1,722 results on '"CARDIAC surgery"'
Search Results
2. Real-world safety and effectiveness of inhaled nitric oxide therapy for pulmonary hypertension during the perioperative period of cardiac surgery: a post-marketing study of 2817 patients in Japan
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Matsugi, Emi, Takashima, Shigeki, Doteguchi, Shuhei, Kobayashi, Tomomi, and Okayasu, Motohiro
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- 2024
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3. Compression brace for secondary pectus carinatum in infants and toddlers undergoing cardiac surgery with midline sternotomy
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Konishi, Hayato, Fujiwara, Kenta, Okazaki, Sayaka, Suzuki, Akiyo, Suzuki, Tatsuya, Katsumata, Takahiro, Nagano, Toru, and Nemoto, Shintaro
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- 2024
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4. Thromboelastographic evaluation after cardiac surgery optimizes transfusion requirements in the intensive care unit: a single-center retrospective cohort study using an inverse probability weighting method
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Tamura, Takahiro, Suzuki, Shogo, Fujii, Tasuku, Hirai, Takahiro, Imaizumi, Takahiro, Kubo, Yoko, Shibata, Yasuyuki, Narita, Yuji, Mutsuga, Masato, and Nishiwaki, Kimitoshi
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- 2024
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5. A prospective randomized controlled study to assess the effectiveness of super FIXSORB WAVE® for sternal stabilization after sternotomy
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Oishi, Kiyotoshi, Arai, Hirokuni, Kuroki, Hidehito, Fujioka, Tomoyuki, Tomita, Makoto, Tasaki, Dai, Oi, Keiji, Nagaoka, Eiki, Fujiwara, Tatsuki, Takeshita, Masashi, Yoshizaki, Tomoya, Someya, Takeshi, and Mizuno, Tomohiro
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- 2023
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6. Symptom progression following on-pump versus off-pump coronary artery bypass graft surgery in patients with peripheral arterial disease
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Sevuk, Utkan and Bahadir, Mehmet Veysi
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- 2023
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7. U-shaped association between elapsed time after surgery and the intensity of chronic postsurgical pain following cardiac surgery via thoracotomy: an observational cohort study
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Minami, Kimito, Kazawa, Masahiro, Kakuta, Takashi, Fukushima, Satsuki, Fujita, Tomoyuki, and Ohnishi, Yoshihiko
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- 2022
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8. Helpfulness of the liver disease scores in cardiac surgery for cirrhotic patients
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Sebestyen, Alexandre, Boutayeb, Alaae, Durand, Michel, Martin, Cécile, Hilleret, Marie-Noëlle, Bedague, Damien, Rhem, Delphine, and Chavanon, Olivier
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- 2022
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9. Temporary epicardial pacing wires post-cardiac surgery: a literature review
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Manuel, Lucy
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- 2022
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10. Clinical efficacy of digital chest drainage system in cardiac valve surgery
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Tamura, Kiyoshi and Sakurai, Shogo
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- 2022
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11. Primary and secondary cardiac tumors: clinical presentation, diagnosis, surgical treatment, and results
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Campisi, Alessio, Ciarrocchi, Angelo Paolo, Asadi, Nizar, and Dell’Amore, Andrea
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- 2022
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12. Inhaled nitric oxide improves pulmonary hypertension and organ functions after adult heart valve surgeries
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Nakane, Takeichiro, Esaki, Jiro, Ueda, Ryoma, Honda, Masanori, and Okabayashi, Hitoshi
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- 2021
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13. Coronary computed tomography angiography before on-pump cardiac surgery does not reduce the risk of postoperative acute kidney injury compared to coronary angiography
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Yan, Yang, Li, Yongxin, Liu, Wenyan, Li, Jing, Zhang, Yongjian, Liu, Fengfeng, and Zheng, Xinglong
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- 2021
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14. Primary cardiac hydatic cyst with multiple locations: an unusual case of chest pain
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Velho, Tiago R., Gonçalves, João Moreira, Pereira, Rafael Maniés, da Cruz, Rafael Moiteiro, Guerra, Nuno Carvalho, Ferreira, Ricardo, and Nobre, Ângelo
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- 2021
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15. Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery
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Toshihiko Shibata, Takuma Tsukioka, Hiroaki Komatsu, T. Kimura, Noritoshi Nishiyama, Hidetoshi Inoue, Nobuhiro Izumi, and Ryuichi Ito
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pleural effusion ,Mediastinal tumor ,Postoperative reaction ,Mediastinal Neoplasms ,胸水 ,Surgical oncology ,縦隔腫瘍 ,medicine ,Pneumothorax, Artificial ,Artificial pneumothorax ,Humans ,Retrospective Studies ,Skin incision ,business.industry ,Clinical course ,Mediastinum ,Pneumothorax ,General Medicine ,respiratory system ,medicine.disease ,respiratory tract diseases ,Cardiac surgery ,Surgery ,surgical procedures, operative ,Cardiothoracic surgery ,胸膜滲出液 ,Cardiology and Cardiovascular Medicine ,business - Abstract
The induction of artificial pneumothorax has many intraoperative advantages. However, few reports on the postoperative effects of artificial pneumothorax induction are available. In this study, we investigated the effect of artificial pneumothorax on postoperative clinical course in patients with mediastinal tumors. We retrospectively investigated the clinical courses of 89 patients who had undergone mediastinal tumor resection between January 2010 and December 2020. Sixty-five patients had undergone resection with artificial pneumothorax. The tumor location significantly varied across patients. The proportion of patients in whom artificial pneumothorax was induced was higher among those having anterior mediastinal tumors. The number of ports and the total skin incision length were significantly higher in patients without artificial pneumothorax. The C-reactive protein level elevation on postoperative day 2 and pleural effusion at 24 h after surgery were significantly higher in patients without artificial pneumothorax. Furthermore, the albumin level reduction and hospital stay after surgery were significantly lower in patients with artificial pneumothorax. Multiple regression analysis showed that the use of artificial pneumothorax was an independent predictive factor of the C-reactive protein level elevation on postoperative day 2 and pleural effusion at 24 h after surgery. In patients without artificial pneumothorax, the operation time positively correlated with the C-reactive protein level (r = 0.646, P
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- 2022
16. Impella CP and ProtekDuo as a bridge to recovery following surgical revascularization complicated by electrical storm
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Chivasso, Pierpaolo, Miele, Mario, Romano, Rosalba, Frunzo, Francesco, Presutto, Oreste, Colombino, Mario, Cafarelli, Francesco, Baldi, Cesare, Fiore, Emanuele, Masiello, Paolo, Mastrogiovanni, Generoso, and Iesu, Severino
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- 2021
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17. Intralobar pulmonary sequestration associated with left main coronary artery obstruction and mitral regurgitation
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Satoru Wakasa, Masato Aragaki, Tatsuya Kato, Kichizo Kaga, Aki Fujiwara-Kuroda, Tsuyoshi Tachibana, Yasuhiro Hida, Yusuke Motohashi, and Nobuyasu Kato
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Mitral Valve Annuloplasty ,Heart Ventricles ,Left main coronary artery obstruction ,Pulmonary sequestration ,Internal medicine ,medicine ,Humans ,Bronchopulmonary Sequestration ,Mitral regurgitation ,business.industry ,Mitral Valve Insufficiency ,General Medicine ,Blood flow ,medicine.disease ,Coronary Vessels ,Cardiac surgery ,medicine.anatomical_structure ,Treatment Outcome ,Ventricle ,Cardiothoracic surgery ,Child, Preschool ,Cardiology ,Surgery ,Intralobar pulmonary sequestration ,Cardiology and Cardiovascular Medicine ,business ,Shunt (electrical) ,Artery - Abstract
A 4-year-old boy with left intralobar pulmonary sequestration associated with left main coronary artery obstruction (LMCAO) and severe mitral regurgitation (MR) was admitted to our hospital. Since the patient presented with dyskinesia of the cardiac apex and increased left ventricular end-diastolic volume (LVEDV), left main coronary artery reconstruction and mitral annuloplasty were performed. The enlargement of the left ventricle was improved after sequential surgeries. There was a risk of deterioration of MR and regrowth of LVEDV due to shunt blood flow; therefore, left lower lobectomy and aberrant artery division were performed. This is a very rare case of a patient with pulmonary sequestration associated with LMCAO and severe MR.
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- 2021
18. Clinical efficacy of digital chest drainage system in cardiac valve surgery
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Kiyoshi Tamura and Shogo Sakurai
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Pulmonary and Respiratory Medicine ,Suction (medicine) ,medicine.medical_specialty ,medicine.medical_treatment ,Surgical oncology ,medicine ,Clinical endpoint ,Humans ,Coronary Artery Bypass ,Pneumonectomy ,Aged ,Aged, 80 and over ,Rehabilitation ,business.industry ,Thoracic Surgery ,General Medicine ,Middle Aged ,Heart Valves ,Surgery ,Cardiac surgery ,Treatment Outcome ,medicine.anatomical_structure ,Cardiothoracic surgery ,Chest Tubes ,Female ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
The portable digitalized suction was used widely in thoracic surgery. The aim of the study was to access the early outcomes of using the portable digitalized suction system after cardiac surgery. We invested 80 patients including 30 women (mean age 72.7 ± 9.2 years) who underwent cardiac surgery at our hospital, excluded coronary artery bypass grafting only, with or only aortic surgery, emergency operation, and patients with hemodialysis. Patients were categorized as those treated with digital chest drainage system (DCS group, n = 38) or analog chest drainage system (ACS group, n = 42), and the following data were analyzed in two groups. The primary endpoint was the duration of chest drainage, and the secondary endpoints were the rate of drainage-related complications and the length of hospitalization. The duration of drainage was significantly shorter in the DCS group (ACS vs. DCS = 94.8 ± 31.5 vs. 81.1 ± 20.6 h, p = 0.036). The duration needed for rehabilitation completion was significantly shorter in the DCS group (ACS vs. DCS = 10.7 ± 1.2 vs. 9.6 ± 1.5 days, p = 0.047), and the length of hospitalization was significantly shorter in the DCS group (ACS vs. DCS = 21.9 ± 5.3 vs. 18.8 ± 7.2 days, p = 0.031). This study provided evidence that DCS might be effective for patients who underwent cardiac valve surgery.
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- 2021
19. Does synchronous early head and neck cancer with esophageal cancer need treatment after preoperative chemotherapy?
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Kenkichi Masutomi, Junya Oguma, Daisuke Kurita, Yuki Hirano, Kohei Kanamori, Koshiro Ishiyama, and Hiroyuki Daiko
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Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Chemotherapy ,business.industry ,medicine.medical_treatment ,Head and neck cancer ,General Medicine ,Esophageal cancer ,medicine.disease ,Cardiac surgery ,Surgical oncology ,Esophagectomy ,Cardiothoracic surgery ,Internal medicine ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Neoadjuvant therapy - Abstract
Treatment options for patients with resectable thoracic esophageal squamous cell cancer (ESCC) and synchronous head and neck cancer (HNC) are unclear. Little has been reported about the effects of chemotherapy on early HNC. The aim of this study was to investigate the treatment outcomes of resectable thoracic ESCC with synchronous early HNC. We retrospectively reviewed 37 patients undergoing esophagectomy for thoracic ESCC with synchronous early HNC from January 2008 to December 2018. Among 37 patients who had synchronous early HNC, 27 patients received preoperative therapy for ESCC before HNC treatment, and 16 of 27 patients achieved a complete response for HNC by preoperative chemotherapy. Fifteen of 16 patients did not receive additional treatment, and regional recurrence of HNC was not observed. In one other case, an oral excision was performed, but no cancer cell remnants were found pathologically. No significant difference in overall survival and disease-free survival was observed between 15 patients with follow-up and 22 patients with surgery or radiation. Our results indicate that early HNC with comorbid ESCC could be followed up without additional treatment if preoperative chemotherapy is successful.
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- 2021
20. Comparison of long-term outcomes between off-pump and on-pump coronary artery bypass grafting using Japanese nationwide cardiovascular surgery database
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Hikaru Kumamaru, Noboru Motomura, Satoshi Numata, Hiroaki Miyata, and Hitoshi Yaku
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Database ,Bypass grafting ,business.industry ,Subgroup analysis ,General Medicine ,computer.software_genre ,medicine.disease ,Cardiac surgery ,Surgery ,law.invention ,medicine.anatomical_structure ,law ,Cardiothoracic surgery ,Propensity score matching ,medicine ,Cardiopulmonary bypass ,Cardiology and Cardiovascular Medicine ,business ,computer ,Stroke ,Artery - Abstract
In Japan, off-pump coronary artery bypass (OPCAB) is more common than on-pump coronary artery bypass. Superior early results of OPCAB have been reported; however, long-term results were still unclear. Purpose of this study is to evaluate the clinical outcomes of OPCAB in Japan using Japan Adult Cardiovascular Surgery Database. Between 2008 and 2010, 23,633 patients who underwent isolated coronary artery bypass were reported in database. We selected the cases from the hospital with mean annual coronary surgery volume of more than 50. Among the total of 7724 cases at 41 institutions, 2150 (31.2%) on-pump coronary artery bypass (ONCAB) and 5574 (68.8%) OPCAB cases were included. Propensity score (PS) matching was performed using PS developed from patient characteristics and preoperative factors resulting in 2007 cases matched pairs. Long-term follow-up data on patients’ mortality and stroke were collected. In-hospital mortality was significantly lower in OPCAB (ONCAB 1.1%, OPCAB 0.4% p = 0.01). Stroke was low in OPCAB group (ONCAB 1.7%, OPCAB 0.8%, p = 0.01). There was no statistically significant difference between OPCAB and ONCAB regarding 7-year overall survival (86.1% vs 88.1% respectively), composite outcomes (72.0% vs 73.9% respectively), or cardiac deaths (97.3% vs 97.1% respectively). Subgroup analysis (more than 75 years old) showed a worse trend in OPCAB group. Only in OPCAB group, incomplete revascularization significantly influenced 7-year survival. OPCAB is associated with early prognostic benefits; however, it might be less favorable outcomes in the long term when patients are older or with incomplete revascularization.
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- 2021
21. Strict control of phosphorus concentration of hemodialysis patients may decrease structural valve deterioration after aortic valve replacement
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Kazunori Yamada, Shinya Takahashi, Shingo Mochizuki, Seimei Go, Toshifumi Hiraoka, and Tomokuni Furukawa
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Phosphorus concentration ,medicine.medical_treatment ,Prosthesis Design ,Aortic valve replacement ,Renal Dialysis ,Internal medicine ,Cox proportional hazards regression ,Humans ,Medicine ,Survival rate ,Retrospective Studies ,Bioprosthesis ,Heart Valve Prosthesis Implantation ,business.industry ,Phosphorus ,Aortic Valve Stenosis ,General Medicine ,medicine.disease ,Prosthesis Failure ,Cardiac surgery ,Stenosis ,Treatment Outcome ,Cardiothoracic surgery ,Aortic Valve ,Heart Valve Prosthesis ,Cardiology ,Surgery ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,business - Abstract
The number of hemodialysis patients requiring aortic valve replacement (AVR) is increasing. Although bioprosthetic valves are increasingly popular, they are associated with a risk of structural valve deterioration (SVD). The aim of this study is to examine the outcomes of bioprosthetic valves in hemodialysis patients undergoing AVR and to identify treatment strategies that can decrease the risk of SVD. Between February 2010 and November 2019, 61 patients on hemodialysis underwent AVR using bioprosthetic valves at our hospital. Five patients died while still in the hospital. Kaplan–Meier estimates of overall survival and univariate Cox proportional hazards regression analyses were performed for the remaining 56 patients. During follow-up, there were six SVD events (10.7%) related to the bioprosthetic valves. The survival rate was 67.9% at 3 years and 39.5% at 5 years. In all SVD cases, SVD was caused by aortic stenosis. The mean interval between AVR and the discovery of SVD was 41.5 months. The SVD-free rate was 88.6% at 3 years and 65.3% at 5 years. Preoperative phosphorus levels are associated with SVD risk. High preoperative phosphorus concentration is associated with elevated SVD risk. In this study, we determined that the risk of SVD can be influenced by preoperative phosphorus level. Strict control of the phosphorus concentration of hemodialysis patients may decrease structural valve deterioration after aortic valve replacement.
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- 2021
22. Primary pulmonary artery reconstruction for functional single ventricle with absent central pulmonary artery and bilateral patent ductus arteriosus
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Makoto Nakamura, Kazuyoshi Kanno, and Masahiko Nishioka
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Heart Defects, Congenital ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pulmonary Artery ,Univentricular Heart ,Interquartile range ,medicine.artery ,Internal medicine ,Humans ,Medicine ,Ductus Arteriosus, Patent ,business.industry ,Bilateral patent ductus arteriosus ,Infant ,General Medicine ,Cardiac surgery ,medicine.anatomical_structure ,Cardiothoracic surgery ,Ventricle ,Pulmonary artery ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Shunt (electrical) ,Artery - Abstract
This study aimed to evaluate and discuss the outcomes of creating a single systemic-pulmonary shunt and reconstruction of the pulmonary artery continuity in patients with a single functional ventricle, absent central pulmonary artery, and bilateral patent ductus arteriosus. Six infants diagnosed with a functional single ventricle, absent central pulmonary artery, and bilateral patent ductus arteriosus were treated by creating a single systemic-pulmonary shunt and reconstructing the pulmonary artery continuity (primary operation) between January 2010 and September 2020. Pulmonary artery continuity was ensured using the remnant pulmonary artery and an autologous pericardial patch in five patients and a rolled autologous pericardium in one patient. All patients eventually underwent total cavopulmonary connection. Two patients underwent intrapulmonary artery septation before Glenn or total cavopulmonary connection procedure. The median follow-up period was 9.02 years (interquartile range, 3.90–9.53). No late deaths were observed. Our strategy of establishing a single systemic-pulmonary shunt with reconstruction of the pulmonary artery continuity was useful for treating patients with a functional single ventricle with absent central pulmonary artery and bilateral patent ductus arteriosus. This procedure helped accomplish pulmonary artery growth and ensured an appropriate volume load after total cavopulmonary connection.
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- 2021
23. Percutaneous drainage and staged valve replacement followed by laparoscopic splenectomy in infective endocarditis with splenic abscess
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Kosuke Hayashi, Fumiyoshi Saijo, Toshihiro Funatsu, Junya Yokoyama, and Masaaki Ryomoto
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Male ,Pulmonary and Respiratory Medicine ,Aortic valve ,medicine.medical_specialty ,medicine.medical_treatment ,Splenectomy ,Valve replacement ,Aortic valve replacement ,medicine ,Humans ,Splenic Diseases ,Endocarditis ,business.industry ,Endocarditis, Bacterial ,General Medicine ,Middle Aged ,medicine.disease ,Abscess ,Cardiac surgery ,Surgery ,medicine.anatomical_structure ,Embolism ,Infective endocarditis ,Drainage ,Laparoscopy ,Transthoracic echocardiogram ,Cardiology and Cardiovascular Medicine ,business - Abstract
Splenic abscess is a severe complication of infective endocarditis. The need for splenectomy to control prosthetic valve infection remains controversial. Here, we present the case of a 49-year-old man who complained of fever and general fatigue. Blood cultures grew Group G Streptococcus, and intravenous antibiotics were started. Abdominal computed tomography showed splenic abscess; thus, percutaneous drainage was performed. Two-dimensional transthoracic echocardiogram revealed a mobile vegetation on the right coronary cusp of the aortic valve with mild aortic regurgitation. The patient underwent aortic valve replacement using a 23-mm SJM Regent mechanic valve, followed by laparoscopic splenectomy 3 days later. The patient was asymptomatic without recurrence of infection 13 months postoperatively. Current guidelines recommend that splenectomy should be performed first, followed by valve replacement. However, we performed valve surgery first because of the risk of embolism. Depending on the patient's condition, performing splenic drainage and valve replacement first may be considered.
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- 2021
24. Perigraft hygroma mimicking recurrent angiosarcoma of the right atrium
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Jort Evers, Kinsing Ko, Guillaume S.C. Geuzebroek, Wim J. Morshuis, and Tim Smith
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Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Vena Cava, Superior ,medicine.medical_treatment ,Hemangiosarcoma ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Heart Neoplasms ,Pregnancy ,Humans ,Medicine ,Angiosarcoma ,Heart Atria ,Vein ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Stent ,General Medicine ,Emergency department ,Cardiac surgery ,medicine.anatomical_structure ,Cardiothoracic surgery ,cardiovascular system ,Recurrent Angiosarcoma ,Female ,Surgery ,Lymphangioma, Cystic ,Tamponade ,Radiology ,Neoplasm Recurrence, Local ,Cardiology and Cardiovascular Medicine ,business - Abstract
Contains fulltext : 251631.pdf (Publisher’s version ) (Closed access) Primary cardiac angiosarcoma is extremely rare, has a poor prognosis and has no specific clinical manifestation. A 31-year-old pregnant woman presented to the emergency department with signs of pericardial tamponade. Transesophageal echocardiography (TEE) showed a mass within her right atrium. Extensive surgical resection was performed with subsequent pericardial patch reconstruction of the right atrium. Histological examination showed the presence of an angiosarcoma. A reoperation was performed 18 months after the initial operation, because of concerns of radicality. Three years later she was re-admitted with a superior caval vein syndrome. A stent was placed to relieve symptoms. Because of the suspicion of a recurrent tumor, a second reoperation followed. During this operation, a perigraft hygroma was found pressing against the previously reconstructed superior caval vein. Histological examination after both reoperations showed no signs of a recurrent angiosarcoma. Until today, 8 years after her first surgery, the patient is still alive without any signs of recurrent tumor.
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- 2021
25. Tracheal stenosis following mild-to-moderate COVID-19 infection without history of tracheal intubation: a case report
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Reza Ershadi, Javad Sarbazzadeh, Shahab Rafieian, and Matin Vahedi
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Side effect ,medicine.medical_treatment ,Tracheal stenosis ,Case Report ,Bronchoscopy ,medicine ,Intubation, Intratracheal ,Intubation ,Humans ,Rigid bronchoscopy ,Aged ,business.industry ,SARS-CoV-2 ,Tracheal intubation ,COVID-19 ,General Medicine ,respiratory system ,medicine.disease ,Cardiac surgery ,Surgery ,Tracheal Stenosis ,Cardiothoracic surgery ,Cardiology and Cardiovascular Medicine ,business ,Laryngotracheal stenosis - Abstract
Laryngotracheal stenosis is a major side effect of intubation in patients with Coronavirus 2019 (COVID-19). However, no study has since reported tracheal stenosis in patients with COVID-19 without a history of tracheal intubation. The current study reports a 77-year-old male patient with the COVID-19 infection but without a history of tracheal intubation diagnosed with distal tracheal stenosis. Tracheal stenosis was successfully treated with rigid bronchoscopy. This study reported the first case of tracheal stenosis due to viral tracheitis associated with COVID-19 infection. However, further studies are required to investigate this speculation.
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- 2021
26. Translational model of vein graft failure following coronary artery bypass graft in atherosclerotic microswine
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Aleem Siddique, Kouassi T. Kouassi, Mohamed M. Radwan, Finosh G. Thankam, and Devendra K. Agrawal
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,General Medicine ,Amiodarone ,medicine.disease ,Cardiac surgery ,Coronary artery bypass surgery ,medicine.anatomical_structure ,Bypass surgery ,Cardiothoracic surgery ,Internal medicine ,Ventricular fibrillation ,cardiovascular system ,medicine ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,Superficial epigastric vein ,business ,medicine.drug ,Artery - Abstract
Vein graft failure is a major complication following coronary artery bypass graft surgery. There is no translational model to understand the molecular mechanisms underlying vein-graft failure. We established a clinically relevant bypass graft model to investigate the underlying pathophysiological mechanisms of vein-graft failure and identify molecular targets for novel therapies. Six female Yucatan microswine fed with high cholesterol diet underwent off-pump bypass, using superficial epigastric vein graft, which was anastomosed to an internal mammary artery and distal left anterior descending artery. Vein-graft patency was examined 10-months after bypass surgery by echocardiography, coronary angiography, and optical coherence tomography followed by euthanasia. Coronary tissues were collected for histomorphometry studies. Atherosclerotic microswine were highly susceptible to sudden ventricular fibrillation with any cardiac intervention. Two out of six animals died during surgery due to ventricular fibrillation. Selection of the anesthetics and titration of their doses with careful use of inotropic drugs were the key to successful swine cardiac anesthesia. The hypotensive effects of amiodarone and the incidence of arrhythmia were avoided by the administration of magnesium sulfate. The vein-graft control tissue displayed intact endothelium with well-organized medial layer. The grafted vessels revealed complete occlusion and were covered with fibrous tissues. Expression of CD31 in the graft was irregular as the layers were not clearly defined due to fibrosis. This model represents the clinical vein-graft failure and offers a novel platform to investigate the underlying molecular mechanisms of vein-graft disease and investigate novel therapeutic approaches to prevent its progression.
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- 2021
27. Surgical outcomes of minimally invasive aortic valve replacement via right mini-thoracotomy for hemodialysis patients
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Ryo Tsuruta, Yujiro Ito, Takuya Narita, Yoshitsugu Nakamura, Miho Kuroda, Taisuke Nakayama, Shuhei Nishijima, Yuto Yasumoto, and Daiki Yoshiyama
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,law.invention ,Aortic valve replacement ,Renal Dialysis ,law ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,business.industry ,Incidence (epidemiology) ,General Medicine ,Length of Stay ,medicine.disease ,Sternotomy ,Intensive care unit ,Surgery ,Cardiac surgery ,Treatment Outcome ,Thoracotomy ,Respiratory failure ,Cardiothoracic surgery ,Median sternotomy ,Aortic Valve ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES Minimally invasive valve surgery has become increasingly accepted as an alternative to conventional median sternotomy in low-risk patients. However, there have been no reports regarding the outcomes of this procedure on high-risk hemodialysis patients. The purpose of this investigation was to assess the surgical outcomes of minimally invasive aortic valve replacement (AVR) via right mini-thoracotomy (MIAVR) in hemodialysis patients compared with those of conventional AVR (CAVR) via full sternotomy. METHODS Two hundred and seventy-four patients underwent isolated AVR for severe AS, and 42 hemodialysis patients were included in this study. MIAVR was performed in 17 cases and CAVR in 25 cases. We compared the short-term surgical outcome among the two groups. RESULTS There was no difference in the aortic cross-clamp or cardiopulmonary bypass time. However, the procedure time was significantly shorter in the MIAVR group. Patients in the MIAVR group had less bleeding and a smaller amount of transfused red blood cells. There were four hospital deaths (18.2%) in the CAVR group. For postoperative complications, there were 2 (9.1%) cerebrovascular incidents, 2 (9.1%) cases of respiratory failure, 1 (4.5%) re-exploration for bleeding in CAVR group. The postoperative ventilation time was significantly shorter in the MIAVR group. There was no difference in the length of postoperative intensive care unit stay or of postoperative hospital stay. CONCLUSION The surgical outcomes of MIAVR in hemodialysis patients were acceptable, with a low incidence of morbidity, reasonable lengths of hospital stay, and no mortality among the patients studied.
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- 2021
28. Staged removal of artificial patches for thoracic empyema after extrapleural pneumonectomy for diffuse malignant pleural mesothelioma
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Yasuto Sakaguchi, Nobuhisa Yamazaki, Makoto Sonobe, Yuuki Kou, and Hirokazu Tanaka
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Male ,Mesothelioma ,Pulmonary and Respiratory Medicine ,Extrapleural Pneumonectomy ,medicine.medical_specialty ,Pleural Neoplasms ,medicine ,Humans ,Pericardium ,Pneumonectomy ,Abscess ,Empyema, Pleural ,Aged ,business.industry ,Pleural mesothelioma ,Mesothelioma, Malignant ,General Medicine ,medicine.disease ,Empyema ,Cardiac surgery ,Surgery ,Diaphragm (structural system) ,medicine.anatomical_structure ,Cardiothoracic surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
A 69-year-old man with occupational exposure to asbestos was referred to our hospital with right diffuse malignant pleural mesothelioma. He underwent extrapleural pneumonectomy with reconstruction of the pericardium and diaphragm using elongated polytetrafluoroethylene patches, followed by postoperative chemotherapy and chest wall irradiation. One year later, he was hospitalized because of a right empyema caused by Escherichia coli infection. As chest drainage and systemic antibiotics did not eliminate the abscess around the artificial patches, a Clagett window was created. To avoid mediastinal and liver overshift into the right thoracic cavity, we only performed partial resection of the diaphragm patch and incision of the artificial pericardium. After 19 days of irrigation and dressing change, the artificial patches were completely removed. Two months later, the patient provided a culture-negative sample and had an improved nutritional status; we therefore performed closure of the Clagett window with thoracoplasty. He did not experience recurrence of empyema.
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- 2021
29. Diagnosis of Carney complex following multiple recurrent cardiac myxomas
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Nobuyuki Fukuda, Akihiko Higashida, Shigeyuki Yamashita, Naoki Yoshimura, Masaya Aoki, Kazuaki Fukahara, Kanetsugu Nagao, Akio Yamashita, Shigeki Yokoyama, and Toshio Doi
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Carney complex ,Case Report ,Right atrial ,Cryoablation for myxoma ,law.invention ,Heart Neoplasms ,Surgical oncology ,law ,medicine ,Cardiopulmonary bypass ,Humans ,Heart Atria ,cardiovascular diseases ,business.industry ,Recurrent of cardiac myxoma ,General Medicine ,medicine.disease ,Cardiac surgery ,Cardiothoracic surgery ,cardiovascular system ,Surgery ,Radiology ,Neoplasm Recurrence, Local ,Left Atrial Myxoma ,Cardiology and Cardiovascular Medicine ,business ,Myxoma ,Cardiac myxomas - Abstract
Carney complex is a rare syndrome caused by a genetic mutation leading to multiple endocrine abnormalities and a variety of tumors. Here, we report a case of Carney complex diagnosed due to recurrent multiple myxomas in the right atrium of a patient 16 years after the resection of the primary left atrial myxoma. Surgical excision was performed for the multiple recurrent right atrial tumors under cardiopulmonary bypass. The patient remained complication-free after surgery and was discharged on the 14th day. He was scheduled to continue echocardiographic follow-up and periodic systemic review by an endocrinologist. This case emphasizes the fact that if cardiac myxomas tend to be multiple and recurrent at a relatively young age, the possibility of Carney complex should be considered, even in the absence of any other related feature other than cardiac tumors.
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- 2021
30. Five-year outcomes after coronary artery bypass grafting and percutaneous coronary intervention in octogenarians with complex coronary artery disease
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Hiroki Watanabe, Shingo Hirao, Tatsuhiko Komiya, Naoki Kanemitsu, Jiro Esaki, Kenji Minatoya, Hiroyuki Hara, Takeshi Morimoto, Yuki Hori, and Takeshi Kimura
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Octogenarians ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Artery Disease ,Lower risk ,Coronary artery disease ,Percutaneous Coronary Intervention ,Interquartile range ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,Coronary Artery Bypass ,Aged ,Aged, 80 and over ,business.industry ,Percutaneous coronary intervention ,Drug-Eluting Stents ,General Medicine ,medicine.disease ,Cardiac surgery ,Death ,Stroke ,Treatment Outcome ,surgical procedures, operative ,medicine.anatomical_structure ,Cardiothoracic surgery ,Conventional PCI ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
We assessed the clinical effectiveness of coronary artery bypass grafting (CABG) in comparison with that of percutaneous coronary intervention (PCI) in octogenarians with triple-vessel disease (TVD) or left main coronary artery (LMCA) disease. From the CREDO-Kyoto registry cohort-2, 527 patients, who were ≥ 80 years of age and underwent the first coronary revascularization for TVD or LMCA disease, were divided into the CABG group (N = 151) and the PCI group (N = 376). The median and interquartile range of patient’s age was 82 (81–84) in the CABG group and 83 (81–85) in the PCI group (P = 0.10). Patients > = 85 years of age accounted for 19% and 31% in the CABG and PCI groups, respectively (P = 0.01). The cumulative 5-year incidence of all-cause death was similar between CABG and PCI groups (35.8% vs. 42.9%, log-rank P = 0.18), while CABG showed a lower rate of the composite of cardiac death/MI than PCI (21.7% vs. 33.9%, log-rank P = 0.005). After adjusting for confounders, the lower risk of CABG relative to PCI was significant for all-cause death (HR 0.61, 95% CI 0.43–0.86, P = 0.005), any coronary revascularization (HR 0.25, 95% CI 0.14–0.43, P
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- 2021
31. Successful thoracoscopic resection of an esophageal bronchogenic cyst
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Masahiro Noda, Yasuto Uchikado, Ryu Matsumoto, Shinichiro Mori, Yusuke Tsuruda, Takaaki Arigami, Takao Ohtsuka, Daisuke Matsushita, Yoshiaki Kita, and Ken Sasaki
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Esophageal Neoplasms ,Bronchogenic cyst ,Asymptomatic ,Endosonography ,Resection ,Bronchogenic Cyst ,Surgical oncology ,medicine ,Humans ,Esophageal Cyst ,Pathological ,Esophageal Mass ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Cardiac surgery ,Cardiothoracic surgery ,Surgery ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
Esophageal bronchogenic cysts are rare, and since a limited number of cases has been reported, the treatment plan for asymptomatic patients is difficult. A 55-year-old man without any symptoms visited our hospital for further examination of an esophageal mass detected on simple computed tomography. Upper endoscopy showed the protruding, submucosal mass covered by normal mucosa, and endoscopic sonography confirmed hypoechoic lesions originating from the muscularis propria. The patient was diagnosed as having an esophageal duplication cyst and underwent thoracoscopic resection. Pathological findings were consistent with an esophageal bronchogenic cyst. The patient was discharged without any problems on the 6th postoperative day. Upper endoscopy was performed 6 months after surgery, and no evidence of esophageal diverticula or narrowing was present. In conclusion, early thoracoscopic resection of esophageal bronchogenic cysts, before appearance of the symptom, can be a considerable treatment option because it is less invasive and may be advantageous for obtaining a definitive diagnosis in patients who are candidates for safe surgical resection.
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- 2021
32. Effectiveness and safety of a newly introduced multidisciplinary perioperative enhanced recovery after surgery protocol for thoracic esophageal cancer surgery
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Hiroshi Sato, Shinichi Sakuramoto, Yutaka Miyawaki, Yasuhiro Tsubosa, Hirofumi Sugita, and Seigi Lee
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Postoperative Complications ,Surgical oncology ,medicine ,Humans ,Retrospective Studies ,business.industry ,Cancer ,General Medicine ,Perioperative ,Length of Stay ,Esophageal cancer ,medicine.disease ,Surgery ,Cardiac surgery ,Esophagectomy ,Treatment Outcome ,Cardiothoracic surgery ,Enhanced Recovery After Surgery ,Cardiology and Cardiovascular Medicine ,business ,Thoracic esophageal cancer - Abstract
Data are sparse regarding the multidisciplinary perioperative enhanced recovery after surgery protocol (E-P) for thoracic esophageal cancer surgery that was newly used at another institution. Therefore, this study aimed to retrospectively evaluate the effectiveness and safety of the protocol. We enrolled 101 patients who underwent transthoracic esophagectomy for E-P at the Shizuoka Cancer Center Hospital (SCC). The outcomes obtained at the SCC were compared with the outcomes of 140 patients treated with E-P at the Saitama Medical University International Medical Center (SMU). At the SMU, we compared the results before and after the introduction of E-P. The rates of morbidity, pulmonary complications, and postoperative pneumonia were 44%, 31%, and 6.9% at the SCC and 44%, 27%, and 6.5% at the SMU (P = 0.91, 0.55, and 0.88, respectively). The mean time to walk was 1.1 and 1.5 days at the SCC and SMU, respectively (P
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- 2021
33. Impact of the first surge of the coronavirus disease pandemic on general thoracic surgery practices in Kanagawa: a questionnaire survey by the Kanagawa General Thoracic Surgical Study Group
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Akihiko Kitami, Takamitsu Maehara, Hiroyuki Ito, Junichi Okamoto, Hisashi Saji, Kazu Shiomi, Takao Morohoshi, Michihiko Tajiri, Noriyuki Matsutani, and Shugo Uematsu
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Disease ,First surge ,Questionnaire survey ,Surveys and Questionnaires ,Health care ,Pandemic ,medicine ,Infection control ,Humans ,Pandemics ,business.industry ,SARS-CoV-2 ,Medical treatment restrictions ,Questionnaire ,COVID-19 ,General Medicine ,medicine.disease ,Cardiac surgery ,Thoracic surgery ,Pneumothorax ,Cardiothoracic surgery ,Emergency medicine ,Surgery ,Original Article ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives The first surge in severe acute respiratory syndrome coronavirus 2 infection had a significant impact on health care institutions. Understanding how the pandemic affected general thoracic surgery would provide valuable data for establishing a health care protocol for upcoming surges. Methods A questionnaire survey on coronavirus disease-related patient statistics and health care was conducted between February 2020 and June 2020 across 14 facilities affiliated with the Kanagawa General Thoracic Surgery Study Group. Results The average number of newly referred patients from February to June 2020 was 65% of that during the same period in 2019. Six facilities placed restrictions on medical care services, among which four restricted surgeries. At all institutions and those placed on surgical restriction, the total number of surgeries under general anesthesia was 92% and 78%, the total number of primary lung cancers was 94% and 86%, and the total number of surgeries for pneumothorax was 71% and 77% of that in the preceding year, respectively. Infection control and insufficient resources of the medical material were the most influential factors impacting the medical institutions’ decision to restrict the services provided. Conclusions Restrictions on surgery had a significant impact on the care provided by general thoracic surgery departments. To avoid patient inconvenience, establishing a collaborative system that refers patients to operational medical institutions in case of medical treatment restrictions may be useful. Supplementary Information The online version contains supplementary material available at 10.1007/s11748-021-01724-z.
- Published
- 2021
34. Letter to Editor: Predictive value of neutrophil to lymphocyte ratio on acute kidney injury after on-pump coronary artery bypass: a retrospective, single-center study
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Das, Devishree and Magoon, Rohan
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- 2022
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35. Can really preoperative furosemide increase the risk of acute kidney injury after coronary artery bypass grafting?
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Yang, Wen-He, Xue, Fu-Shan, and Wan, Lei
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- 2022
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36. Review of the use of simulators in learning revascularization techniques
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EL-Andari, Ryaan, Bozso, Sabin J., Kang, Jimmy J. H., and Nagendran, Jeevan
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- 2021
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37. Factors influencing activated clotting time following heparin administration for the initiation of cardiopulmonary bypass
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Matsushita, Satoshi, Kishida, Akinori, Wakamatsu, Yoshihito, Mukaida, Hiroshi, Yokokawa, Hirohide, Yamamoto, Taira, and Amano, Atsushi
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- 2021
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38. Tranexamic acid after cardiopulmonary bypass does not increase risk of postoperative seizures: a retrospective study
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Lei Du, Jing Liu, and Changwei Chen
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Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Blood Loss, Surgical ,law.invention ,Seizures ,law ,Blood product ,Cardiopulmonary bypass ,medicine ,Humans ,Retrospective Studies ,Cardiopulmonary Bypass ,business.industry ,General Medicine ,Antifibrinolytic Agents ,Cardiac surgery ,Tranexamic Acid ,Cardiothoracic surgery ,Anesthesia ,Cryoprecipitate ,Surgery ,Fresh frozen plasma ,Cardiology and Cardiovascular Medicine ,business ,Tranexamic acid ,medicine.drug - Abstract
OBJECTIVE To evaluate the effects of administering tranexamic acid (TXA) after cardiopulmonary bypass, instead of after anesthesia induction, on postoperative seizures and blood transfusion requirements. METHODS Adult patients who underwent valve surgery and/or coronary artery bypass grafting at West China Hospital between July 1, 2011 and December 31, 2016 were retrospectively analyzed. Patients either received TXA after bypass (n = 2062) or not (n = 4236). Logistic regression and propensity score matching analysis were performed to assess effects of TXA on postoperative seizures and blood product requirements in hospital. RESULTS Among 6298 patients, seizures occurred in 2.4% (102/4236) in the no-TXA group and 2.7% (56/2062) in the TXA group (P = 0.46). The number of patients receiving any blood products was greater in the no-TXA group (57.3%, 2428/4236) than in the TXA group (53.1%, 1095/2062) (P
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- 2021
39. Early results after aortic annuloplasty with a complete external Dacron band
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Jan Otto Beitnes, Runar Lundblad, and John-Peder Escobar Kvitting
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Reoperation ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aortic Valve Insufficiency ,Regurgitation (circulation) ,Cardiac Valve Annuloplasty ,Bicuspid aortic valve ,Aortic valve repair ,Internal medicine ,Humans ,Medicine ,Endocarditis ,Polyethylene Terephthalates ,business.industry ,General Medicine ,medicine.disease ,Cardiac surgery ,Treatment Outcome ,Early results ,Cardiothoracic surgery ,Aortic Valve ,Cardiology ,Mitral Valve ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective This study evaluates the early results of our initial experience with aortic annuloplasty using a complete external Dacron band in the setting of type Ic or type II aortic regurgitation (AR). Methods From May 2017 to August 2019, 16 patients (88% bicuspid aortic valves, no patients with connective tissue disorders) underwent aortic annuloplasty with an external complete Dacron band. Clinical and echocardiographic follow-up was 100% complete. Clinical and echocardiographic follow-up averaged 24.4 ± 9.3 and 15.1 ± 8.3 months, respectively. Results Mean cardiopulmonary and cross-clamp times were 105 ± 15 (72–127) and 86 ± 15 (51–113) min, respectively. Early and late mortality was 0%, with no incidents of endocarditis or cerebrovascular events during the follow-up. Two patients were re-operated during the follow-up, one due recurrent aortic regurgitation (12 months after the first operation) yielding a freedom from reoperation due to AR at 1 year and 3 years of 100% ± 0% and 93.3% ± 5.7%, respectively. Based on the latest echocardiogram, five patients had either none or trivial AR, six had mild AR, and three had mild-to-moderate AR. Conclusions The early clinical and echocardiographic results after using a complete external Dacron band are promising; however, more data and longer follow-up are needed to determine its role in annular management during aortic valve repair.
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- 2021
40. An improved method of anchoring chest drain and suture technique for Uni-portal VATS incision
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Zhiyong Sun, Jiajie Zheng, Ziang Cao, and Xiaojing Zhao
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Improved method ,Post surgery ,Suture (anatomy) ,medicine ,Humans ,Uni-portal ,Suture ,Chest drain ,Thoracic Surgery, Video-Assisted ,Thoracic cavity ,business.industry ,Suture Techniques ,General Medicine ,Cardiac surgery ,Surgery ,Chest tube ,medicine.anatomical_structure ,Effusion ,Cardiothoracic surgery ,Chest Tubes ,How to Do It ,Cardiology and Cardiovascular Medicine ,business - Abstract
Uni-portal video-assisted thoracoscopic approach is currently a popular surgical technique in general thoracic surgery. After operation, a chest tube is usually placed through the incision to drain the effusion and gas from the thoracic cavity. In the conventional method, the retaining stitches should be taken out ten days after removing chest drain. To get better would-healing and avoid unsightly scar, we explored a method of anchoring chest drain and two-layer suture for Uni-portal incision without removing stitches post operation.
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- 2021
41. Trends in open lobectomy outcomes for lung cancer over the last 15 years: national cohort
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Salem Rustom, Rachit D. Shah, Yahya Alwatari, Walker A. Julliard, Dawit Ayalew, Daniel Scheese, and Athanasios E. Sevdalis
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,General surgery ,Specialty ,Mean age ,General Medicine ,medicine.disease ,National cohort ,Cardiac surgery ,Cardiothoracic surgery ,Surgical oncology ,medicine ,Intubation ,Surgery ,Cardiology and Cardiovascular Medicine ,Lung cancer ,business - Abstract
Adoption of thoracoscopic lobectomy has been increasing in the US; however, open lobectomy (OL) is still performed in half of the cases. Postoperative care and enhanced recovery after surgery (ERAS) pathways have evolved and improved outcomes. The study aims to evaluate postoperative outcomes of OL over the last 15 years. Patients who underwent lobectomy for lung cancer between 2005 and 2019 were identified in the National Surgical Quality Improvement Program and divided into three groups; pre-ERAS (2005–2011), transitional period (2012–2015), and wider ERAS implementation (2016–2019). Preoperative characteristics and postoperative outcomes were compared and multivariable regression analysis was constructed to assess independent predictors of outcomes. OL was comprised of 40% of lobectomies for lung cancer. 10,021 patients met inclusion criteria. 49% were males and mean age was 67. Patients who belonged to the (2016–2019) period group had significantly higher comorbidities and ASA classification. General surgeons performed
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- 2021
42. Aortic valve replacement in a patient with self-reported systemic multiple metal allergy
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Mari Sakai, Hayato Obi, Saori Nagura, and Kazuaki Fukahara
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,Prosthesis Design ,Metal allergy ,Transcatheter Aortic Valve Replacement ,Aortic valve replacement ,Hypersensitivity ,Medicine ,Humans ,In patient ,Aged ,Bioprosthesis ,Heart Valve Prosthesis Implantation ,business.industry ,Stent ,General Medicine ,Aortic Valve Stenosis ,medicine.disease ,Surgery ,Cardiac surgery ,Stenosis ,Treatment Outcome ,Cardiothoracic surgery ,Aortic valve stenosis ,Aortic Valve ,Heart Valve Prosthesis ,cardiovascular system ,Self Report ,Cardiology and Cardiovascular Medicine ,business - Abstract
We report our experience with aortic valve replacement in a patient with severe aortic stenosis who had self-reported allergies to multiple metals. The patient was a 74-year-old man. He developed palmoplantar pustulosis after using a dental prosthesis, and a patch test revealed reactions to several metals; therefore, he was diagnosed with systemic metal allergy. His condition progressed to severe aortic stenosis, and bioprosthetic aortic valve replacement was planned. The Avalus valve (Medtronic, Minneapolis, MN, USA) was selected for aortic valve replacement, since the patient reported having allergies to several metals. While most devices used in cardiac surgery contain some amount of metal, the Avalus bioprosthetic valve does not contain metal in the stent and has been extremely useful for aortic valve replacement in patients with suspected metal allergies.
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- 2021
43. Which factors have a great impact on coagulopathy and hemostatic impairment after cardiopulmonary bypass in cardiovascular surgery? An analysis based on rotational thromboelastometry
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Takuya Tsusue, Kenshi Yoshimura, Hirotsugu Hamamoto, Hiroki Sato, Norio Itai, Shinji Miyamoto, Hideo Iwasaka, Takafumi Abe, Satomi Tahara, and Shuichiro Uehara
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Hemostatics ,Fibrin ,law.invention ,A10 ,Coagulopathy ,law ,Rotational thromboelastometry ,medicine ,Cardiopulmonary bypass ,Humans ,Multiple linear regression analysis ,Retrospective Studies ,Cardiopulmonary Bypass ,biology ,business.industry ,General Medicine ,Perioperative ,Blood Coagulation Disorders ,medicine.disease ,Thrombelastography ,Surgery ,Cardiac surgery ,Thromboelastometry ,Clotting time ,Cardiothoracic surgery ,biology.protein ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives This study aimed to investigate which factors have a great impact on coagulopathy after cardiopulmonary bypass (CPB) using rotational thromboelastometry (ROTEM)., Methods Ninety-eight patients undergoing cardiovascular surgery using CPB were enrolled. Data of amplitude 10 min after clotting time (A10) of ROTEM measured routinely before and after CPB were retrospectively collected. ROTEM has some assays by which we can evaluate the capacity of extrinsic coagulation (EXTEM), intrinsic coagulation (INTEM), fibrin polymerization (FIBTEM), and the effect of heparin (HEPTEM). The platelet component, defined as PLTEM, can be calculated by subtracting FIBTEM from EXTEM. Age, sex, total plasma volume, pre-CPB A10, lowest body temperature, in–out balance during CPB, intraoperative bleeding amount, and type of pumps were considered as possible factors. Univariate and multivariate analyses were performed for the rate of change of A10., Results The change rate of each A10 had a significant negative correlation with bleeding amount (p < 0.01 for EXTEM; p < 0.01 for INTEM; p = 0.02 for FIBTEM; p < 0.01 for PLTEM). Female sex was a significant contributive predictor for the greater decline of EXTEM (p < 0.01) and INTEM (p < 0.01); positive balance for EXTEM (p < 0.01), FIBTEM (p = 0.01), and PLTEM (p < 0.01); long CPB time for INTEM (p = 0.01); centrifugal pump for FIBTEM (p < 0.01); and large pre-CPB A10 for PLTEM (p < 0.01)., Conclusion In perioperative hemostatic management using ROTEM, attention should be given to the effects of these multiple factors.
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- 2021
44. Effects of remote ischemic postconditioning on HIF-1α and other markers in on-pump cardiac surgery
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Jaume Perez-Griera, Tania Moreno, Marina Soro, Javier Belda, José García-de-la-Asunción, Alejandro Duca, Nuria García-del-Olmo, and Eva García-del-Olmo
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Ischemia ,law.invention ,Double blind ,Randomized controlled trial ,law ,Internal medicine ,Cardiopulmonary bypass ,Humans ,Medicine ,Cardiac Surgical Procedures ,Ischemic Postconditioning ,Troponin T ,business.industry ,General Medicine ,Oxygenation ,Hypoxia-Inducible Factor 1, alpha Subunit ,medicine.disease ,Cardiac surgery ,Cardiothoracic surgery ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
There is a lack of data about the effects of remote ischemic postconditioning (RIPostC) on hypoxia-inducible factor-1α (HIF-1α) plasma levels after on-pump cardiac surgery (OPCS). This study aimed to measure the effects of RIPostC on postoperative HIF-1α plasma levels, cardiac markers and arterial oxygenation in patients undergoing OPCS. This single-centre randomized, double blind, controlled trial, enrolled 70 patients (35 control and 35 RIPostC). RIPostC was performed by 3 cycles (5 min of ischemia followed by 5 min of reperfusion) administered in upper arm immediately after the pump period. The primary outcome was to measure HIF-1α plasma levels: before surgery (T0), and 2 h (T1), 8 h (T2), 24 h (T3), 36 h (T4) and 48 h (T5) after RIPostC. As secondary endpoint, Troponin T, CK-MB, CPK plasma levels and PaO2/FiO2 ratio were measured. HIF-1α plasma levels were increased at T1–T3 compared to T0 in both groups (P
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- 2021
45. Prosthetic vascular graft infection: A systematic review and meta-analysis on diagnostic accuracy of 18FDG PET/CT
- Author
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Mahboobeh Sheikh, Zohre Mahmoodi, and Morteza Salarzaei
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Diagnostic accuracy ,Standardized uptake value ,General Medicine ,Sensitivity and Specificity ,Cardiac surgery ,Fluorodeoxyglucose F18 ,Predictive Value of Tests ,Cardiothoracic surgery ,Positron Emission Tomography Computed Tomography ,Positron-Emission Tomography ,Meta-analysis ,Diagnostic odds ratio ,medicine ,Risk of mortality ,Humans ,Surgery ,Radiology ,Radiopharmaceuticals ,18fdg pet ,Cardiology and Cardiovascular Medicine ,business - Abstract
There is a high risk of mortality and morbidity associated with Vascular Graft Infections (VGI) which requires early diagnosis. The aim of the present systematic review and meta-analysis was to evaluate the diagnostic accuracy, sensitivity and specificity of 18FDG PET/CT in diagnosing VGI. A systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. We evaluated five parameters including specificity, sensitivity, negative and positive predictive values (NPV and PPV), and accuracy. We used STATA/MP 15.0 (StataCorp, College Station, TX) for all of our analyses. Overall 10 studies including 320 patients undergone 18FDG PET/CT were included. The sensitivity, specificity, positive and negative likelihood ratios along with their 95% CI were 0.92 (95% CI 0.88–0.95), 0.76 (95% CI 0.76–0.70), 3.49 (95% CI 3.49–2.32) and 0.14 (95% CI 0.09–0.23), respectively. The diagnostic odds ratio (DOR) for diagnosis of VGI was 37.12 (95% CI 14.84–92.82). The mean cut-off value of the maximum standardized uptake value (SUVmax) for diagnosis of VGI was 5.39 while the overall mean SUVmax among patients with VGI was 8.47. According to our results, 18FDG PET/CT is a useful diagnostic method in detecting active VGI with high diagnostic accuracy. Because of its ability to evaluate morphology and main texture using SUVmax, the 18FDG PET/CT provides an objective assessment of aspects and extent of disease activity, which results in preventing unnecessary surgery, proper treatment planning, and evaluating the effectiveness of treatment.
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- 2021
46. A valuable echocardiographic indicator for the optimal tightness of bilateral pulmonary artery banding
- Author
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Junko Katagiri, Takamasa Takeuchi, Hiroshi Koshiyama, and Yusuke Iwata
- Subjects
Pulmonary and Respiratory Medicine ,Pulmonary Circulation ,medicine.medical_specialty ,genetic structures ,Pulmonary Artery ,Pulmonary artery banding ,Internal medicine ,Humans ,Medicine ,Pulmonary blood flow ,Lung ,business.industry ,General Medicine ,Blood flow ,Hypoxia (medical) ,Cardiac surgery ,medicine.anatomical_structure ,Echocardiography ,Cardiothoracic surgery ,Cardiology ,Surgery ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Perfusion ,Blood Flow Velocity ,circulatory and respiratory physiology - Abstract
The optimal tightness of bilateral pulmonary artery banding (BPAB) is considered to balance not only systemic-to-pulmonary blood flow but also each pulmonary blood flow, which is still challenging. To achieve them, we adopt the end-diastolic velocity (EDV) to the peak systolic velocity (PSV) ratio at BPAB with intraoperative epicardial echocardiography. We evaluated the usefulness of the EDV to PSV ratio and the patient outcomes. 34 patients underwent BPAB with this indicator and using a looped polytetrafluoroethylene suture. The PSV and the EDV to PSV ratio with echocardiography were measured in the intraoperative, early postoperative and late postoperative period. Lung perfusion scintigraphy was performed to quantify flow to each lung. There were 3 early deaths (
- Published
- 2021
47. Tension pneumothorax decompression with colorimetric capnography: pilot case series
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Michael Ferrara, Joseph Immerman, Michael D. Traynor, Matthew C. Hernandez, Arjunmohan Mohan, Martin D. Zielinski, Cillian R. Mahony, Johnathon M. Aho, and Juna Musa
- Subjects
Pulmonary and Respiratory Medicine ,Atmospheric air ,medicine.medical_specialty ,Capnography ,medicine.diagnostic_test ,business.industry ,Decompression ,Needle decompression ,Atelectasis ,General Medicine ,medicine.disease ,Tension pneumothorax ,Thoracostomy ,respiratory tract diseases ,Cardiac surgery ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business - Abstract
Tension pneumothorax is a life-threatening condition that can develop when either the visceral pleura is disrupted, or with injury to the tracheobronchial tree. Rapid, accurate diagnosis and appropriate management are required to prevent significant atelectasis, hypoxia, circulatory arrest, and ultimate patient demise. Needle decompression is the current standard of care for the management of tension pneumothorax. Healthcare providers struggle to assess the success of decompression due to a lack of any immediate objective feedback. The gaseous composition of tension pneumothorax is similar to that of end respiratory gas. This includes an increased partial pressure of carbon dioxide in comparison to atmospheric air, which makes colorimetric capnography an ideal confirmatory test. This colorimetric capnography device may help the healthcare providers to make an objective and accurate assessment of the success of the needle decompression, in particular in prehospital environments.
- Published
- 2021
48. Predictive factors and economic impact of prolonged air leak after pulmonary resection
- Author
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Kazuo Nakagawa, Shun-ichi Watanabe, Masaya Yotsukura, Yukihiro Yoshida, and Yu Okubo
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Bilobectomy ,Pneumonectomy ,Postoperative Complications ,Risk Factors ,Internal medicine ,medicine ,Humans ,Lung cancer ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Postoperative complication ,General Medicine ,Odds ratio ,medicine.disease ,humanities ,Cardiac surgery ,Cardiothoracic surgery ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Prolonged air leak (PAL) is one of the most common complications after pulmonary resection for lung cancer. This study aimed to identify the factors that predict PAL, and to evaluate the impact of PAL on the development of additional complications and cost of hospitalization.A total of 2278 patients who underwent pulmonary resection other than pneumonectomy for lung cancer from 2014 to 2018 were retrospectively enrolled in this study. PAL was defined as air leak that continued more than 5 days after the operation. Multivariate analyses were conducted to identify significant predictors of PAL, using clinical information. Development of complications other than PAL, and cost of hospitalization care were also analyzed.PAL was observed in 91 (4.0%) cases. Multivariate logistic regression analysis revealed that the presence of intrathoracic adhesion (odds ratio [OR] 4.476, p 0.001), smoking history 20 pack-year (OR 2.441, p = 0.005), male sex (OR 2.269, p = 0.013), and lobectomy or bilobectomy (OR 1.935, p = 0.025) were significant risk factors for PAL. The presence of PAL was related to the development of additional complications (p 0.001). The cost of hospitalization care in patients with PAL was about 1.3 times higher than that in patients without PAL (p 0.001).PAL is related to additional complications and higher cost of hospitalization care. Surgeons should pay careful attention to minimize the incidence of PAL in patients with risk factors including intrathoracic adhesion, history of heavy smoking, male sex, and lobectomy or bilobectomy.
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- 2021
49. Relationships between coronary arteries and atrioventricular annuli: surgical and percutaneous implications
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Emilie Chessel, Olivier Chavanon, Fahd Bennani, Prune Grimont, Dylan Cavallo, Alexandre Sebestyen, Matthias Nocenti, Nicolas Tardy, Nael Ghaffar, and Philippe Chaffanjon
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Coronary Angiography ,medicine.artery ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,Myocardial infarction ,Circumflex ,Atrioventricular valve ,business.industry ,Mitral Valve Insufficiency ,General Medicine ,medicine.disease ,Coronary Vessels ,Cardiac surgery ,Coronary arteries ,medicine.anatomical_structure ,Cardiothoracic surgery ,Right coronary artery ,cardiovascular system ,Cardiology ,Mitral Valve ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Atrioventricular valve surgery poses a risk of myocardial infarction due to the proximity of the coronary arteries. Percutaneous techniques also present a risk of coronary injury. Our objective was to identify, on the mitral and the tricuspid annuli, the zones of high risk given their proximity to the circumflex artery and the right coronary artery, respectively. We dissected the courses of the circumflex artery and the right coronary artery in 25 explanted hearts. The distances were measured at reference points according to a clock-face model. Proximity was “very high”, “high”, or “relative” for distances of less than 5 mm, between 5 and 10 mm, or more than 10 mm, respectively. The mitral annulus zone of “high” proximity was located between “7:30” and “10:00” (minimum 6.5 mm at “9:30”). The tricuspid annulus zone of “very high” proximity was located between “1:30” and “3:00” (minimum 4.0 mm at “2:00”). The circumflex artery seemed closer to the mitral annulus in the hearts with left coronary dominance (n = 2), emphasizing the importance of the preoperative coronary angiography. Zones at risk of coronary damage were identified on the mitral and the tricuspid annuli between “7:30” and “10:00”, and between “1:30” and “3:00”, respectively. Knowing them can help interventionists avoid ischemic complications. Based on an innovative clock-face orientation scheme in which the distance data were collected at multiple reference points on a superimposed template, our study provides an intuitive and detailed overview of the critical distances between valves and arteries.
- Published
- 2021
50. Acute mitral valve endocarditis at the 24th gestational week
- Author
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Masuda, Zenichi, Miyamoto, Yosuke, Une, Dai, Inoue, Yoshinori, Tateishi, Atsushi, Yokota, Yutaka, Nakai, Mikizo, and Okada, Masahiro
- Published
- 2020
- Full Text
- View/download PDF
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