BACKGROUND: Video assisted thoracic sympathectomy or sympathicotomy is a safe and effective therapy for the treatment of palmar hyperhidrosis with immediate symptomatic imporvement. However the degree of satisfaction may diminish with time due to cmpensatory sweating or excessive hand dryness. Therefore by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathectomy or sympathicotomy at various levels we aim to determine the optimal level of sympathetic nerve block which will result in minimal side effects and maximal benefit. MATERIAL AND METHOD: Among 194 patients having undergone video assisted thoracic sympathectomy or sympathicotomy between January 1996 and June 1999, 137 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into three groups. Group I(n=61) ; patients having undergone T2,3,4 sympathectomy group II(35) ; patients having undergone T2 sympathicotomy and group III(41) ; patients having undergone limited T2 sympathicotomy which consist of block of interganglionic neuronal fiber on the third rib. The parameters studied comprised of pre- and post-operative palmar temperature change treatment satisfaction the degree of compensatory sweating or discomfort from palmar dryness postoperative complication and changes in plantar sweating. RESULT: There was no difference in age and sex among the groups and the mean postoperative elevation in palmar temperature was 21.59degrees C without any differences among the groups. Patients expressing satisfaction were 65.6%, 62.9% and 90.24% in groups I, II and III, respectively(p<0.05) Moderate to severe compensatory sweating was present in 65.6% 51.4%, and 24.39%, in group I, II, and III, respectively (p<0.05) Slight but comfortable amount of palmar humidness was expressed in decreasing order group III(41.6%) group I(24.6%) and group II(5.7%) (p<0.05) Ineffectiveness or recurrence was present in 5patients in group I(8.2%) 1 patient in group II(2.9%) and none in group III. With regards to plantar sweating decrease in sweating was expressed in 43 patients(31.4%) while similar degree of sweating in 61 patients(44.5%) and increase in sweating in another 33 patinets(24.1%). CONCLUSION: Limited T2 sympathicotomy resection of the lower interganglionic neuronal fiber of the second sympathetic ganglion on the third rib showed immediate effect in palmar hyperhidrosis and caused lesser compensatory sweating and hand dryness.
Autonomic Nerve Block ; Ganglia, Sympathetic ; Hand ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Neurons ; Postoperative Complications ; Surveys and Questionnaires ; Recurrence ; Ribs ; Sweat ; Sweating ; Sympathectomy

Spontaneous non-traumatic rupture of thoracic aorta is a vary rare, life-threatening condition for which emergency surgery is indicated. We eport a case of spontaneous aortic rupture diagnosed with computed tomogram and transesophageal echocardiogram which was successfully treated by emergency hemi-arch replacement.
Aorta, Thoracic* ; Aortic Rupture ; Emergencies ; Rupture*

Sliding annuloplasty has been used for mitral valve repair in conjunction with posterior leaflet quadrangular resection to avoid systolic anterior motion of the anterior leaflet of the mitral valve. Herein, we report on a case of successful mitral valve repair with using the annular plication technique to facilitate sliding annuloplasty and extensive quadrangular resection was also done for treating a Marfan's syndrome patient who had an extremely redundant leaflet and a severely dilated annulus.
Humans ; Marfan Syndrome* ; Mitral Valve

The da Vinci telemanipulator system (Intuitive Surgical, Sunnyvale, CA USA) is the most advanced robotic surgical system and has been increasingly used for cardiac surgical procedures. We report out first clinical experience of use of the da Vinci telemanipulator system for endoscopic harvesting of the bilateral thoracic artery and multi-vessel small thoracotomy off pump CABG for 3-vessel disease. The da Vinci telemanipulator system has been previously utilized primarily for mitral valve surgery.
Cardiac Surgical Procedures ; Mammary Arteries ; Mitral Valve ; Robotics ; Thoracic Arteries ; Thoracotomy

A 33-year-old man presented to the physician with epigastric discomfort. Computed tomography of the chest and echocardiography showed a mass in the left atrium; this mass was resected and diagnosed as myxoma. 12 months later, myxoma recurred in the right atrium, and it was resected without recurrence for 10 months until now. As there are only a few reports on recurred right atrial myxoma after left atrial myxoma, we report here on successful surgical removal of a recurred right atrial myxoma after resection of left atrial myxoma.
Adult ; Echocardiography ; Heart Atria ; Heart Neoplasms ; Humans ; Myxoma* ; Recurrence ; Thorax

As higher mortality rate and frequent incidence of morbidity, early surgical treatment is generally recommended for the multivalvular endocarditis. A 46-year-old female presented with high fever. Echocardiography showed the vegetation on pulmonic valve, tricuspid valve and mitral valve with a ventricular septal defect. Emergency operation was conducted due to uncontrolled infection. We present a clinical success of this rare case with review of the medical literature.
Echocardiography ; Emergencies ; Endocarditis ; Female ; Fever ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Middle Aged ; Mitral Valve ; Tricuspid Valve

A 61-year-old man presented with chest pain and ST elevation, and he underwent coronary angiography under the impression of acute myocardial infarction. Coronary intervention under intra-aortic balloon pumping was necessary due to his hemodynamic instability from the acute total occlusion of a large obtuse marginal branch. In spite of successful intervention, the cardiogenic shock persisted, and so extracoporeal membranous oxygenation was performed to treat this. Afterwards, the cardiogenic shock still persisted, and the auscultatory and echocardiographic findings revealed severe acute mitral valve regurgitation. Emergency mitral valve replacement was then performed. The ECMO and IABP were removed on the 2nd postoperative day. The patient was discharged on the 48th postoperative day.
Chest Pain ; Coronary Angiography ; Emergencies ; Extracorporeal Membrane Oxygenation ; Hemodynamics ; Humans ; Intra-Aortic Balloon Pumping ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Myocardial Infarction ; Oxygen ; Papillary Muscles ; Rupture ; Shock, Cardiogenic

Cardiac capillary hemangioma is an extremely rare benign tumor. We report a case of 13 year old male patient who was admitted for dyspnea. After we confirmed the right ventricular mass with moderate flow obstruction by echocardiogram, we performed complete resection of the mass through the right atrium and identified the capillary hemangioma with pathologic examination. Therefore, we report the case with literature review.
Adolescent ; Capillaries* ; Dyspnea ; Heart Atria ; Heart Neoplasms ; Heart Ventricles* ; Hemangioma ; Hemangioma, Capillary* ; Humans ; Male

We performed a hybrid procedure for a 58-year-old man with coronary artery disease and a left subclavian artery stenosis. He underwent left subclavian artery stenting and off-pump coronary artery bypass surgery, including grafting the in situ left internal mammary artery to the left anterior descending coronary artery. The post-operative coronary angiogram and computed tomography showed good patency of the graft and stent. He discharged at postoperative 8 days and he has been followed up for six month with an excellent clinical condition.
Chimera ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Mammary Arteries ; Middle Aged ; Stents ; Subclavian Artery ; Subclavian Steal Syndrome ; Transplants

A 64 year-old woman presented to our hospital because of syncope. Transesophageal echocardiography showed a 4.2x2.4 cm hypervascular mass in the left atrium. We assessed the mass to be a myxoma and we planned to excise the mass. The preoperative coronary angiography showed a feeding artery with an inner diameter of 2mm originating from the left circumflex coronary artery, so we excised the mass and clipped the feeding artery with two clips at the epicardium with a good result.
Arteries* ; Coronary Angiography ; Coronary Vessels* ; Echocardiography, Transesophageal ; Female ; Heart Atria ; Heart Neoplasms ; Humans ; Middle Aged ; Myxoma* ; Pericardium ; Syncope