Postpericardiotomy syndrome after thymothymectomy: report of two cases.

Two cases of postpericardiotomy syndrome (PPS) after thymothymectomy associated with pericardiotomy are described. The incidence of PPS in cardiac operations is reportedly 10-30%. Although no reports have been described in the English literature, our retrospective analysis revealed similar incidents following mediastinal tumor operation associated with pericardiotomy in cardiac surgery. Clinicians should thus be aware of this syndrome.

Successful resection of a massive mediastinal liposarcoma that rapidly extended into the entire left thoracic cavity: report of a case.

Primary mediastinal liposarcomas are rare malignancies, comprising fewer than 1% of all mediastinal tumors. We herein report a radical resection of a massive liposarcoma arising from the anterior mediastinum. A 63-year-old male patient presented with a 4-week history of dyspnea that had worsened over the previous several days. The patient had also experienced hoarseness for 2 weeks. Chest X-ray and computed tomography revealed a huge tumor occupying the entire left thoracic cavity. Anesthesia was induced when the patient was in the left semilateral position. The patient was moved into the right lateral position after initially stabilizing anesthesia with separate lung ventilation. The fourth rib was initially resected for thoracotomy, but there was no clearance between the tumor and the adjacent mediastinal structures, and two more ribs were therefore removed. The tumor had not invaded the other structures such as the chest wall, lung, or mediastinum. To reduce the tumor blood flow, the left internal mammary artery was ligated before the tumor was resected en bloc. The tumor was diagnosed as a liposarcoma arising from the thymus. The patient remains alive with no evidence of disease recurrence at 22 months after the operation.

Off-pump coronary artery bypass grafting in two renal transplant patients.

Coronary artery disease is a critical problem for a renal transplant patient. This paper reports off-pump coronary artery bypass grafting (OPCABG) in two cases after renal transplantation. The first, a 65-year-old woman, experienced chest pain 5 years after a renal transplantation. Coronary angiography (CAG) revealed stenosis of the left anterior descending artery (LAD) and the first diagonal artery (DB1). OPCABG [left internal thoracic artery (LITA) to DB1 and LAD] was performed. The second, a 67-year-old man, underwent percutaneous coronary intervention in the LAD 10 years ago. He experienced chest pain 2 years after a renal transplantation. CAG revealed restenosis of LAD. OPCABG (LITA to LAD) was performed. The patients' postoperative course was uneventful. OPCABG for a renal transplant patient was safe and useful since it is a less invasive procedure and easily managed perioperatively.

Simultaneous off-pump coronary artery bypass grafting and in vivo heterogenous renal transplantation. Considering results and indications.

Complications of arterial sclerosis lesions are found in patients in dialysis for end-stage chronic renal failure. We present a case of simultaneous coronary artery bypass grafting (CABG) and renal transplantation. A 64-year-old man was to undergo in vivo heterogenous renal transplantation for chronic renal failure. Angiography was undertaken for preoperative abnormal electrocardiography, which showed severe long segmental stenosis of the left anterior descending coronary artery. We discussed the possibility of simultaneous surgery, conducting off-pump CABG and renal transplantation at the same time. Postoperative management of the implanted kidney was easy despite high infusion. His postoperative course went well, without cardiac events. Simultaneous off-pump CABG and in vivo heterogenous thus provide a viable option for patients with comorbid disease.