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. · May 2004
Case ReportsSutureless patch repair for small blowout rupture of the left ventricle after myocardial infarction.
Rupture of the left ventricular free wall is one of the most serious complications of myocardial infarction. A 73-year-old man with severe chest pain visited our hospital. Coronary angiography revealed acute myocardial infarction in the territory of the diagonal branch. ⋯ We repaired the tear with an off-pump sutureless patch using collagen fleece with fibrinogen-based impregnation (TachoComb) and equinous pericardium with fibrin spray. The patient was free of both re-rupture and pseudoaneurysm postoperatively, and was discharged 20 days after the operation. Considering previously reported various procedures for surgical repair, this technique may be useful if the tear is small.
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Jpn. J. Thorac. Cardiovasc. Surg. · Apr 2004
Case ReportsIntravascular ultrasound imaging for detection of pseudoaneurysm with aortobronchopulmonary fistula after graft replacement of descending aorta.
A 63-year-old man had undergone graft replacement of the descending aorta due to dissection of aortic aneurysm nine years before and closure of an aortobronchopulmonary fistula two years before. He was admitted to our hospital because of massive hemoptysis. ⋯ Replacement of the ascending, arch and distal aorta including the graft was performed, and the patient's postoperative course has been satisfactory. We have concluded that intravascular ultrasound is a useful method for detecting pseudoaneurysm after graft replacement which is not evident on cineangiography, CT or distal subtraction angiography.
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Jpn. J. Thorac. Cardiovasc. Surg. · Apr 2004
Case ReportsWhen should pulmonary artery angioplasty be performed for Fontan candidates with pulmonary coarctation? Two cases of pulmonary artery angioplasty with the Blalock-Taussig shunt on pump in neonates.
We performed concomitant pulmonary artery angioplasty and the Blalock-Taussig shunt under median sternotomy and cardiopulmonary bypass at the neonatal stage in Fontan candidates with pulmonary coarctation to obtain optimum pulmonary circulation. This surgical strategy realized appropriate early growth of the pulmonary artery necessary for the Fontan operation.
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Jpn. J. Thorac. Cardiovasc. Surg. · Mar 2004
Six-minute walking and pulmonary function test outcomes during the early period after lung cancer surgery with special reference to patients with chronic obstructive pulmonary disease.
To evaluate physical dysfunction during the early period after lung resection in patients with lung cancer and coexisting chronic obstructive pulmonary disease (COPD), we examined the relationship between the ratio of the forced expiratory volume in 1 second to the forced vital capacity (FEV1/FVC%) and the results of a 6-minute walk (6MW) test before and after surgery. ⋯ The decreases in 6MWD and SpO2 after surgery were significantly influenced by the preoperative FEV1/FVC%, but not by the decrease in VC. COPD patients have a limited capacity for walking during the early period after surgery due to significant oxygen desaturation.
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Jpn. J. Thorac. Cardiovasc. Surg. · Feb 2004
Critical values of hematocrit and mixed venous oxygen saturation as parameters for a safe cardiopulmonary bypass.
Mixed venous oxygen saturation (SvO2) is high despite a low hematocrit implies that the relationship between oxygen demand and supply is in a safe state. This study was sought to determine the critical values for hematocrit and SvO2 for safe cardiopulmonary bypass. ⋯ Continuous monitoring of hematocrit and SvO2 provides evidence-based guidelines for safe cardiopulmonary bypass. The lower limits of critical range for a safer cardiopulmonary bypass are hematocrit of 12% and SvO2 of 46%.