The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai zasshi
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Jpn. J. Thorac. Cardiovasc. Surg. · Apr 1999
Case ReportsBronchoscopic removal of bronchial foreign bodies through the laryngeal mask airway in pediatric patients.
The laryngeal mask airway was used to perform fiberoptic removal of bronchial foreign bodies (peanuts) in two pediatric patients. Laryngeal mask airway offers easy access to the airway, safe respiratory management and direct visualization of the airway during bronchoscopic procedures. ⋯ In each case, the peanuts were removed safely and easily using a Fogarty catheter through the fiberoptic bronchoscope. These cases suggest that laryngeal mask airway is useful in maintaining a secure airway during the removal of bronchial foreign bodies in children.
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Jpn. J. Thorac. Cardiovasc. Surg. · Apr 1999
Case ReportsAortic valve replacement in a patient with idiopathic thrombocytopenic purpura.
A patient with aortic regurgitation and idiopathic thrombocytopenic purpura underwent a successful valve replacement. Cardiac surgery requiring a cardiopulmonary bypass in idiopathic thrombocytopenic purpura can be safely carried out with the preoperative intravenous administration of high-dose gammaglobulin, which may thereby reduce the need for either perioperative transfusion or prophylactic splenectomy.
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Jpn. J. Thorac. Cardiovasc. Surg. · Jan 1999
Case ReportsMitral regurgitation after pericardiectomy for constrictive pericarditis.
We report a case of constrictive pericarditis in which trace mitral valve regurgitation was detected preoperatively and temporarily worsened after a pericardiectomy was performed. The early postoperative data suggested that the increased mobility of the lateral wall, in conjunction with an increase in the left ventricular volume, might be one of the causes of the perioperative mitral valve dysfunction. The mitral valve function returned to the preoperative baseline thirteen months after the pericardiectomy.
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Jpn. J. Thorac. Cardiovasc. Surg. · Jan 1999
Case ReportsGuideline of surgical management based on diffusion of descending necrotizing mediastinitis.
Descending necrotizing mediastinitis resulting from oropharyngeal abscess, is a serious, life-threatening infection. Exisiting strategies for surgical management, such as transcervical mediastinal drainage or aggressive thoracotomic drainage, remain controversial. ⋯ The mediastinal infection, the extent of which has been accurately determined by computed tomograms, necessitates radical cervicotomy followed by pleuromediastinal drainage. Situations where infection has spread to posterior medisatinum, particularly when it reaches in the level of the carina (descending necrotizing mediastinitis-type I), may not always require aggressive mediastinal drainage. In comparison, diffuse descending necrotizing mediastinitis-Type IIB demands complete mediastinal drainage with debridement via thoracotomy. Subxiphoidal mediastinal drainage without sternotomy may provide adequate drainage in diffuse descending necrotizing mediastinitis-Type IIA.
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Jpn. J. Thorac. Cardiovasc. Surg. · Jan 1999
Clinical TrialHypothermic circulatory arrest and hypothermic perfusion for extensive disease of the thoracic and thoracoabdominal aorta.
Hypothermic cardiopulmonary bypass with or without an interval of circulatory arrest has been evaluated for the treatment of complex aortic disease of the descending thoracic and thoracoabdominal aorta. Hypothermia has a protective effect on spinal cord function, and its use should reduce the incidence of paraplegia and paraparesis in traditionally high-risk patients. Experimentally, the protective effect of hypothermia has been related to amelioration of excitotoxic injury by reduction of neurotransmitter release and to inhibition of delayed apoptopic cell death. ⋯ Our experience with hypothermic cardiopulmonary bypass and circulatory arrest confirms that hypothermia provides substantial protection against spinal cord ischemic injury. It allows complex operations on the descending thoracic and thoracoabdominal aorta to be performed with acceptable mortality, a low incidence of renal failure, and an incidence of other complications that does not exceed that reported with other techniques.