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Minimally invasive cardiac surgery off-pump coronary artery bypass (MICSOPCAB) has become increasingly prevalent, with devices like the heart positioner aiding in surgical precision. However, rare complications such as epicardial hematoma can occur. Here, we present a case of a 75-year-old man undergoing MICSOPCAB who developed an epicardial hematoma due to the heart positioner. The hematoma was successfully repaired intraoperatively with direct suturing and large felts. Postoperative recovery was uneventful, highlighting the importance of vigilant monitoring and prompt management of such complications. This case underscores the need for careful attention during the use of cardiac positioners to minimize adverse events and ensure favorable patient outcomes. [ABSTRACT FROM AUTHOR]

Objectives: We would like to present our experience in repairing all types of atrial septal defect at Lampang Regional Hospital. In this study we also report the results of conventional and on-pump beating heart technique. Methods: From January 2010 to April 2015, 124 patients underwent atrial septal defect closure. There were 91 females and 33 males, with mean age 36.2 (range, 3 months-75 years). Results: The operation was performed with conventional technique in 45 patients compared to beating heart in 79 patients. The mean cardiopulmonary bypass time was 41.15 minutes in patients with conventional closure technique without tricuspid valve repair and 32.55 minutes in patients with beating heart closure technique without tricuspid valve repair. There was no death, no stroke and no residual shunt in all patients. The mean ICU stay was less than 24 hours in all patients. Conclusion: Repair of atrial septal defect at Lampang Regional Hospital is safe with no stroke or death. Repair of atrial septal defect secundum type with beating heart under cardiopulmonary bypass technique is an alternative technique that is also safe and can avoid ischemic-reperfusion injury. [ABSTRACT FROM AUTHOR]

Objective: Conventional coronary artery bypass grafting (CABG) is the standard treatment for patients with coronary artery heart disease. However, its major and life threatening complications include stroke and renal dysfunction. Off-pump coronary bypass grafting (OPCABG), by avoiding cardiopulmonary bypass, may reduce these compUcations. Patients and Methods: We retrospectively reviewed the records of 125 consecutive patients (male 59 cases, female 66 cases) who underwent elective OPCABG from April 2011 through September 2013.The mean age (sd) was 63.8±8.6 years. Left main disease was present in 24.8%. Preoperative renal insufficiency (Cr > 2.5 mg/dl) was seen in 20% of cases while previous stroke was found in 2.4%. Mean Euroscore (sd) was 6.65± 2.9. Results: Mean graft per patient (sd) was 3.4±1.1. The internal mammary artery was used in 84.8% of cases. Endarterectomy was performed in 11 patients (9.1%). Total arterial grafting was performed in 20 patients (16.0%). Conversion to on-pump technique occurred in 2 cases (1.6%); 2 patients died within 30 days (1.6%); and late deaths occurred in 4 cases (3.2%). Renal dysfunction requiring dialysis occurred in 1 (0.79%), and re-exploration for bleeding occurred in 2 cases (1.6%). There were no stroke events and no sternal wound infections. The mean foUow-up time (sd) was 16.4 ±11.03 months. Conclusions: Early results of OPCABG at Lampang hospital were promising, with no mortality and low morbidity. [ABSTRACT FROM AUTHOR]

Objective: To review the results of the first three years of experience in treating patients at the Cardiovascular and Thoracic Surgery Unit of Lampang Hospital, and to compare these results with those obtained from standard databases such as the first National Adult Cardiac Surgical Database Report 2011 of the Society of Thoracic Surgeons of Thailand, the Society of Cardiothoracic Surgeons of Great Britain and Ireland, and the Society of Thoracic Surgeons national database. Materials and Methods: We reviewed the medical records of the initial 766 cases of open heart surgery at Lampang Hospital between January 2010 and December 2012. Patient's demographic characteristics, preoperative New York Heart Association (NYHA) class, diagnosis of heart disease, operation, postoperative course, morbidity, and short-term follow up were reviewed. Results: There were 410 women and 356 men, with an average age of 44.5 years (range: from 12 days to 82 years). Among these, 76 patients (10 % ) were NYHA class 1,405 patients (53%) were NYHA class 2, 163 patients (21%) were NYHA class 3, and 122 patients (16 %) were NYHA class 4. Acquired heart disease was diagnosed in 660 patients (86%) and 106 patients (14 %) were diagnosed with congenital heart diseases. Extubation within 6 hours after operation could be achieved in 567 patients (74%) and 628 patients (82%) stayed in the ICU for only I day. Death within 30 days of operation occurred in 18 patients (2.3% mortality). Most of our patients were NYHA class 1 postoperatively. Conclusion: As a newly opened cardiothoracic surgery center, we provide our services to patients in an effective and timely manner while achieving acceptable morbidity and mortality rates for a variety of operative procedures. [ABSTRACT FROM AUTHOR]

A 57-year-old male presented with dyspnea and an enlarged cardiac silhouette on a chest X-ray. Further evaluation with contrast-enhanced computed tomography revealed a giant heterogeneous mediastinal mass, ~8.9 × 7.3 × 12.2 cm, with peripheral calcifications. Surgical resection was performed via a left thoracotomy approach using the left fifth intercostal space. Cardiopulmonary bypass was established through the femoral vessels for safer and more controlled resection. The tumor, contiguous with the left atrium, was successfully excised using two Endo GIA staplers. Pathological examination confirmed the diagnosis of schwannoma. This case demonstrates that the left thoracotomy approach with cardiopulmonary bypass and the use of Endo GIA staplers is a feasible and effective option for resecting large, well-defined cardiac schwannomas., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024.)

Introduction: This study aims to clarify the good inflow site for saphenous vein grafts (SVG) in minimally invasive off-pump coronary artery bypass grafting (mini-CABG), between the ascending aorta, the internal thoracic arteries (ITAs) and the left axillary artery (LAA)., Methods: This retrospective study included 126 patients who underwent Mini-CABG at our center between January 2014 and July 2023. Patients were divided into three groups according to the SVG inflow site for patency comparison: Aorta group ( n  = 56), LAA group ( n  = 23), and ITA group ( n  = 47)., Results: There were 84 males, with mean age of 65.9 ± 7.0 years. There were no significant differences in preoperative characteristics between groups. Mean operation times were 254.6 ± 72.2, 213.7 ± 57.6, and 253.0 ± 81.2 min, and the average numbers of distal anastomoses were 2.9 ± 0.9, 2.4 ± 0.7 and 2.9 ± 1.1 in the Aorta, ITA and LAA groups respectively. Days in intensive care, hospital stay, and major complications did not differ between the groups. Early patency of SVG did not significantly differ among groups: 93.0% in the Aorta group, 98.0% in the ITA group, and 100% in the LAA group. Mean follow-up period was 136.7 ± 295.7 days, and follow-up coronary CTA revealed 18 SVG occlusions (Aorta group n  = 8, ITA group n  = 5, LAA group n  = 5). The Kaplan-Meier curve for SVG patency rates did not show any significant differences among the three groups., Conclusion: The ascending aorta, the ITAs, and the LAA serve as reliable inflow sites with similar results in mini-CABG., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Ushioda, Hirofuji, Yoongtong, Sakboon, Cheewinmethasiri, Lokeskrawee, Patumanond, Lawanaskol, Kamiya and Arayawudhikul.)

Background: The roles of excision repair cross-complementing group 1 gene (ERCC1) expression and ribonucleotide reductase subunit M1 gene (RRM1) expression in completely resected non-small cell lung cancer (NSCLC) are still debatable. Previous studies have shown that both genes affected the overall survival and outcomes of patients who received platinum-based chemotherapy; however, some studies did not show this correlation. The aim of this study was to evaluate the prognostic values of ERCC1 and RRM1 gene expression in predicting tumor recurrence and overall survival in patients with completely resected NSCLC who received adjuvant chemotherapy and in those who did not., Patients and Methods: A retrospective cohort study was conducted in 247 patients with completely resected NSCLC. All patients had been treated with anatomic resection (lobectomy or pneumonectomy) with systematic mediastinal lymphadenectomy between January 2002 and December 2011 at Chiang Mai University Hospital, Chiang Mai, Thailand. They were divided into two groups: recurrence and no recurrence. Protein expression of ERCC1 and RRM1 was determined by immunohistochemistry. Correlations between clinicopathologic variables, including ERCC1 and RRM1 expression and tumor recurrence, were analyzed. Univariate and multivariate Cox proportional hazards regression analysis stratified by nodal involvement, tumor staging, intratumoral blood vessel invasion, intratumoral lymphatic invasion, and tumor necrosis was used to identify the prognostic roles of ERCC1 and RRM1., Results: ERCC1 and RRM1 expression did not demonstrate prognostic value for tumor recurrence and overall survival in patients with completely resected NSCLC. In patients who did not receive adjuvant chemotherapy treatment, those with high ERCC1 and high RRM1 expression seemed to have greater potential for tumor recurrence and shorter overall survival than did those who had low ERCC1 and low RRM1 (hazard ratio [HR] =1.7, 95% confidence interval [CI] =0.6-4.3, P=0.292 and HR =1.6, 95% CI =0.5-4.5, P=0.411, respectively). In contrast, in patients who received adjuvant chemotherapy treatment, those with high ERCC1 and high RRM1 expression seemed to have benefited from adjuvant chemotherapy and showed good overall survival compared with those who had low ERCC1 and low RRM1 (HR =0.8, 95% CI = 0.4-1.8, P=0.612 and HR = 0.4, 95% CI = 0.1-2.4, P=0.325, respectively). Subgroup analysis in patients whose first-line metastatic chemotherapy failed demonstrated that ERCC1 expression and RRM1 expression were not prognostic factors for tumor recurrence and overall survival; however, patients who had high ERCC1 and high RRM1 expression seemed to have benefited from first-line chemotherapy treatment (HR =0.7, 95% CI =0.3-1.8, P=0.458)., Conclusion: ERCC1 expression and RRM1 expression were not prognostic of tumor recurrence and overall survival in patients with completely resected NSCLC, either with or without adjuvant chemotherapy. Prospective studies that include a larger number of patients are needed for definite conclusions.