1.A Case Report of Mediastinitis after Subtotal Graft Replacement of the Thoracic Aorta.
Hidenori Yoshitaka ; Takato Hata ; Yoshimasa Tsushima ; Mitsuaki Matsumoto ; Souhei Hamanaka ; Atsushi Morishita ; Kohki Nakamura ; Susumu Shinoura ; Hitoshi Minami
Japanese Journal of Cardiovascular Surgery 1999;28(6):374-376
A 57-year-old man underwent subtotal graft replacement of the thoracic aorta for aneurysms of both the ascending and descending aorta. On the 20th post-operative day, pus was found to be draining from the sternotomy wound. The wound was opened and irrigated with 2% Povidoneiodine solution for a total of 3 months. Culture of the pus from the irrigation revealed Staphylococcus epidermidis. When there were no clinical indications of infection and wound cultures were negative, the necrotic sternum and surrounding tissue were debrided and an omental graft was placed in the cavity. Upon follow-up examination, the patient is doing well 10 months after the initial surgery.
2.A Case of Video-Assisted Thoracoscopic Surgery for Clipping the Patent Ductus Arteriosus in a Child.
Mitsuaki Matsumoto ; Takato Hata ; Kohki Nakamura ; Yoshimasa Tsushima ; Sohei Hamanaka ; Hidenori Yoshitaka ; Susumu Shinoura ; Hitoshi Minami ; Satoru Otani
Japanese Journal of Cardiovascular Surgery 2000;29(1):49-52
We performed a video-assisted thoracoscopic surgery (VATS) to clip the patent ductus arteriosus (PDA), which was 5mm in internal diameter, in an 11-year-old girl, who first underwent a coil embolization ending in failure. Under general anesthesia with one-lung ventilation in a right lateral decubitus position, four thoracostomies were made in the left hemithorax. The PDA was clipped by two titanium clips, the length of which is 11mm at closing. Transesophageal echocardiography confirmed the location of the PDA and the absence of a residual shunt. The patient showed neither left recurrent laryngeal nerve dysfunction nor hemorrhage after operation, and was discharged on the 9th postoperative day. The clipping of the PDA by VATS can be applied for PDA without calcification if the external diameter is up to 7mm. This technique was minimally invasive and reliable. It was excellent in terms of the high quality of life achieved by the patient.