The Annals of thoracic surgery
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Giant coronary artery aneurysm with a fistula is a rare condition. We present one of the largest aneurysms of left circumflex coronary artery territory, arising from the left atrial branch of the left circumflex coronary artery. ⋯ Total exclusion of the aneurysmal mass was achieved by ligation of the afferent artery, closure of the entry point from within the aneurysm, and closure of the fistulous communication from within the right atrium. The patient's postoperative course was uneventful.
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Randomized Controlled Trial Comparative Study
Effect of phrenic nerve palsy on early postoperative lung function after pneumonectomy: a prospective study.
The issue of phrenic nerve preservation during pneumonectomy is still an unanswered question. So far, its direct effect on immediate postoperative pulmonary lung function has never been evaluated in a prospective trial. ⋯ Our results show that phrenic nerve palsy causes a significant impairment of dynamic lung volumes during the early postoperative period after pneumonectomy. Therefore, in these already compromised patients, intraoperative phrenic nerve injury should be avoided whenever possible.
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Randomized Controlled Trial Comparative Study
Sivelestat attenuates lung injury in surgery for congenital heart disease with pulmonary hypertension.
Pulmonary hypertension associated with congenital heart disease increases the risk of surgery using cardiopulmonary bypass. Sivelestat is a neutrophil elastase inhibitor thought to have a prophylactic effect against lung injury after surgery using bypass. We elucidated that Sivelestat had the protective effect on lung in patients with congenital heart disease and pulmonary hypertension who underwent surgery using bypass. ⋯ Administration of sivelestat during bypass prevented pulmonary damage and activities of proinflammatory cytokines at the cardiac operation in neonates or infants. Our results show that sivelestat may be considered to protect pulmonary function against the injury by bypass.
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Comparative Study
Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic tuberculosis.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that has enabled mediastinal and hilar lymph node assessment with a high sensitivity, but its role in the diagnosis of intrathoracic tuberculosis (TB) has not been established. ⋯ Endobronchial ultrasound-guided transbronchial needle aspiration has a high diagnostic yield in the investigation of suspected intrathoracic TB by means of aspiration of intrathoracic lymph nodes and tracheobronchial wall-adjacent lung lesions.
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Comparative Study
Effect of coronary artery disease extent on contemporary outcomes of combined aortic valve replacement and coronary artery bypass graft surgery.
Concomitant aortic valve replacement (AVR) and coronary artery bypass graft surgery (CABG) is a common procedure. Whether the extent of coronary artery disease (CAD) influences outcomes of AVR plus CABG is unknown. ⋯ Compared with AVR plus CABG for one- or two-vessel CAD, AVR plus CABG for left main or three or more vessel CAD had higher observed and risk-adjusted rates of postoperative complications but not operative or 1-year mortality.