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. · Jul 1998
Case ReportsLeft atrial ball thrombi without mitral valve disease treated by surgical removal.
We describe two patients with free-floating left atrial ball thrombi with no evidence of cardiac disease except atrial fibrillation. One patient had experienced an embolic stroke, and the second patient had a history of stroke and peripheral thromboembolism. In each patient, the thrombi, which were not visible on transthoracic echocardiography, were detected by transesophageal echocardiography. Each patient underwent successful surgical removal using cardiopulmonary bypass.
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Jpn. J. Thorac. Cardiovasc. Surg. · Jul 1998
Clinical Trial[Evaluation of cerebral circulation during cardiopulmonary bypass using near-infrared spectroscopy].
Cerebral oxygenation level during cardiopulmonary bypass (CPB) was measured using near-infrared spectroscopy as a monitor of cerebral circulation in 30 patients. Six adult cases with thoracic aortic aneurysm were operated on using selective cerebral perfusion (SCP). CPB was established under moderate hypothermic temperature in 9 adult cases (hypothermic group, lowest blood temperature during CPB; 25 degrees C) and under normothermic temperature in 9 adult cases (normothermic group, lowest blood temperature during CPB; 34 degrees C). ⋯ The mixed venous saturation (SvO2) in the normothermic group showed significant lower levels than those in the hypothermic group (p < 0.01). However, there was no significant difference in HbO2 levels between the two groups. In conclusion, these results suggest that near-infrared spectroscopy may be a noninvasive and useful technique for the cerebral circulation monitoring during CPB.
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Jpn. J. Thorac. Cardiovasc. Surg. · Jun 1998
Case ReportsReconstruction of thoracic wall defects after tumor resection using a polytetrafluoroethylene soft tissue (Gore-Tex) patch.
Recently, there have been a few reports recommending use of a 2 mm thick polytetrafluoroethylene soft tissue (Gore-Tex) patch for repair of thoracic wall defects. The potential role of these Gore-Tex patches was examined. ⋯ Our experience with Gore-Tex patches has been positive, and we recommend patch closure for thoracic wall defects.
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Of 161 patients with blunt thoracic injury, 135 were male (83.9%) and 26 were female. The most common cause of injury was traffic accidents (130 patients, 80.7%), followed by falls (22 patients), and crushing (7 patients). There were 46 third decade and 36 second decade patients. ⋯ Continued bleeding at a rate of more than 200 ml/h from the chest drainage tube or no recovery from shock and large air leakage preventing re-expansion of the lung are indications for emergency thoracotomy. Thoracotomy should also be considered after conservative treatment in patients with continued air leakage or intrabronchial bleeding negatively affecting respiration. Indications for thoracotomy should be determined individually based on evaluating of vital sign.
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Jpn. J. Thorac. Cardiovasc. Surg. · May 1998
Case Reports[Acute mediastinitis due to esophageal perforation--a case report].
A 55-year-old female consulted her family physician because of pharyngeal discomfort after eating a fish. She underwent rigid fiberscopy and was pointed out a fish bone. Family physician failed to extract the bone and the patient was referred to our hospital. ⋯ Two weeks after the second operation esophagogram still showed a fistula. So she received injections of alprostadil and factor XIII. One month after the injections esophagogram showed a diverticulum without leakage.