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 2014
Case ReportsTracheomediastinal fistula caused by non-Hodgkin's lymphoma.
Non-Hodgkin's lymphoma involving the tracheobronchial tree is uncommon. A 60-year-old man presented with severe cough for two months. ⋯ After chemo-radiotherapy, the tracheomediastinal fistula healed, but eight months later, tracheal stenosis was diagnosed by bronchoscopy. A self-expansible metallic stent was placed, which successfully maintained the airway.
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Ann Thorac Cardiovasc Surg · Jan 2014
Preoperative estimated glomerular filtration rate is an independent predictor of late cardiovascular morbidity after mitral valve surgery.
Renal dysfunction affects outcomes of cardiac surgery, although its role in mitral valve operation has been limitedly documented. ⋯ Patients who underwent mitral valve surgery had acceptable perioperative and long-term survival, irrespective of preoperative renal function. However, eGFR <60 ml/min/1.73 m(2) was an independent predictor of late MACE.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsThe importance of interleaflet triangles for aortic valve competence in a marfan patient with dilated aortic sinuses.
We report a case of advanced aortic sinus aneurysm without the aggravation of aortic valve regurgitation after a simple reduction procedure for dilated aortic root base and sinotubular junction (STJ) in a Marfan patient with annuloaortic ectasia and severe aortic valve regurgitation. The aortic valve competence was well preserved by limited change of distances among the interleaflet triangles after reduction of the dilated aortic root base and STJ in the Marfan patient, although the sinus dilatation was aggravated.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsPartial anomalous pulmonary venous connection associated with lung cancer in the same lobe: report of a case.
A 64-year-old man with primary lung cancer (cT1aN0M0) was diagnosed as having partial anomalous pulmonary venous connection (PAPVC) in the same lobe by preoperative chest computed tomography (CT). The anomalous vein originated from left upper lobe pulmonary vein and flowed into the left brachiocephalic vein. Although the patient was asymptomatic, cardiac catheterization revealed that pulmonary-systemic blood flow ratio (Qp/Qs ratio) was 2.0, and his pulmonary arterial pressure was marginally elevated (60/18 mmHg). ⋯ He is living well without relapse of lung cancer 56 months after surgery. Although PAPVC is detectable on computed tomography, out of 7 previous reports of PAPVC associated with lung cancer, only 2 cases were diagnosed preoperatively. The presence of PAPVC should be kept in mind before major lung resections.
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Ann Thorac Cardiovasc Surg · Jan 2014
Case ReportsFour cases of invasive anterior mediastinal tumors definitively diagnosed by the chamberlain procedure.
Percutaneous needle biopsy, commonly used for a definitive diagnosis of anterior mediastinal tumors, is sometimes inconclusive because of the small size of the biopsy specimens and the histologic heterogeneity of the tumors. We herein report 4 cases of invasive anterior mediastinal tumors, in which the definitive diagnosis was made using the Chamberlain procedure. [Case 1] A 33-year-old man was found to have an anterior mediastinal tumor on chest X-ray and computed tomography (CT). The tumor was histologically diagnosed as thymic carcinoma (squamous cell carcinoma) using the Chamberlain procedure. ⋯ This was followed by a decrease in the tumor size and avoidance of invasive surgery. The patient remains well, 15 months after the biopsy. [Conclusion] The Chamberlain procedure proved useful for definitive diagnosis in all 4 cases of invasive anterior mediastinal tumors. We recommend the Chamberlain procedure for biopsy since it enables safe, rapid, and successful collection of tissue samples.