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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#1
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132704/extent-of-resection-and-lymph-node-assessment-for-clinical-stage-t1an0m0-typical-carcinoid-tumors
#2
Lisa M Brown, David T Cooke, James R Jett, Elizabeth A David
BACKGROUND: The optimal extent of lung resection and lymph node (LN) assessment for surgical treatment of clinical stage T1aN0M0 typical carcinoid tumors is unclear. Using a cohort including only these patients, we aimed to determine the impact of extent of lung resection and LN assessment on overall survival. METHODS: Patients undergoing lobectomy or sublobar resection for clinical stage T1aN0M0 intraparenchymal typical carcinoid tumor were identified in the National Cancer Data Base from 1998 to 2012...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132700/early-operation-in-patients-with-mitral-valve-infective-endocarditis-and-acute-stroke-is-safe
#3
Mehrdad Ghoreishi, Nate Foster, Chetan Pasrija, Aakash Shah, A Claire Watkins, Charlie F Evans, Sam Maghami, Rachael Quinn, Brody Wehman, Bradley S Taylor, Murtaza Y Dawood, Bartley P Griffith, James S Gammie
BACKGROUND: To determine if preoperative embolic stroke is associated with an increased risk of postoperative stroke among patients undergoing early operation for mitral valve (MV) infective endocarditis (IE), we compared outcomes among patients presenting with and without acute stroke. METHODS: From 2003 to 2015, 243 consecutive patients underwent surgery for active MV IE. Patients were categorized into 2 groups: 72% (174 of 243 patients) with no preoperative acute stroke (clinical, radiographic or both) and 28% (69 of 243 patients) with stroke...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132699/is-endocan-a-diagnostic-marker-for-pneumonia-after-cardiac-surgery-the-endolung-study
#4
Andréa Perrotti, Camille Chenevier-Gobeaux, Fiona Ecarnot, Karine Bardonnet, Benoit Barrucand, Guillaume Flicoteaux, Philippe Lassalle, Sidney Chocron
BACKGROUND: Postoperative pneumonia is frequent after cardiac surgery and is associated with increased morbidity and mortality. We tested the hypothesis that endocan is an early biomarker for the detection of pneumonia after cardiac surgery. METHODS: Between January and May 2016, 155 patients scheduled to undergo elective cardiac surgery with cardiopulmonary bypass were prospectively included in the study. Serum level of endocan was measured at five timepoints (preoperative, and at 6, 24, 48, and 72 hours after the end of surgery)...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132698/risk-factor-analysis-for-intraoperative-extracorporeal-membrane-oxygenation-weaning-failure-after-lung-transplantation
#5
Kyoung Shik Narm, Seokkee Lee, Jee Won Suh, Anes Kim, Jin Gu Lee, Moo Suk Park, Song Yee Kim, Joo Han Song, Su Jin Jeong, Hyo Chae Paik
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used for hemodynamic support during lung transplantation (LTx). We evaluated the risk factors associated with failure of weaning from ECMO in the operating room during LTx. METHODS: We retrospectively reviewed 74 consecutive patients who had undergone LTx from March 2013 to February 2016. Patients who underwent single LTx, multiorgan transplantation, and LTx for pulmonary hypertension were excluded...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132697/treatment-of-postsurgical-chylothorax
#6
Janani S Reisenauer, Carlos A Puig, Chris J Reisenauer, Mark S Allen, Emily Bendel, Stephen D Cassivi, Francis C Nichols, Rob K Shen, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: Postoperative chylothorax can be managed by any or all of observation, parenteral nutrition, surgical duct ligation, pleurodesis, or thoracic duct embolization. The objective of this study was to determine the efficacy of standard therapies, such as surgical duct ligation and observation, compared with newer treatment methods (thoracic duct embolization). METHODS: A prospectively maintained database at a single institution was used to identify and review patients with postoperative chylothorax from 2008 to 2015...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132703/rapid-deployment-aortic-valve-replacement-excellent-results-and-increased-effective-orifice-areas
#7
Parwis B Rahmanian, Süreyya Kaya, Kaveh Eghbalzadeh, Hruy Menghesha, Navid Madershahian, Thorsten Wahlers
BACKGROUND: The aim of this study was to evaluate the effects of rapid deployment aortic valve replacement (RDAVR) on surgical outcome and hemodynamics compared with standard aortic valve replacement (AVR). METHODS: One hundred sixty-three RDAVR patients (isolated, n = 67; combined with coronary artery bypass graft surgery [CABG], n = 96) were compared with a propensity matched control group (n = 163). Primary endpoints included association between valve type and procedure times, prosthesis size, transvalvular gradient, and indexed effective orifice area...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132702/neutrophil-lymphocyte-ratio-prognostic-impact-in-heart-surgery-early-outcomes-and-late-survival
#8
Shuli Silberman, Ulfat Abu-Yunis, Rachel Tauber, Linda Shavit, Tal Grenader, Daniel Fink, Daniel Bitran, Ofer Merin
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) is a recognized marker of inflammation associated with poor outcomes in various clinical situations. We analyzed the prognostic significance of preoperative elevated NLR in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of 3,027 consecutive patients undergoing cardiac surgery. Receiver-operating-characteristic was used to determine the cutoff value for elevated NLR. Multivariate regression was used to determine the predictive value of preoperative NLR on clinical outcomes...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132701/postoperative-outcome-after-pulmonary-surgery-for-non-small-cell-lung-cancer-in-elderly-patients
#9
Deniece D E M A Detillon, Eelco J Veen
BACKGROUND: Lung cancer is the main cause of cancer-related death in the Netherlands. Surgery offers the best potential cure, but lower rates of surgery are recorded for octogenarians because of concerns regarding morbidity and mortality. METHODS: We analyzed the Dutch Lung Surgery Audit database to determine the postoperative outcome of lung cancer resections for patients aged 60 years or more between January 2013 and December 2014. Three groups were compared: patients aged 80 years or more, patients aged 70 to 79 years, and patients aged 60 to 69 years...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29128047/use-of-lung-allografts-from-donation-after-cardiac-death-donors-a-single-center-experience
#10
Joseph Costa, Lori Shah, Hilary Robbins, Kashif Raza, Sowmya Sreekandth, Selim Arcasoy, Joshua R Sonett, Frank D'Ovidio
BACKGROUND: Lung transplantation remains the only treatment for end-stage lung disease. Availability of suitable lungs does not parallel this growing trend. Centers using donation after cardiac death (DCD) donor lungs report comparable outcomes with those from brain-dead donors. Donor assessment protocols and consistent surgical teams have been advocated when considering using the use of DCD donors. We present our experience using lungs from Maastricht category III DCD donors. METHODS: Starting 2007 to July 2016, 73 DCD donors were assessed, 44 provided suitable lungs that resulted in 46 transplants...
November 8, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29128046/preoperative-anemia-in-cardiac-operation-does-hemoglobin-tell-the-whole-story
#11
Lu Dai, Stephanie L Mick, Keith R McCrae, Penny L Houghtaling, Joseph F Sabik, Eugene H Blackstone, Colleen G Koch
BACKGROUND: Preoperative anemia, defined by hemoglobin level, is associated with elevated risk after cardiac operation. Better understanding of anemia requires characterization beyond this. This investigation focuses on red cell size and its association with patient characteristics and outcomes after cardiac operation. METHODS: From January 2010 to January 2014, 10,589 patients underwent elective cardiac operations at Cleveland Clinic. Anemia was characterized as normocytic, microcytic, or macrocytic based on mean corpuscular volume (MCV)...
November 8, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29126549/predicting-new-onset-post-coronary-artery-bypass-graft-atrial-fibrillation-with-existing-risk-scores
#12
Benjamin D Pollock, Giovanni Filardo, Briget da Graca, Teresa K Phan, Gorav Ailawadi, Vinod Thourani, Ralph J Damiano, James R Edgerton
BACKGROUND: New-onset atrial fibrillation (AF) after coronary artery bypass graft (CABG) operation is associated with poorer survival. Blanket prophylaxis efforts have not appreciably decreased incidence, making targeted prevention for high-risk patients desirable. We compared predictive abilities of existing scores developed/used to predict adverse CABG outcomes (Society of Thoracic Surgeons' [STS] risk of mortality) or AF not associated with cardiac operation (the Cohorts for Heart and Aging Research in Genomic Epidemiology [CHARGE]-AF score, the CHA2DS2-VASc score), and a risk model for predicting postoperative AF following cardiac operations (POAF score), with age (the most consistently identified post-CABG AF risk factor)...
November 7, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29103584/selective-aortic-arch-and-root-replacement-in-repair-of-acute-type-a-aortic-dissection
#13
Fernando Fleischman, Ramsey S Elsayed, Robbin G Cohen, James M Tatum, S Ram Kumar, Kayvan Kazerouni, Wendy J Mack, Mark L Barr, Mark J Cunningham, Amy E Hackmann, Craig J Baker, Vaughn A Starnes, Michael E Bowdish
BACKGROUND: Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. METHODS: Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair...
November 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29102303/national-trends-and-geographic-variation-in-bilateral-internal-mammary-artery-use-in-the-united-states
#14
Alexander Iribarne, Philip P Goodney, Alyssa M Flores, Joseph DeSimone, Anthony W DiScipio, Andrea Austin, Jock N McCullough
BACKGROUND: The goal of this study was to characterize the adoption rate and regional variation in bilateral internal mammary artery (BIMA) use during coronary artery bypass grafting (CABG) in the United States. METHODS: Observational study of 100% sample of fee-for-service Medicare beneficiaries aged 65 years or older, continuously enrolled in Parts A and B from 2009 to 2014 (n = 162,860,439). Rates of beneficiaries receiving a BIMA versus single internal mammary artery (SIMA) during CABG are expressed per 1,000 beneficiaries and aggregated by Hospital Referral Region (HRR)...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29102302/national-analysis-of-unplanned-readmissions-after-thoracoscopic-versus-open-lung-cancer-resection
#15
Rohun Bhagat, Michael R Bronsert, Austin N Ward, Jeremiah Martin, Elizabeth Juarez-Colunga, Natalia O Glebova, William G Henderson, David Fullerton, Michael J Weyant, John D Mitchell, Robert A Meguid
BACKGROUND: Hospital readmissions are viewed as a mark of inferior health care quality and are penalized. Unplanned postoperative readmission reason and timing after lung resection are not well understood. We examine related, unplanned readmissions after thoracoscopic versus open anatomic lung resections to identify opportunities to improve patient care. METHODS: We analyzed the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data set, 2012 to 2015, characterizing 30-day related, unplanned postoperative readmissions after anatomic lung resections for primary lung cancer...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100649/lung-retransplantation-for-chronic-rejection-a-single-center-experience
#16
Sreeja Biswas Roy, Roshan Panchanathan, Rajat Walia, Katherine E Varsch, Paul Kang, Jasmine Huang, A Samad Hashimi, Thalachallour Mohanakumar, Ross M Bremner, Michael A Smith
BACKGROUND: Chronic lung allograft dysfunction (CLAD) is nonreversible and remains the biggest obstacle to long-term survival after lung transplantation (LTx). Retransplantation is the sole definitive therapeutic option for CLAD. We analyzed our single-center experience with retransplantation as a treatment option for CLAD. METHODS: From March 1, 2010, to May 31, 2016, 419 consecutive patients underwent LTx at our institution; 29 of these procedures were retransplantations for CLAD...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100647/subglottic-stenosis-in-granulomatosis-with-polyangiitis-the-role-of-laryngotracheal-resection
#17
Christina L Costantino, John L Niles, Cameron D Wright, Douglas J Mathisen, Ashok Muniappan
BACKGROUND: Granulomatosis with polyangiitis (GPA) is associated with development of subglottic stenosis in about one-fourth of all patients. Although endoscopic management is the primary treatment method for tracheobronchial stenosis, some patients have refractory disease, and tracheostomy is required. It is unclear if laryngotracheal resection and reconstruction (LTRR) can be safely performed in patients with GPA. METHODS: A retrospective review was performed of 11 patients with GPA undergoing LTRR...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100646/an-unexpected-risk-factor-for-early-structural-deterioration-of-biological-aortic-valve-prostheses
#18
Carlo Bassano, Valentina Gislao, Emanuele Bovio, Sonia Melino, Ilaria Tropea, Guglielmo Saitto, Marta Pugliese, Dionisio F Colella, Antonio Scafuri, Giovanni Ruvolo
BACKGROUND: An alarming rate of early failure has been recently reported for the LivaNova (previously Sorin) Mitroflow (LivaNova, London, UK) bioprosthesis. Here, we aimed at verifying if this possible underperformance is confirmed in a large, single-center experience and identifying the risk factors associated with early deterioration. METHODS: In all, 459 Mitroflow valves have been implanted from July 2009 to December 2013 (patients' mean age 73 years; 204 women)...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100645/subclavian-axillary-access-for-self-expanding-transcatheter-aortic-valve-replacement-renders-equivalent-outcomes-as-transfemoral
#19
Thomas G Gleason, John T Schindler, Robert C Hagberg, G Michael Deeb, David H Adams, John V Conte, George L Zorn, G Chad Hughes, Jia Guo, Jeffrey J Popma, Michael J Reardon
BACKGROUND: Iliofemoral arterial disease can preclude transfemoral (TF) transcatheter aortic valve replacement (TF-TAVR). Transthoracic access by direct aortic or a transapical approach imparts a greater risk of complications and death than TF access. We hypothesized that subclavian/axillary arterial (SCA) access offers equivalent risks and outcomes as TF access. METHODS: The outcomes of 202 patients from the CoreValve (Medtronic, Minneapolis, MN) United States Pivotal Trial Program treated with SCA access were propensity matched with patients treated with TF access and analyzed...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29100644/a-comprehensive-risk-score-to-predict-prolonged-hospital-length-of-stay-after-heart-transplantation
#20
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Alejandro Suarez-Pierre, Nishant Patel, Christopher M Sciortino, Kenton J Zehr, Kaushik Mandal, Ryan J Tedford, Stuart D Russell, John V Conte, Robert S Higgins, Duke E Cameron, Glenn J Whitman
BACKGROUND: Prolonged hospital length of stay (PLOS) after heart transplantation increases cost and morbidity. To better inform care, we developed a risk score to identify patients at risk for PLOS after heart transplantation. METHODS: We queried the United Network for Organ Sharing Scientific Registry of Transplant Recipients database for adult patients who underwent isolated heart transplantation from 2003 to 2012. The population was randomly divided into a derivation cohort (80%) and a validation cohort (20%)...
November 1, 2017: Annals of Thoracic Surgery
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