The Annals of thoracic surgery
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Bronchopeural fistula after pneumonectomy, with associated empyema, has no standard therapy. The transsternal, transpericardial approach was used in all patients presenting with a large fistula. ⋯ Long-term results of transsternal closure are good, but hospital mortality is high. The present treatment of patients with large postpneumonectomy bronchopleural fistula includes early open thoracostomy, improvement of nutritional status, transsternal closure using resorbable sutures, and closure of the pleural space 3 weeks later.
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Biography Historical Article
Cemil Topuzlu Pacha and his arterial suture technique.
Cemil Topuzlu Pacha (1868-1958) is known to be one of the most famous surgeons in Turkey through the early decades of the twentieth century. Being a talented and courageous surgeon, he performed many of the avoided operations of that time. He presented his vascular suture techniques at the International Medical Congress in Moscow in August 1897 and at the annual Congress of the Societe de Chirurgie de Paris in July 1904. ⋯ He also reported the removal of a pen cover from the right main bronchus of a 7-year-old girl through a tracheotomy in 1903. He worked for 3 years with the famous French surgeon Jules Pean and became a preferred surgeon of the Ottoman Imperial family in Istanbul. He was admired for his scientific studies in international congresses and was one of the first Turkish surgeons who became a member of important European surgical associations.
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Review Case Reports
Coronary artery bypass grafting in immune thrombocytopenic purpura.
Reports of patients with idiopathic thrombocytopenic purpura undergoing cardiac operations are scarce and no recommendations exist regarding their management. We report 3 patients with idiopathic thrombocytopenic purpura and severe coronary artery disease who underwent uncomplicated coronary bypass grafting. ⋯ Coronary artery bypass grafting can be safely performed in patients with idiopathic thrombocytopenic purpura using conventional conduits after pretreating with immunoglobulin G and avoiding splenectomy.
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Reoperations on the aortic root and the ascending aorta are being performed with increasing frequency and remain a challenging problem. ⋯ Reoperations on the aortic root and the ascending aorta can be accomplished with acceptable early mortality and satisfactory long-term results. More frequent resection of the aneurysmal or dissected segments of the ascending aorta and aortic root at the initial operation may reduce the need for subsequent reoperation.
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Hypoxic endothelial cell activation plays a key role in the myocardial dysfunction resulting from ischemia-reperfusion injury. Recent evidence suggests that vascular endothelial growth factor (VEGF) may, in addition to promoting angiogenesis, modulate various aspects of endothelial function and repair. We examined whether administration of VEGF in the cardioplegic solution might have a beneficial effect on myocardial ischemia-reperfusion injury in an isolated rat heart model. ⋯ Addition of VEGF to hyperkalemic cardioplegia protects against myocardial ischemia-reperfusion injury in the isolated rat heart.