Kyobu geka. The Japanese journal of thoracic surgery
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Total arch replacement and ascending aorta and arch replacement are the gold standard treatments for aortic arch aneurysm and are possible treatment strategies for chronic type A dissection, with good outcomes. However, because total arch replacement is alternative invasive, it can be difficult to perform in some patients. The thoracic endovascular aneurysm repair (TEVAR) landing on zone2 is a less invasive and suitable treatment for descending aortic aneurysm. ⋯ The some type of fenestrated TEVAR were usefull technique for high risk patients. We present the various fenestrated TEVAR procedures. Especially, we designed an endovascular total arch repair procedure with use of in situ fenestration and commercially available devices, and we present our initial experience.
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We report a case of an 80-year-old female presenting with a mitral valve tumor. Postoperatively, pathologic diagnosis was caseous calcification of the mitral annulus. ⋯ The importance of correctly making a preoperative diagnosis cannot be over-emphasized. Technical discussion on possibility of mitral valve repair and patient-prosthesis mismatch after mitral valve replacement is also made.
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Isolated pulmonary valve endocarditis is an extremely rare clinical condition. Here, we report a case of pulmonary valve endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA). An 84-year-old man with a history of aortic regurgitation and patent foramen ovale was admitted to our hospital due to fever of unknown origin for 4 weeks' duration. ⋯ At surgery, a large vegetation was still attached to the pulmonary valve, but the leaflets remained with minimum damage. Aortic valve replacement, direct closure of the patent foramen ovale, and simple resection of the vegetation were performed. The postoperative course was uneventful.
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The demand for outpatient management of spontaneous pneumothorax (SP) has been increased, therefore we evaluated the effectiveness of Thoracic Egg(TE), a portable thoracic drainage kit for SP. We studied 43 SP patients who had received TE treatment between May 2008 and October 2010. Ages were ranged 12~73 years (mean:29.1), with 39 males, 4 females, 25 had primary, 18 had recurrent, pneumothorax. ⋯ The average length of treatment was 8.4 days for outpatient therapy only cases. Of 25 patients who had primary SP, 18( 72%) were not required hospitalization. Outpatient therapy using TE was considered very useful for SP, especially for primary cases.
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Intrapulmonary aberrant needles are rarely encountered in clinical practice. A 82-year-old woman, though she was asymptomatic, was referred to our department due to an abnormal shadow on a chest X-ray. Chest X-ray and chest computed tomography showed a foreign body suspected to be a sewing needle in the left upper lobe. The needle was successfully removed by video-assisted thoracoscopic surgery.