Kyobu geka. The Japanese journal of thoracic surgery
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A laryngeal mask provides maintaining airway with a larger inner diameter of the tube. A little information is available about bronchoscopic treatment for upper tracheal lesions. Three patients undergoing bronchoscopic treatment for upper tracheal lesions with a laryngeal mask were reviewed. ⋯ The treatment was performed under general anesthesia using a laryngeal mask. All cases were successfully treated without operative and postoperative complications related to the use of the laryngeal mask placement. Use of a laryngeal mask may facilitate insertion and retrieval of a flexible bronchoscope and instruments with an excellent manipulation in therapeutic bronchoscopy for subglottic and upper tracheal lesions.
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We reviewed 21 patients with bilateral multiple bronchogenic carcinomas. Eleven of them had synchronous carcinomas and 10 had metachronous carcinomas. ⋯ Two patients who had lobectomy on both lungs were dead, one of whom of pulmonary edema 2 weeks after second operation and the other of respiratory failure 3 years after second operation. We concluded that lobectomy on both lungs are not recommended because of high mortality rate (10%) and the limited resection under thoracoscopic surgery should be considered to treat the other contra lateral primary lung cancers.
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Bentall operation was performed for the ascending aortic dissection in the patient of a 70-year old man, who had undergone aortic valve replacement (AVR) for aortic valve regurgitation 7 years ago. At the AVR, the diameter of the ascending aorta was 50 mm on CT. ⋯ These situations suggested that the aortic dissection might be occurred just or early after AVR, and the reinforcement of aortotomy using felt-strips and AVR could not prevent progression of aortic root enlargement and dissection. From some previous reports about ascending aortic dissection after AVR, an adequate surgical treatment for a dilated ascending aorta (40-50 min) should be required at the same time of AVR.
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We reported a 55-year-old man, who had coronary and cerebral vascular disease. Cerebral angiography showed occlusion at left internal carotid artery (ICA) and 50% stenosis at right ICA C4 portion. ⋯ The patient underwent coronary artery bypass grafting using cardiopulmonary bypass with intraaortic balloon pumping to keep intraoperative blood pressure high. After the operation he recovered uneventfully without neurological complication.
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Conotruncal repair for tetralogy of Fallot consists of (1) precise closure of the VSD with the membranous flap and (2) reconstruction of the right ventricular outflow tract (RVOT) by a short transannular patch (< 30% of the RV length) with a wide PTFE monocusp. This report describes the mid-term results in 46 patients with tetralogy of Fallot who underwent conotruncal repair with PTFE monocusped transannular patch and have been followed up for 4 years or more. There was no early and late death and no patient required reoperation. ⋯ The mobility of the PTFE monocusp was echocardiographically detected in 86% over a mean follow-up period of 84 +/- 34 months and % freedom from pulmonary regurgitation (> II) was 85.9% at 10 years postoperatively. Excellent long-term durability of the PTFE monocusp provided the normal right vent performance with RVEDV of 91.8 +/- 29.5% of normal and a central venous pressure of 5 +/- 1 mmHg. In conclusion, conotruncal repair with a wide and short transannular patch has provided good mid-term results with the excellent long-term durability of PTFE monocusp.