Treatment of Primary Spontaneous Pneumothorax Using a Commercialized 8-French Catheter (Pleuracan(R)) / 대한흉부외과학회지

Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter (Pleuracan(R)) for the initial treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P (Pleuracan(R) group). RESULT: Initially, the Pleuracan(R) catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%); three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time (T: 2.1+/-1.5 days, P: 2.1+/-1.3 days), hospital stay (T: 6.4+/-5.4 days, P: 5.2+/-2.9 days) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy (T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage (T: 0.5+/-0.7 days, P: 0.5+/-1.2 days) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. CONCLUSION: Application of the Pleuracan(R) catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.

Risk Factors of Atrial Fibrillation after Coronary Artery Bypass Grafting / 대한흉부외과학회지

BACKGROUND: Postoperative atrial fibrillation is the most frequently arrhythmic complication associated with coronary artery bypass graft surgery. This study was designed to investigate the incidence of atrial fibrillation in patients undergoing OPCAB and on-pump CABG and to identify the risk factors associated with its development. MATERIAL AND METHOD: 247 consecutive patients were evaluated among 306 patients who underwent the coronary artery bypass graft surgery between January, 2002 and December, 2005. 178 patients underwent OPCAB (OPCAB group) and 69 patients underwent On-pump CABG (On-pump CABG group). The incidence and the risk factors of atrial fibrillation in two groups were determined. RESULT: There were no significant differences between two groups with respect to the preoperative demographic characteristics of the patients. The incidences of postoperative atrial fibrillation were 25 cases (14%) in OPCAB group and 15 cases (21%) in On-pump CABG group. Age over 65 years, net positive fluid imbalance for postoperative 3 days, and chest tube bleeding for postoperative 3 days were independent predictive factors in OPCAB group. Age over 65 years and net positive fluid imbalance for postoperative 3 days were independent predictive factors in On-pump CABG group. In multivariate analysis, age over 65 years was the only risk factor of postoperative atrial fibrillation in both groups. CONCLUSION: Atrial fibrillation is a common complication after procedures of myocardial revascularization. There wasn't a low incidence of postoperative atrial fibrillation in OPCAB, compared with On-pump CABG. Age over 65 years was associated with postoperative atrial fibrillation irrespective of the use of cardiopulmonary bypass.