Journal of Yeungnam Medical Science

Original articles

Thoracic and Cardiovascular Surgery
Chest packing with negative pressure for refractory mediastinal bleeding after cardiac surgery: a low-cost, simple technique as an alternative to vacuum-assisted closure systems in a retrospective study: Hunbo Shim, Seok Soo Lee, Changseok Jeon, Tae Hee Won, Sang-Wan Ryu, JongHyun Baek; J Yeungnam Med Sci. 2026;43:49. Published online July 27, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.49 [Epub ahead of print]

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Abstract PDF: Background
Refractory mediastinal bleeding after cardiac surgery occasionally requires temporary open sternum and delayed sternal closure. We evaluated the feasibility and short‑term clinical performance of a modified chest‑gauze suction (c‑GSUC) technique that generates negative pressure using readily available materials.
Methods
We retrospectively reviewed 20 patients who underwent chest packing primarily for refractory bleeding following cardiac or thoracic aorta surgery. After routine drainage placement, gauze sponges were packed around the bleeding sites, and an additional temporary chest tube was positioned over the gauze. The open sternotomy was sealed with an adhesive drape and connected to a standard three-chamber drainage bottle to generate negative pressure and collapse the packed gauze.
Results
The median patient age was 57.0 years, and 19 patients (95.0%) underwent aorta-related procedures. Definitive chest closure was achieved within 2 days in 18 patients (90.0%). One patient (5.0%) required emergent washout for cardiac tamponade during open chest management. One patient (5.0%) developed mediastinitis after closure. Two patients (10.0%) died during hospitalization, one from septic shock and the other from intracranial hemorrhage.
Conclusion
Temporary open sternum with negative‑pressure gauze packing using the c‑GSUC technique was feasible in patients with refractory mediastinal bleeding and was associated with acceptable short‑term outcomes. Although less sophisticated than commercial vacuum-assisted closure systems, this simple and inexpensive approach may be a practical alternative in selected cases.

Thoracic and Cardiovascular Surgery
Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center study: Eun Yeung Jung, Ji Eun Im, Ho-Ki Min, Seok Soo Lee; J Yeungnam Med Sci. 2024;41(3):213-219. Published online June 12, 2024; DOI: https://doi.org/10.12701/jyms.2024.00290

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Abstract PDF: Background
Aortic valve replacement (AVR) has recently been performed at many centers using a minimally invasive approach to reduce postoperative mortality, morbidity, and pain. Most previous reports on minimally invasive AVR (MiAVR) have mainly focused on aortic stenosis, and those exclusively dealing with aortic regurgitation (AR) are few. The purpose of this study was to investigate early surgical results and review our experience with patients with chronic severe AR who underwent AVR via right anterior mini-thoracotomy (RAT).
Methods
Data were retrospectively collected in this single-center study. Eight patients who underwent RAT AVR between January 2020 and January 2024 were enrolled. Short-term outcomes, including the length of hospital stay, in-hospital mortality, postoperative complications, and echocardiographic data, were analyzed.
Results
No in-hospital mortalities were observed. Postoperative atrial fibrillation occurred temporarily in three patients (37.5%). However, none required permanent pacemaker implantation or renal replacement therapy. The median values of ventilator time, length of intensive care unit stay, and hospital stay were 17 hours, 34.5 hours, and 9 days, respectively. Preoperative and postoperative measurements of left ventricular ejection fraction were similar. However, the left ventricular end systolic and diastolic diameters significantly decreased postoperatively from 42 mm to 35.5 mm (p=0.018) and 63 mm to 51 mm (p=0.012), respectively.
Conclusion
MiAVR via RAT is a safe and reproducible procedure with acceptable morbidity and complication rates in patients with chronic severe AR. Despite some limitations such as a narrow surgical field and demanding learning curve, MiAVR is a competent method for AR.

Thoracic and Cardiovascular Surgery
Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study: Ji Eun Im, Eun Yeung Jung, Seok Soo Lee, Ho-Ki Min; J Yeungnam Med Sci. 2024;41(2):96-102. Published online February 26, 2024; DOI: https://doi.org/10.12701/jyms.2023.01228

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2 Web of Science
3 Crossref

Abstract PDF

Background
The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease.
Methods
In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed.
Results
There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001).
Conclusion
In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

Citations

Citations to this article as recorded by

Selection of patients for aortic valve replacement via right anterior minithoracotomy based on different CT criteria
I.V. Dvadtsatov, R.S. Tarasov, T.B. Pecherina, A.A. Akimov, A.I. German
Russian Journal of Cardiology and Cardiovascular Surgery.2026; 19(1): 38. CrossRef
Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center study
Eun Yeung Jung, Ji Eun Im, Ho-Ki Min, Seok Soo Lee
Journal of Yeungnam Medical Science.2024; 41(3): 213. CrossRef
Sutureless Aortic Prosthesis Valves versus Transcatheter Aortic Valve Implantation in Intermediate Risk Patients with Severe Aortic Stenosis: A Literature Review
Laura Asta, Adriana Sbrigata, Calogera Pisano
Journal of Clinical Medicine.2024; 13(18): 5592. CrossRef

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Thoracic and Cardiovascular Surgery
Effective treatment of empyema thoracis caused by a ruptured large hepatic cyst: Seok Soo Lee, Hyuckgoo Kim; J Yeungnam Med Sci. 2023;40(3):315-316. Published online May 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00262

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PDF

Case report

Thoracic and Cardiovascular Surgery
Rectus abdominis muscle atrophy after thoracotomy: Jang Hoon Lee, Seok Soo Lee; Yeungnam Univ J Med. 2020;37(2):133-135. Published online November 27, 2019; DOI: https://doi.org/10.12701/yujm.2019.00381

12,564 View
132 Download
7 Crossref

Abstract PDF

Intercostal nerve injury is known to occur during thoracotomy; however, rectus abdominis muscle atrophy has rarely been reported. We describe a 52-year-old man who underwent primary closure of esophageal perforation and lung decortication via left thoracotomy. He was discharged 40 days postoperatively without any complications. He noticed an abdominal bulge 2 months later, and computed tomography revealed left rectus abdominis muscle atrophy. We report thoracotomy induced denervation causing rectus abdominis muscle atrophy.

Citations

Citations to this article as recorded by

Intercostal nerve injury after rib fractures: A case series correlating electrodiagnostic testing with imaging, ultrasound, and surgical findings
Matthew Sherrier, Dane Daley, Evert Eriksson
PM&R.2026; 18(5): 510. CrossRef
Rehabilitation strategies for abdominal wall reinnervation after intercostal nerve injury: A narrative review
Kian Bagheri, Alex Reid, Dane N Daley, Evert Eriksson, Melissa C Kolski, Matthew C Sherrier
Journal of International Medical Research.2026;[Epub] CrossRef
Sonographic anatomy of surgically acquired abdominal pseudohernia—A guide to the documentation of anterolateral integument denervation with ultrasound
Donna Napier
Sonography.2025; 12(1): 90. CrossRef
Anterior Abdominal Wall Pseudohernias After Anatomic Lung Resection: Incidence and Risk Factors
Andrew Behrmann, Blake Wojciechowski, Chase Schlesselman, Jussuf Kaifi, Sebastian Wiesemann
Annals of Thoracic Surgery Short Reports.2025; 3(3): 693. CrossRef
Rectus Abdominis Muscle Atrophy and Asymmetry After Pulmonary Lobectomy
Aidan S. Weitzner, Myan Bhoopalam, Jeffrey Khong, Arushi Biswas, Allison Karwoski, Meron Haile, Natalie Waldron, Resham Mawalkar, Anjana Srikumar, Stephen Broderick, Jinny Ha, Kristen P. Broderick
Journal of Surgical Research.2024; 299: 137. CrossRef
Intercostal nerve electrodiagnostic testing in rib fractures
Kristen Gambardella, Cody Ashy, Dane Daley, Evert Eriksson, Matthew Sherrier
Muscle & Nerve.2024;[Epub] CrossRef
Ingenuity of minimally invasive thoracoscopic lobectomy for undiagnosed pulmonary tumour
Sumitaka Yamanaka, Takashi Yoshimatsu, Takeaki Miyata, Hanae Higa
Respirology Case Reports.2020;[Epub] CrossRef

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