septal defect closure device safely and adequately.
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The generation of thrombin and its procoagulant activity are upregulated during cardiopulmonary bypass (CPB). Thrombophilia associates with increased basal thrombin generation and might therefore propagate thrombin generation during CPB. The objective of this study was to test whether preoperative thrombophilic variables associate with increased generation of thrombin or its procoagulant activity during and after CPB. ⋯ Preoperative thrombophilic variables do not associate with perioperative thrombin generation or its procoagulant activity in patients undergoing CABG. Our results do not support routine thrombophilia screening before CABG.
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Comparative Study
Video-assisted thoracic surgery major lung resection can be safely taught to trainees.
Video-assisted thoracoscopic surgery (VATS) major lung resection for lung cancer has been an important part of thoracic surgical training program in our institution. In this study, we compared the results of VATS major lung resection performed by surgical trainees with those performed by experienced thoracic surgeons with specialist interest in VATS. ⋯ Video-assisted thoracic surgery major lung resection for early stage nonsmall-cell lung cancer can be taught to residents who work under the supervision of experienced VATS surgeons. Video-assisted thoracic surgery major lung resection for lung cancer should be an integral part of thoracic surgical training program.