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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/28063468/computational-fluid-dynamics-and-aortic-thrombus-formation-following-thoracic-endovascular-aortic-repair
#1
Foeke J H Nauta, Kevin D Lau, Christopher J Arthurs, Kim A Eagle, David M Williams, Santi Trimarchi, Himanshu J Patel, Carlos A Figueroa
BACKGROUND: We present the possible utility of computational fluid dynamics in the assessment of thrombus formation and virtual surgical planning illustrated in a patient with aortic thrombus in a kinked ascending aortic graft following thoracic endovascular aortic repair. METHODS: A patient-specific three-dimensional model was built from computed tomography. Additionally, we modeled 3 virtual aortic interventions to assess their effect on thrombosis potential: (1) open surgical repair, (2) conformable endografting, and (3) single-branched endografting...
January 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28027733/restricted-albumin-utilization-is-safe-and-cost-effective-in-a-cardiac-surgery-intensive-care-unit
#2
Joseph Rabin, Timothy Meyenburg, Ashleigh V Lowery, Michael Rouse, James S Gammie, Daniel Herr
BACKGROUND: Volume expansion is often necessary after cardiac surgery, and albumin is often administered. Albumin's high cost motivated an attempt to reduce its utilization. This study analyzes the impact limiting albumin infusion in a cardiac surgery intensive care unit. METHODS: This retrospective study analyzed albumin use between April 2014 and April 2015 in patients admitted to a cardiac surgery intensive care unit. During the first 9 months, there were no restrictions...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28027732/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-in-the-nodal-staging-of-stereotactic-ablative-body%C3%A2-radiotherapy-patients
#3
Macarena R Vial, Kashif A Khan, Oisin O'Connell, S Andrew Peng, Daniel R Gomez, Joe Y Chang, David C Rice, Reza Mehran, Carlos J Jimenez, Horiana B Grosu, David E Ost, George A Eapen
BACKGROUND: Patients with non-small cell lung cancer (NSCLC) being evaluated for stereotactic ablative body radiotherapy (SABR) are typically staged noninvasively with positron emission tomography/computed tomography (PET/CT). Incorporating endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) into the staging workup of these patients has not been evaluated. Our primary objective was to compare the performance of PET/CT with EBUS-TBNA for intrathoracic nodal assessment among SABR-eligible patients...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28027731/pathologic-findings-and-long-term-results-after-surgical-treatment-for-pulmonary-sarcomatoid-tumors-a-multicenter-analysis
#4
Filippo Lococo, Cristian Rapicetta, Giuseppe Cardillo, Alessandro Stefani, Stefano Margaritora, Giovanni Leuzzi, Giulio Rossi, Leonardo Petracca Ciavarella, Uliano Morandi, Francesco Facciolo, Tommaso Ricchetti, Alfredo Cesario, Massimiliano Paci
BACKGROUND: Pulmonary sarcomatoid carcinoma (PSC) is a very rare subtype of non-small cell lung cancer (NSCLC). The aim of this study was to clarify the pathologic characteristics and long-term survival after surgical treatment in patients with PSC. METHODS: From January 2003 to December 2013, we retrospectively reviewed the clinical findings, surgical notes, and pathologic and follow-up data from 148 consecutive patients who underwent curative resection for PSC in 5 institutions...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28027730/vancomycin-paste-does-not-reduce-the-incidence-of-deep-sternal-wound-infection-after-cardiac-operations
#5
Heather L Lander, Julius I Ejiofor, Siobhan McGurk, Kaneko Tsuyoshi, Prem Shekar, Simon C Body
BACKGROUND: Deep sternal wound infection (DSWI) is a devastating complication that increases morbidity and death in cardiac surgical patients. Vancomycin is often administered intravenously for antibiotic prophylaxis in cardiac operations. Many cardiac surgeons also apply vancomycin paste topically to the sternal edges. We examined the effect of vancomycin paste on the incidence of DSWI in patients undergoing elective cardiac operations. METHODS: We retrospectively reviewed the medical records of all patients from 2003 to 2015 who underwent coronary artery bypass grafting, valve, or combined coronary artery bypass grafting and valve operations at a single institution...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28024650/recoarctation-after-norwood-i-procedure-for-hypoplastic-left-heart-syndrome-impact-of-patch-material
#6
Keti Vitanova, Julie Cleuziou, Jelena Pabst von Ohain, Melchior Burri, Andreas Eicken, Rüdiger Lange
BACKGROUND: The development of recoarctation after the Norwood I procedure is a known complication in patients with hypoplastic left heart syndrome (HLHS). METHODS: We reviewed data on 194 consecutive patients with HLHS who underwent the Norwood I procedure between 2000 and 2015. All patients who survived until the second stage of the procedure were included. Recoarctation was defined by the need for intervention, either catheter based or surgical. The aim of our study was to determine if the patch material used for the initial arch reconstruction had an influence on the development of recoarctation...
December 23, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28024649/management-strategy-for-patients-with-chronic-subclavian-vein-thrombosis
#7
REVIEW
Graham Keir, M Blair Marshall
We performed a systematic review to determine best practice for the management of patients with chronic or subacute subclavian vein thrombosis. This condition is best managed with surgical excision of the first rib followed by long-term anticoagulation. Interventional techniques aimed at restoring patency are ineffective beyond 2 weeks postthrombosis. Additional therapeutic options should be made based on the severity of symptoms as well as vein status. Patients with milder symptoms are given decompression surgery followed by anticoagulation whereas patients with more severe symptoms are considered for either a jugular vein transposition or saphenous patch based on the vein characteristics...
December 23, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28024648/extent-of-lymphadenectomy-is-associated-with-improved-overall-survival-after-esophagectomy-with-or-without-induction%C3%A2-therapy
#8
Pamela Samson, Varun Puri, Stephen Broderick, G Alexander Patterson, Bryan Meyers, Traves Crabtree
BACKGROUND: National Comprehensive Cancer Network (NCCN) guidelines recommend sampling 15 or more lymph nodes during esophagectomy. The proportion of patients meeting this guideline is unknown, as is its influence on overall survival (OS). METHODS: Univariate analysis and logistic regression were performed to identify variables associated with sampling 15 or more lymph nodes among patients undergoing esophagectomy in the National Cancer Data Base (NCDB). The NCCN guideline was evaluated in Cox proportional hazards modeling, along with alternative lymph node thresholds...
December 23, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28017338/complications-associated-with-femoral-cannulation-during-minimally-invasive-cardiac-surgery
#9
Joseph Lamelas, Roy F Williams, Maurice Mawad, Angelo LaPietra
BACKGROUND: Different types of cannulation techniques are available for minimally invasive cardiac surgery. At our institution, we favor a femoral platform for most minimally invasive cardiac procedures. Here, we review our results utilizing this cannulation approach. METHODS: We retrospectively reviewed all minimally invasive valve surgeries that were performed at our institution between January 2009 and January 2015. Operative times, lengths of stay, postoperative complications, and mortality were analyzed...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28017337/biatrial-or-left-atrial-lesion-set-for-ablation-during-mitral-surgery-risks-and-benefits
#10
Andrei Churyla, Adam Iddriss, Adin-Christian Andrei, Jane Kruse, S Chris Malaisrie, Rod Passman, Zhi Li, Richard Lee, Patrick M McCarthy
BACKGROUND: Controversy exists when performing surgical atrial fibrillation ablation whether there is an increase in postoperative complications using biatrial (BA) lesions compared with only left atrial (LA) lesions, and some studies indicate similar efficacy. This study compares the clinical outcomes of BA and LA ablation lesions in mitral valve surgery patients. METHODS: From 2004 through 2014, 2,137 patients had mitral valve surgery with or without other surgeries in a single center...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28017336/spasm-and-reopening-of-the-right-gastroepiploic-artery-conduit-after-coronary-artery-bypass-grafting
#11
Jae-Hak Huh, Kyung-Hak Lee, Kwang Ree Cho, Ho Young Hwang, Ki-Bong Kim
BACKGROUND: The right gastroepiploic artery (RGEA) has advantages for use as an arterial conduit in coronary artery bypass graft surgery but perioperative spasm often develops. This study assessed the spasm and occlusion rates of RGEA conduits and elucidated the mechanism of reopening of occluded RGEA conduits. METHODS: Patients who received an RGEA conduit in coronary artery bypass graft surgery were studied (n = 976; 700 composite, 276 in situ, 16 free grafts; 16 received both in situ and composite grafts)...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28017335/two-decades-of-lung-retransplantation-a-single-center-experience
#12
David J Hall, Erol V Belli, Jon A Gregg, Juan C Salgado, Maher A Baz, E Denmark Staples, Thomas M Beaver, Tiago N Machuca
BACKGROUND: Lung retransplantation (ReTx) comprises an increasing share of lung transplants and recently has shown improved outcomes. The aim of this study was to identify risk factors affecting overall survival after pulmonary ReTx. METHODS: The United Network for Organ Sharing database was used to identify patients undergoing lung transplantation at our institution from 1995 to 2014. Of the total 542 lung transplants performed, 87 (16.1%) were ReTxs. The primary outcome was overall survival...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28012643/reoperation-for-coronary-artery-bypass-grafting-surgery-outcomes-and-considerations-for-expanding-interventional-procedures
#13
Simon Maltais, Robert J Widmer, Malcolm R Bell, Richard C Daly, Joseph A Dearani, Kevin L Greason, David L Joyce, Lyle D Joyce, Hartzell V Schaff, John M Stulak
BACKGROUND: Owing to an inevitable degeneration of grafts over time, patients may require consideration for repeat coronary artery bypass graft (CABG) surgery. As our understanding of preoperative risks associated with redo CABG surgery is limited and availability of data is limited to historical cohorts, we sought to evaluate our contemporary 20-year experience with this challenging patient population. METHODS: Between January 1993 and June 2014, 748 patients underwent redo CABG surgery at our institution...
December 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28012642/postoperative-cerebral-and-somatic-near-infrared-spectroscopy-saturations-and-outcome-in-hypoplastic-left-heart-syndrome
#14
George M Hoffman, Nancy S Ghanayem, John P Scott, James S Tweddell, Michael E Mitchell, Kathleen A Mussato
BACKGROUND: Circulatory vulnerability reflected by low systemic venous oxygen saturation after surgical palliation of hypoplastic left heart syndrome predicts adverse neurologic outcome and reduced survival, and targeting venous saturation may improve outcome. We herein test the hypothesis that near-infrared spectroscopy (NIRS)-derived cerebral and somatic/renal regional saturations can predict survival. METHODS: Patient data, from a prospective Institutional Review Board-approved registry of hemodynamic measures after initial palliation of hypoplastic left heart syndrome, were analyzed with logistic and multivariable mixed regression methods to determine relationships between standard hemodynamic measures, direct and NIRS measures of saturation, and outcome...
December 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28012641/the-unintended-consequences-of-over-reducing-cardiopulmonary-bypass-circuit-prime-volume
#15
Benjamin C Sun, Timothy A Dickinson, Eric A Tesdahl, Donald S Likosky, Christopher Wells, Samuel Weinstein
BACKGROUND: The Society of Thoracic Surgeon blood conservation guidelines recommend minimizing cardiopulmonary bypass circuit prime volume (PV) as an integral, evidence-based (Class I, Level A) blood conservation strategy. We used a large, multiinstitutional registry to evaluate the effectiveness of restricting cardiopulmonary bypass PV on intraoperative red blood cell (RBC) transfusion. METHODS: We reviewed 47,273 isolated coronary artery bypass graft procedures performed among 189 institutions between April 2012 and May 2015...
December 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28010875/achievements-and-limitations-of-a-strategy-of-rehabilitation-of-native-pulmonary-vessels-in-pulmonary-atresia-ventricular-septal-defect-and-major-aortopulmonary-collateral-arteries
#16
Jerome Soquet, Matthew Liava'a, Lucas Eastaugh, Igor E Konstantinov, Johann Brink, Christian P Brizard, Yves d'Udekem
BACKGROUND: A strategy of rehabilitation for pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries (PA/VSD/MAPCAs) comprises repetitive shunting and patching procedures of the central pulmonary arteries. We wanted to determine the feasibility and limitations of a strategy of rehabilitation. METHODS: The outcomes of 37 consecutive patients operated from June 2003 to December 2014 for PA/VSD/MAPCAs were reviewed. The patients were directed to a rehabilitation strategy, except when they presented in heart failure with very large collaterals...
December 20, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27993378/aortic-remodeling-after-endovascular-repair-of-complicated-acute-type-b-aortic%C3%A2-dissection
#17
Bradley G Leshnower, Yazan M Duwayri, Edward P Chen, Chun Li, Carl A Zehner, Jose N Binongo, Ravi K Veeraswamy
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is the optimal therapy for complicated acute type B aortic dissection (aTBAD). This study examined clinical outcomes and aortic remodeling parameters after TEVAR for patients with complicated aTBAD. METHODS: From January 2012 to December 2015, 51 patients underwent TEVAR for complicated aTBAD. Preoperative and postoperative imaging studies were analyzed for sizes of the true lumen (TL) and false lumen (FL) and for the FL thrombosis status at five locations in the thoracic and abdominal aorta...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27993377/recurrence-pattern-of-pathologic-stage-i-lung-adenocarcinoma-with-visceral-pleural%C3%A2-invasion
#18
Dhihintia Jiwangga, Sukki Cho, Kwhanmien Kim, Sanghoon Jheon
BACKGROUND: Visceral pleural invasion (VPI) is well known to be a poor prognostic factor in lung adenocarcinoma. There were few studies reporting postoperative recurrence pattern in lung adenocarcinoma with VPI. This study was to evaluate the clinical effect of VPI on recurrence pattern in pathologic stage I lung adenocarcinoma after curative resection. METHODS: Among 574 patients with pathologic stage I lung adenocarcinoma after complete resection between 2003 and 2012, the clinicopathologic characteristics of 89 patients (16%) who had recurrence were retrospectively reviewed...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#19
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27964921/esophagectomy-outcomes-in-the-endoscopic-mucosal-resection-era
#20
Karen J Dickinson, Kenneth Wang, Lizhi Zhang, Mark S Allen, Stephen D Cassivi, Francis C Nichols, Robert Shen, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: Endoscopic mucosal resection (EMR) and esophagectomy are treatment options for cT1 esophageal adenocarcinoma. Our aim was to study outcomes for patients undergoing EMR then esophagectomy. METHODS: We identified patients undergoing EMR and esophagectomy for cT1 esophageal adenocarcinoma over 10 years. EMR histology was used to predict nodal involvement with a risk-scoring tool. Patient demographics, surgical techniques, pathology, postoperative outcomes, and survival were recorded...
December 10, 2016: Annals of Thoracic Surgery
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