We experienced a case of papillary fibroelastoma of aortic valve, which had been located for preoperative 12 years without any symptom. We could assess tumor growth rate of 0.17 mm/year. Because of recent reports of recurrence, close follow-up should be continued.
{"title":"[Aortic Valve Papillary Fibroelastoma Stated for Preoperative Twelve Years without Any Symptom: Report of a Case].","authors":"Masashi Toyama, Masato Nakayama, Sho Akita, Takahito Tomida, Yoshifumi Arai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We experienced a case of papillary fibroelastoma of aortic valve, which had been located for preoperative 12 years without any symptom. We could assess tumor growth rate of 0.17 mm/year. Because of recent reports of recurrence, close follow-up should be continued.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shunsuke Kimishima, Satoshi Uesugi, Soki Kurumisawa, Kei Aizawa, Koji Kawahito
A 63-year-old woman with severe aortic regurgitation was admitted to our hospital due to congestive heart failure. She also had antiphospholipid syndrome (APS), necessitating strict coagulation management. Given her history of cerebellar infarction, deep vein thrombosis, and recurrent miscarriages, her thrombosis risk was higher, with all three types of antiphospholipid antibodies testing positive. Before the surgery, we created a heparin-activated clotting time (ACT) titration curve using the patient's blood, and the calculated ACT corresponding to the target heparin concentration of 3 U/ml was 650 seconds. We planned to administer heparin according to this target during cardiopulmonary bypass. The patient underwent an aortic valve replacement (AVR) using a bioprosthesis and was discharged without complications.
{"title":"[Coagulation Management During Open Heart Surgery Based on a Heparin Dose Sensitivity Test for Antiphospholipid Antibody Syndrome].","authors":"Shunsuke Kimishima, Satoshi Uesugi, Soki Kurumisawa, Kei Aizawa, Koji Kawahito","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 63-year-old woman with severe aortic regurgitation was admitted to our hospital due to congestive heart failure. She also had antiphospholipid syndrome (APS), necessitating strict coagulation management. Given her history of cerebellar infarction, deep vein thrombosis, and recurrent miscarriages, her thrombosis risk was higher, with all three types of antiphospholipid antibodies testing positive. Before the surgery, we created a heparin-activated clotting time (ACT) titration curve using the patient's blood, and the calculated ACT corresponding to the target heparin concentration of 3 U/ml was 650 seconds. We planned to administer heparin according to this target during cardiopulmonary bypass. The patient underwent an aortic valve replacement (AVR) using a bioprosthesis and was discharged without complications.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 51-year-old man visited to our hospital because of chest discomfort and hematemesis. He was diagnosed with Mallory-Weiss syndrome and followed in outpatient clinic. One week later, he visited our hospital again for fever and discomfort. Chest computed tomography (CT) showed a foreign body perforated in the mediastinum in the upper esophagus, and he was urgently hospitalized for surgical removal of esophageal foreign body. Before surgery he vomited the esophageal foreign body with a lot of blood. Hematemesis was stopped spontaneously and contrast-enhanced CT revealed a pseudoaneurysm in the distal aortic arch, so thoracic endovascular aortic repair (TEVAR) was performed to prevent rupture. Esophageal endoscopy found that the site of esophageal injury healed spontaneously, so the patient was followed conservatively with antibiotics. He was discharged on postoperative day 18 uneventfully. TEVAR was an effective treatment for aortic injury caused by esophageal foreign body in our case.
{"title":"[Endovascular Repair of Aortic Injury Caused by Esophageal Foreign Body:Report of a Case].","authors":"Masahito Saito, Hiroki Nakamura, Ryohei Tsuji, Naoki Asano, Kazunori Ota, Kazuho Niimi, Hironaga Ogawa, Kei Torikai, Hiroshi Takano, Koichi Toda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 51-year-old man visited to our hospital because of chest discomfort and hematemesis. He was diagnosed with Mallory-Weiss syndrome and followed in outpatient clinic. One week later, he visited our hospital again for fever and discomfort. Chest computed tomography (CT) showed a foreign body perforated in the mediastinum in the upper esophagus, and he was urgently hospitalized for surgical removal of esophageal foreign body. Before surgery he vomited the esophageal foreign body with a lot of blood. Hematemesis was stopped spontaneously and contrast-enhanced CT revealed a pseudoaneurysm in the distal aortic arch, so thoracic endovascular aortic repair (TEVAR) was performed to prevent rupture. Esophageal endoscopy found that the site of esophageal injury healed spontaneously, so the patient was followed conservatively with antibiotics. He was discharged on postoperative day 18 uneventfully. TEVAR was an effective treatment for aortic injury caused by esophageal foreign body in our case.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ikumi Osawa, Yasutoshi Tsuda, Atomu Hino, Takahito Yokoyama, Masato Nakajima
Purpose: We investigated the relationship between aortic remodeling and timing of thoracic endovascular aortic repair( TEVAR) in patients with uncomplicated Stanford type B aortic dissection.
Methods: 29 patients with sub-acute and early chronic uncomplicated Stanford type B aortic dissection underwent TEVAR between February 2019 and August 2022 in our hospital. We retrospectively compared aortic remodeling between 19 patients in the sub-acute( SA) group( 15-90 days from onset) and 10 patients in the early chronic( ECh) group( 91-365 days from onset) using the false luminal area reduction rate using computed tomography imagings.
Results: The false lumen area reduction rates at the level of the carina in the SA and ECh groups were 21.9±13.5% and 7.0±21.2% (p=0.04) around 3-8 days after TEVAR, 91.8±13.8% and 62.6±48.4 % (p=0.26) at 6 months, 96.6±7.2% and 68.7±42.5% (p=0.14) at 12 months, and 96.2±10.0% and 79.2±37.6% (p=0.62) at 18 months respectively. There were no significant differences between the two groups regarding any complication.
Conclusion: Preemptive TEVAR for sub-acute and early chronic uncomplicated Stanford type B aortic dissection resulted in good remodeling and it may provide a good prognosis, especially in the subacute stage.
{"title":"[Aortic Remodeling in Uncomplicated Stanford Type B Aortic Dissection Stratified by The Timing of Thoracic Endovascular Aortic Repair:A Retrospective Cohort Study].","authors":"Ikumi Osawa, Yasutoshi Tsuda, Atomu Hino, Takahito Yokoyama, Masato Nakajima","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the relationship between aortic remodeling and timing of thoracic endovascular aortic repair( TEVAR) in patients with uncomplicated Stanford type B aortic dissection.</p><p><strong>Methods: </strong>29 patients with sub-acute and early chronic uncomplicated Stanford type B aortic dissection underwent TEVAR between February 2019 and August 2022 in our hospital. We retrospectively compared aortic remodeling between 19 patients in the sub-acute( SA) group( 15-90 days from onset) and 10 patients in the early chronic( ECh) group( 91-365 days from onset) using the false luminal area reduction rate using computed tomography imagings.</p><p><strong>Results: </strong>The false lumen area reduction rates at the level of the carina in the SA and ECh groups were 21.9±13.5% and 7.0±21.2% (p=0.04) around 3-8 days after TEVAR, 91.8±13.8% and 62.6±48.4 % (p=0.26) at 6 months, 96.6±7.2% and 68.7±42.5% (p=0.14) at 12 months, and 96.2±10.0% and 79.2±37.6% (p=0.62) at 18 months respectively. There were no significant differences between the two groups regarding any complication.</p><p><strong>Conclusion: </strong>Preemptive TEVAR for sub-acute and early chronic uncomplicated Stanford type B aortic dissection resulted in good remodeling and it may provide a good prognosis, especially in the subacute stage.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The patient is a 77-year-old man. He was referred to our hospital after a chest computed tomography (CT) scan revealed a 6.5 cm-sized mass in the right lung apex. Bronchoscopy revealed adenocarcinoma, clinical stageⅡB, and the patient was referred for surgery. Preoperative 3D-CT revealed the presence of a displaced bronchus, probably B1a, branching from the right main bronchus centrally from the upper lobe bronchus, and an abnormal vessel (V2) running dorsal to the upper lobe bronchus and the right main bronchus, and returning directly to the left atrium. Surgery was performed by resectioning the right upper lobe through a posterolateral incision, combined resection of the wall pleura, and lymph node dissection (ND2a-2). Because lung cancer surgery is sometimes accompanied by abnormal bronchial and pulmonary vascular branches, it is essential to thoroughly examine the patient before surgery for checking abnormal branches by bronchoscopy and 3D-CT.
{"title":"[Resected Right Upper Lobe Lung Cancer with Displaced Bronchus and Anomalous Pulmonary Vein].","authors":"Ryotaro Katsuya, Keiyu Sato, Junzo Ishida, Ryo Yamashita","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The patient is a 77-year-old man. He was referred to our hospital after a chest computed tomography (CT) scan revealed a 6.5 cm-sized mass in the right lung apex. Bronchoscopy revealed adenocarcinoma, clinical stageⅡB, and the patient was referred for surgery. Preoperative 3D-CT revealed the presence of a displaced bronchus, probably B1a, branching from the right main bronchus centrally from the upper lobe bronchus, and an abnormal vessel (V2) running dorsal to the upper lobe bronchus and the right main bronchus, and returning directly to the left atrium. Surgery was performed by resectioning the right upper lobe through a posterolateral incision, combined resection of the wall pleura, and lymph node dissection (ND2a-2). Because lung cancer surgery is sometimes accompanied by abnormal bronchial and pulmonary vascular branches, it is essential to thoroughly examine the patient before surgery for checking abnormal branches by bronchoscopy and 3D-CT.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Lung segment anatomy is complex and difficult for medical students to comprehend, so education is a challenging issue. Three-dimensional (3D) models may be a more effective teaching tool for medical students. We evaluated the usefulness of 3D models in education for segmentectomy.
Methods: Sixty-six students who participated in clinical training for thoracic surgery from November 2020 to March 2022 were included in the study. Computed tomography (CT) images, 3D-CT images, and 3D models were used to investigate students' level of understanding for each lung segment. Levels of understanding were assessed using a questionnaire administered using the interview method. The results of the questionnaire were tabulated and analyzed using the Kruskal-Wallis test.
Results: The response rate was 100%. Comprehension scores for all questions were highest for 3D models, followed by 3D-CT and CT. These results suggest that use of a 3D entity model may have a high educational effect.
Conclusion: Although it is unclear whether students' comprehension was directly related to their understanding of correct anatomy, our results suggest that 3D models may be an effective way for medical students to understand lung segmentectomy.
{"title":"[Educational Impact of Using Three-dimentional Models for Preoperative Simulation of Segmentectomy for Medical Students].","authors":"Satoshi Takamori, Chikara Nakagami, Marina Nakatsuka, Hikaru Watanabe, Jun Suzuki, Makoto Endo, Satoshi Shiono","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Lung segment anatomy is complex and difficult for medical students to comprehend, so education is a challenging issue. Three-dimensional (3D) models may be a more effective teaching tool for medical students. We evaluated the usefulness of 3D models in education for segmentectomy.</p><p><strong>Methods: </strong>Sixty-six students who participated in clinical training for thoracic surgery from November 2020 to March 2022 were included in the study. Computed tomography (CT) images, 3D-CT images, and 3D models were used to investigate students' level of understanding for each lung segment. Levels of understanding were assessed using a questionnaire administered using the interview method. The results of the questionnaire were tabulated and analyzed using the Kruskal-Wallis test.</p><p><strong>Results: </strong>The response rate was 100%. Comprehension scores for all questions were highest for 3D models, followed by 3D-CT and CT. These results suggest that use of a 3D entity model may have a high educational effect.</p><p><strong>Conclusion: </strong>Although it is unclear whether students' comprehension was directly related to their understanding of correct anatomy, our results suggest that 3D models may be an effective way for medical students to understand lung segmentectomy.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We experienced a case of surgical aortic valve re-replacement due to structural valve deterioration caused by pannus formation 4 years after transcatheter aortic valve replacement( TAVR). The patient underwent surgery because the mean transvalvular pressure gradient increased to 48 mmHg on echocardiography. Contrast-enhanced computed tomography (CT) was useful for predicting the site of adhesion to surrounding tissue preoperatively and exploring the presence of the pannus. Intraoperative findings showed the TAVR valve was covered with neointima except around the origins of the left and right coronary arteries and was firmly adhered to the surrounding tissues. As residual pannus was present in the subvalvular tissues, it was carefully removed. The explanted TAVR valve functioned well with good opening and closure. The postoperative course was uneventful. Pannus formation can result from mechanical stress. TAVR valves put significantly greater stress on the left ventricular outflow tract than surgical valves and may be more likely to cause pannus formation.
{"title":"[Left Ventricular Outflow Tract Obstruction After Transcatheter Aortic Valve Replacement due to Pannus Formation].","authors":"Makoto Matsuura, Satoshi Kuroyanagi, Onichi Furuya, Norihiko Hiramatsu, Tetsushi Takemoto, Masaaki Kobayashi, Shintaro Okuda, Kazuya Hashimoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We experienced a case of surgical aortic valve re-replacement due to structural valve deterioration caused by pannus formation 4 years after transcatheter aortic valve replacement( TAVR). The patient underwent surgery because the mean transvalvular pressure gradient increased to 48 mmHg on echocardiography. Contrast-enhanced computed tomography (CT) was useful for predicting the site of adhesion to surrounding tissue preoperatively and exploring the presence of the pannus. Intraoperative findings showed the TAVR valve was covered with neointima except around the origins of the left and right coronary arteries and was firmly adhered to the surrounding tissues. As residual pannus was present in the subvalvular tissues, it was carefully removed. The explanted TAVR valve functioned well with good opening and closure. The postoperative course was uneventful. Pannus formation can result from mechanical stress. TAVR valves put significantly greater stress on the left ventricular outflow tract than surgical valves and may be more likely to cause pannus formation.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a case of bioprosthetic valve dysfunction and acute aortic valve regurgitation. The case was a 75-year-old female who had sudden onset chest pain. ST-segment depression in several leads on electrocardiogram( ECG) suggested acute coronary syndrome. Coronary angiography showed no significant stenosis in coronary arteries. Transesophageal echocardiography revealed severe aortic regurgitation, suggesting that angina was caused by myocardial ischemia associated with acute aortic regurgitation. She was diagnosed as having bioprosthetic valve dysfunction, and underwent redo aortic valve replacement. One leaflet of the bioprosthetic valve was torn along the stent post and caused bioprosthetic valve dysfunction. Failed bioprosthetic valve was removed and replaced by a mechanical valve.
我们报告了一例生物人工瓣膜功能障碍和急性主动脉瓣反流的病例。病例为一名 75 岁女性,突发胸痛。心电图上多个导联的 ST 段压低提示急性冠脉综合征。冠状动脉造影显示冠状动脉无明显狭窄。经食道超声心动图显示主动脉瓣严重反流,这表明心绞痛是由急性主动脉瓣反流导致的心肌缺血引起的。她被诊断为生物人工瓣膜功能障碍,并接受了主动脉瓣置换术。生物人工瓣膜的一片瓣叶沿着支架柱撕裂,导致生物人工瓣膜功能障碍。失败的生物人工瓣膜被移除,取而代之的是一个机械瓣膜。
{"title":"[Sudden Chest Pain due to Early Bioprosthetic Valve Dysfunction:Report of a Case].","authors":"Masato Yamakawa, Yukifusa Yokoyama, Masao Yamada, Shinichi Ashida, Hiroki Hasegawa, Jun Yokote","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case of bioprosthetic valve dysfunction and acute aortic valve regurgitation. The case was a 75-year-old female who had sudden onset chest pain. ST-segment depression in several leads on electrocardiogram( ECG) suggested acute coronary syndrome. Coronary angiography showed no significant stenosis in coronary arteries. Transesophageal echocardiography revealed severe aortic regurgitation, suggesting that angina was caused by myocardial ischemia associated with acute aortic regurgitation. She was diagnosed as having bioprosthetic valve dysfunction, and underwent redo aortic valve replacement. One leaflet of the bioprosthetic valve was torn along the stent post and caused bioprosthetic valve dysfunction. Failed bioprosthetic valve was removed and replaced by a mechanical valve.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shotaro Hashimoto, Nanase Haga, Masato Morimoto, Yukiko Doi
A 74-year-old man was found a left completely atelectasis on chest X-ray. He had undergone left lower lobe resection because of an adenocarcinoma at the age of 58. Bronchoscopy revealed a tumor near the left upper lobe branch entry that obstructed the lumen, and a biopsy confirmed the diagnosis of adenocarcinoma. A left completion pneumonectomy was performed, but #4L and #10 lymph nodes could not be completely resected. Programmed cell death 1-ligand 1( PD-L1) was positive with tumor proportion score (TPS) 15%, so chemotherapy with pembrolizumab+pemetrexed+carboplatin was started about 1.5 months after surgery. Pancytopenia appeared from the seventh course and did not improve after discontinuation of chemotherapy, so we consulted to the hematologist. He was diagnosed as aplastic anemia by bone marrow biopsy. Aplastic anemia was unresponsive to treatment and chemotherapy could not be resumed. He died of exacerbation of lung cancer.
一名 74 岁的男子在胸部 X 光片上发现左肺完全无气。他在 58 岁时曾因腺癌接受过左下叶切除术。支气管镜检查发现,左上肺叶分支入口附近的肿瘤阻塞了管腔,活检证实了腺癌的诊断。患者接受了左侧完整肺切除术,但4L号和10号淋巴结未能完全切除。肿瘤比例评分(TPS)为15%,PD-L1(Programmed cell death 1-ligand 1)呈阳性,因此术后约1个半月开始接受pembrolizumab+培美曲塞+卡铂化疗。全血细胞减少症从第七个疗程开始出现,停止化疗后仍不见好转,于是我们请血液科医生会诊。通过骨髓活检,他被诊断为再生障碍性贫血。再生障碍性贫血对治疗无反应,无法恢复化疗。他死于肺癌恶化。
{"title":"[Adenocarcinoma with Aplastic Anemia as an Immune-related Adverse Event Caused by Pembrolizumab: Report of a Case].","authors":"Shotaro Hashimoto, Nanase Haga, Masato Morimoto, Yukiko Doi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 74-year-old man was found a left completely atelectasis on chest X-ray. He had undergone left lower lobe resection because of an adenocarcinoma at the age of 58. Bronchoscopy revealed a tumor near the left upper lobe branch entry that obstructed the lumen, and a biopsy confirmed the diagnosis of adenocarcinoma. A left completion pneumonectomy was performed, but #4L and #10 lymph nodes could not be completely resected. Programmed cell death 1-ligand 1( PD-L1) was positive with tumor proportion score (TPS) 15%, so chemotherapy with pembrolizumab+pemetrexed+carboplatin was started about 1.5 months after surgery. Pancytopenia appeared from the seventh course and did not improve after discontinuation of chemotherapy, so we consulted to the hematologist. He was diagnosed as aplastic anemia by bone marrow biopsy. Aplastic anemia was unresponsive to treatment and chemotherapy could not be resumed. He died of exacerbation of lung cancer.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Congenital pericardial defect is a rare congenital condition. It is often asymptomatic and discovered incidentally, frequently during autopsies, medical investigations, or surgery. Nevertheless, there are few reported cases of its discovery during lung cancer surgery. Lung cancer surgery can lead to changes in lung volume, potentially resulting in postoperative complications. Hence, it is crucial to consider potential complications and exercise caution when determining the course of action, taking into account the extent of the pericardial defect.
{"title":"[Congenital Pericardial Defect Incidentally Discovered During Lung Cancer Surgery:Report of Two Cases].","authors":"Kyo Hirayama, Masahiro Matsuno, Katsuyuki Suzuki, Nobuo Tsunooka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Congenital pericardial defect is a rare congenital condition. It is often asymptomatic and discovered incidentally, frequently during autopsies, medical investigations, or surgery. Nevertheless, there are few reported cases of its discovery during lung cancer surgery. Lung cancer surgery can lead to changes in lung volume, potentially resulting in postoperative complications. Hence, it is crucial to consider potential complications and exercise caution when determining the course of action, taking into account the extent of the pericardial defect.</p>","PeriodicalId":17841,"journal":{"name":"Kyobu geka. The Japanese journal of thoracic surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}