Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Jan 2012
Results of emergency coronary artery bypass grafting for acute myocardial infarction: importance of intraoperative and postoperative cardiac medical therapy.
The results of emergency coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) are less than satisfactory, and readmission for cardiac events is common. ⋯ Early results of this study are similar to those seen in previous reports, whereas late phase results yield some new and interesting findings. We suggest that intraoperative hANP, and postoperative aldosterone blocker and ARB, following CABG for AMI, will, through control of the renin-angiotensin-aldsterone system, inhibit left ventricular remodelling, reduce the extent of infarction, and improve cardiac function, yielding a favourable long-term prognosis.
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A 44-year-old woman was found to have an abnormal shadow on a chest X-ray during a regular health checkup, and visited our department. Chest computed tomography showed multiple nodular shadows in both lungs. The patient had no history of neoplasm except for myomectomy for uterine leiomyoma 6 years previously. ⋯ Benign metastasizing leiomyoma is defined as a histologically benign uterine smooth muscle tumor that acts in a somewhat malignant fashion and produces benign metastases. Although it is a rare condition, it should be considered in asymptomatic women of reproductive age with a history of uterine leiomyoma, who present with solitary or multiple pulmonary nodules. Herein, we report a case of pulmonary benign metastasizing leiomyoma.
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This study aimed to evaluate the clinical outcomes of chest wall reconstruction using a relatively new expanded polytetrafluoroethylene prosthesis Gore-Tex(®) dual mesh. ⋯ Chest wall reconstruction using Gore-Tex(®) dual mesh demonstrated acceptable durability.
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Ann Thorac Cardiovasc Surg · Jan 2012
Randomized Controlled Trial Comparative StudyIntrapleural analgesia using ropivacaine for postoperative pain relief after minimally invasive thoracoscopic surgery.
to evaluate the efficacy and safety of intrapleural analgesia (IPA) using ropivacaine after thoracoscopic surgery, compared with thoracic epidural analgesia (TEA) using ropivacaine. ⋯ in IPA group, pain was managed with less consumption of additional analgesics. IPA could be one of the good choices after thoracoscopic surgery for its efficacy, safety, and benefit of easy placement of the catheter.
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Ann Thorac Cardiovasc Surg · Jan 2012
Case ReportsApico-aortic conduit for aortic stenosis in a patient with chronic thoracic wall infection.
We report a case of an apico-aortic bioprothesis-valved conduit for a 70-year-old-woman with symptomatic, severe aortic stenosis and severe calcification of the ascending aorta. She had a history of mastectomy and radiation therapy for breast cancer and was suffering from radiodermatitis and chronic thoracic wall infection. Transthoracic echocardiography showed severe aortic valve stenosis with heavy calcification and high aortic valve pressure gradients. ⋯ We underwent apico-aortic bypass with a hand-made composite graft: 19-mm bioprosthetic valve and a 22-mm woven polyester vascular graft. The surgical intervention successfully decreased pressure gradient across the aortic valve, also separating an incision from chronic infection allowed us to avoid postoperative mediastinitis. The patient had remained in good condition for 15 months without developing any complications.