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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/28811003/the-impact-of-thoracic-endovascular-aortic-repair-on-long-term-survival-in-type-b-aortic%C3%A2-dissection
#1
Xiaoying Lou, Edward P Chen, Yazan M Duwayri, Ravi K Veeraswamy, William D Jordan, Carl A Zehner, Bradley G Leshnower
BACKGROUND: Currently, optimal medical therapy is first-line therapy for uncomplicated acute type B aortic dissection (aTBAD) despite poor long-term outcomes. This study examines the impact of thoracic endovascular aortic repair (TEVAR) in the acute and chronic phases on short-term and long-term survival of patients presenting with aTBAD. METHODS: A review of the Emory aortic database from 2000 to 2016 identified 398 patients diagnosed with aTBAD. At index hospitalization, complicated patients underwent TEVAR (aTEVAR [thoracic endovascular aortic repair in the acute phase], n = 80) and uncomplicated patients received optimal medical therapy (n = 318)...
August 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28811002/in-debakey-type-i-aortic-dissection-bovine-aortic-arch-is-associated-with-arch-tears-and-stroke
#2
Julia Dumfarth, Sven Peterss, Markus Kofler, Michaela Plaikner, Bulat A Ziganshin, Thomas Schachner, Maryann Tranquilli, Michael Grimm, John A Elefteriades
BACKGROUND: The study sought to evaluate if a bovine aortic arch (BAA) influences the location of the entry site in acute aortic dissection type A (AADA) and to identify the impact of BAA on postoperative outcome, especially stroke. METHODS: A total of 315 patients underwent surgery due to AADA DeBakey type I (72.1% men, mean age 59.5 ± 13.4 years) between 2002 and 2015. Imaging studies and operative reports were screened for presence of BAA and location of the entry site...
August 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28778343/economic-impact-of-an-enhanced-recovery-pathway-for-lung-resection
#3
Philippe Paci, Amin Madani, Lawrence Lee, Juan Mata, David S Mulder, Jonathan Spicer, Lorenzo E Ferri, Liane S Feldman
BACKGROUND: Multimodal enhanced recovery pathways (ERP) improve clinical outcomes and hospital length of stay for patients undergoing lung resection. However, data supporting their economic impact is lacking. This study evaluated the effect of an ERP on costs of lung resection. METHODS: Adult patients undergoing elective lung resection from August 2011 to August 2013 at a single university-affiliated institution were prospectively recruited. Pneumonectomies and extended resections were excluded...
August 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760469/delayed-electroanatomic-mapping-after-surgical-ablation-for-persistent-atrial-fibrillation
#4
Alan Bulava, Ales Mokracek, Vojtech Kurfirst
BACKGROUND: Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently but their true efficacy has never been systematically tested. METHODS: Seventy patients (median age 63.5 years) with persistent atrial fibrillation underwent epicardial thoracoscopic radiofrequency pulmonary vein (PV) isolation, linear ablation, Marshal ligament disruption, and exclusion of the left atrial appendage...
July 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760477/the-society-of-thoracic-surgeons-congenital%C3%A2-heart-surgery-database-2017-update-on-research
#5
Marshall L Jacobs, Jeffrey P Jacobs, Kevin D Hill, Christoph Hornik, Sean M O'Brien, Sara K Pasquali, David Vener, S Ram Kumar, Robert H Habib, David M Shahian, Fred H Edwards, Felix G Fernandez
The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It contains data pertaining to more than 435,000 total operations. The most recent biannual feedback report to participants (Spring 2017, Report of the Twenty-Sixth Harvest) included analysis of data submitted from 127 hospitals in North America. That represents nearly all centers performing pediatric and congenital heart operations in the United States and Canada...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760476/continuous-procedural-full-lung-ventilation-during-minimally-invasive-coronary-bypass-grafting
#6
Stephan Sixt, Hug Aubin, Robert Kalb, Philipp Rellecke, Artur Lichtenberg, Alexander Albert
BACKGROUND: In the past, minimally invasive cardiac surgery (MICS)- coronary artery bypass graft surgery (CABG) alternatives have been introduced that dramatically reduce the invasiveness of standard operative procedures while still showing excellent clinical outcomes. However, in patients with high morbidity, reduced lung function impeding single-lung ventilation is one of the major concerns for MICS-CABG procedures, although those patients might reap the largest benefit from a procedure of reduced invasiveness...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760475/cardiac-progenitor-cells-enhance-neonatal-right-ventricular-function-after-pulmonary-artery-banding
#7
Brody Wehman, Nicholas Pietris, Grace Bigham, Osama Siddiqui, Rachana Mishra, Tieluo Li, Emily Aiello, Godly Jack, Wendy Wang, Sarah Murthi, Sudhish Sharma, Sunjay Kaushal
BACKGROUND: C-kit(+) cardiac progenitor cells (CPCs) have been shown to be safe and effective in large-animal models and in an early-phase clinical trial for adult patients with ischemic heart disease. However, CPCs have not yet been evaluated in a preclinical model of right ventricular (RV) dysfunction, which is a salient feature of many forms of congenital heart disease. METHODS: Human c-kit(+) CPCs were generated from right atrial appendage biopsy specimens obtained during routine congenital cardiac operations...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760474/impact-of-postoperative-liver-dysfunction-on-survival-after-left-ventricular-assist-device-implantation
#8
Kaustav Majumder, John R Spratt, Christopher T Holley, Samit S Roy, Rebecca J Cogswell, Kenneth Liao, Ranjit John
BACKGROUND: Liver dysfunction in left ventricular assist device (LVAD) recipients is common both before and after implantation. Postoperative liver dysfunction (PLD) develops in some LVAD recipients without preoperative liver dysfunction. The aim of this study was to assess clinical outcomes in such patients. METHODS: Records of all patients undergoing implantation of a HeartMate II (HM II, St. Jude Medical, Inc, Minneapolis, MN) LVAD at a single center at the University of Minnesota from January 2005 through June 2014 were analyzed...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760473/transapical-mitral-valve-implantation-for-native-mitral-valve-stenosis-using-a-balloon-expandable-prosthesis
#9
Philipp Kiefer, Thilo Noack, Joerg Seeburger, Alexandro Hoyer, Axel Linke, Norman Mangner, Lukas Lehmkuhl, Friedrich Wilhelm Mohr, David Holzhey
BACKGROUND: Transcatheter mitral valve implantation (TMVI) is still in its infancy and is mainly limited to valve-in-valve or valve-in-ring implantations. We present the early experience with TMVI for severe calcified native MV stenosis. METHODS: Between January 2014 and June 2015, 6 of 11 patients screened (mean age, 77.4 ± 6.3 years; 66% men) with severe native mitral valve (MV) stenosis (mean gradient [Pmean], 11.1 ± 2.1 mm Hg; mean effective orifice area [EOA], 0...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760472/mitochondrial-dysfunction-in-atrial-tissue-of-patients-developing-postoperative-atrial-fibrillation
#10
Jelliffe Jeganathan, Rabya Saraf, Feroze Mahmood, Anam Pal, Manoj K Bhasin, Thomas Huang, Aaron Mittel, Ziyad Knio, Russell Simons, Kamal Khabbaz, Venkatachalam Senthilnathan, David Liu, Frank Sellke, Robina Matyal
BACKGROUND: Mitochondria are the major site of cellular oxidation. Metabolism and oxidative stress have been implicated as possible mechanisms for postoperative atrial fibrillation (POAF) after cardiac operations. Establishing the precise nature of mitochondrial dysfunction as an etiologic factor for oxidative stress-related cell death and apoptosis could further the understanding of POAF. To establish this relationship, mitochondrial function was studied in patients undergoing cardiac operations that developed POAF and compared it with patients without POAF...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760471/adjuvant-chemotherapy-does-not-confer-superior-survival-in-patients-with-atypical-carcinoid-tumors
#11
Kevin L Anderson, Michael S Mulvihill, Paul J Speicher, Babatunde A Yerokun, Brian C Gulack, Daniel P Nussbaum, David H Harpole, Thomas A D'Amico, Mark F Berry, Matthew G Hartwig
BACKGROUND: Although the use of adjuvant chemotherapy in patients with pathologically node-positive (pN+) atypical carcinoid tumor of the lung is an accepted practice, controversy exists about its use in pathologically node-negative (pN0) patients. Our aim was to determine whether a survival advantage exists in patients receiving chemotherapy postoperatively for pN0 or pN+ atypical carcinoid tumors of the lung. METHODS: Adult patients treated with lobectomy or pneumonectomy for pulmonary atypical carcinoid tumor were identified using the National Cancer Data Base, 2006 to 2011...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760470/improved-approach-with-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-difference-in-on-and-off-pump
#12
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Emily Phillips, Joyce Wald, Matthew L Williams, David W Low, Michael A Acker, Pavan Atluri
BACKGROUND: The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. METHODS: This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC)...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760468/experience-with-pericardiectomy-for-constrictive-pericarditis-over-eight-decades
#13
Takashi Murashita, Hartzell V Schaff, Richard C Daly, Jae K Oh, Joseph A Dearani, John M Stulak, Katherine S King, Kevin L Greason
BACKGROUND: The purpose of this study was to review the surgical outcomes of pericardiectomy for constrictive pericarditis and to examine risk factors for overall mortality in a contemporary period. METHODS: We reviewed all patients who underwent pericardiectomy for constriction from 1936 through 2013. The investigation included constrictive pericarditis cases confirmed intraoperatively, all other types of pericarditis were excluded; 1,071 pericardiectomies were performed in 1,066 individual patients...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760467/resident-autonomy-in-the-operating-room-expectations-versus-reality
#14
Shari L Meyerson, Joel M Sternbach, Joseph B Zwischenberger, Edward M Bender
BACKGROUND: There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. METHODS: Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760466/outcomes-of-early-mitral-valve-reoperation-in-the-medicare-population
#15
Kathleen Kwedar, Christian McNeely, Alan Zajarias, Steve Markwell, Christina M Vassileva
BACKGROUND: Surgical series on mitral valve reoperation are limited by small numbers and lack of national representation. Large-scale outcomes of reoperation for mitral valve surgery remain uncertain. METHODS: This is a descriptive analysis of 1,627 Medicare beneficiaries who underwent mitral valve reoperation within a 3-year follow-up period after an initial mitral operation (repair or replacement) that took place between 2000 and 2006. The primary outcomes were hospital mortality and long-term survival...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760465/elective-aortic-arch-repair-factors-influencing-neurologic-outcome-in-791-patients
#16
Mariano Cefarelli, Giacomo Murana, Giuseppina G Surace, Sebastiano Castrovinci, Giuliano Jafrancesco, Johannes Christiaan Kelder, Patrick Klein, Uday Sonker, Wim J Morshuis, Robin H Heijmen
BACKGROUND: The aim of this study was to determine perioperative factors influencing neurologic outcome in a single-center cohort of patients undergoing elective aortic arch operations. METHODS: From January 2005 to June 2015, 791 consecutive patients received open aortic arch operations with either antegrade selective cerebral perfusion (ASCP) (636 patients [80.4%]) or deep hypothermic circulatory arrest (DHCA) (155 patients [19.6%]). Main indications were degenerative aneurysm (85%) and chronic postdissection aneurysm (9...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760464/low-accuracy-of-computed-tomography-and-positron-emission-tomography-to-detect-lung-and-lymph-node-metastases-of-colorectal-cancer
#17
Francesco Guerrera, Stéphane Renaud, Mickaël Schaeffer, Victor Nigra, Paolo Solidoro, Nicola Santelmo, Pier Luigi Filosso, Pierre-Emmanuel Falcoz, Enrico Ruffini, Alberto Oliaro, Gilbert Massard
BACKGROUND: Minimally invasive surgery, stereotactic radiotherapy, and radiofrequency ablation are commonly proposed in the case of pulmonary colorectal-metastasis as alternatives to conventional open surgery. Preoperative imaging assessment by computed tomography (CT) scan and fluorodeoxyglucose positron emission tomography (FDG-PET) are critical to guide oncologic radical treatment. Our aim was to investigate the accuracy of CT and FDG-PET for the evaluation of the number of pulmonary colorectal metastases and thoracic lymph nodal involvement (LNI)...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760463/survival-after-esophagectomy-a-propensity-matched-study-of-different-surgical-approaches
#18
Benny Weksler, Jennifer L Sullivan
BACKGROUND: Although open esophagectomy (OE) is considered the "gold standard" treatment for esophageal cancer, robotic-assisted minimally invasive esophagectomy (RAMIE), and laparoscopic/thoracoscopic minimally invasive esophagectomy (MIE) are becoming more common. This study aimed to compare short-term outcomes and overall survival of patients undergoing RAMIE, MIE, and OE. METHODS: The National Cancer Data Base was queried for patients who had OE, RAMIE, or MIE for esophageal cancer from 2010 to 2013...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760462/histone-modification-is-correlated-with-reverse-lv-remodeling-in-nonischemic-dilated-cardiomyopathy
#19
Emiko Ito, Shigeru Miyagawa, Satsuki Fukushima, Yasushi Yoshikawa, Shunsuke Saito, Tetsuya Saito, Akima Harada, Maki Takeda, Noriyuki Kashiyama, Yuki Nakamura, Motoko Shiozaki, Koichi Toda, Yoshiki Sawa
BACKGROUND: Although implantation of a left ventricular assist device (LVAD) induces reverse remodeling of the left ventricle in end-stage nonischemic dilated cardiomyopathy (DCM), the underlying mechanism is not fully understood. It has been shown that epigenetic modification, such as methylation or acetylation of the histone, is one of the most important upstream signals in cardiac failure. This study hypothesized that histone profiles may be modified by LVAD implantation for end-stage nonischemic DCM, in association with reverse left ventricular remodeling...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28803638/impact-of-obesity-on-intensive-care-unit-resource-utilization-after-cardiac-operations
#20
Brandon R Rosvall, Keir Forgie, Jeffrey B MacLeod, Alexandra M Yip, Christie Aguiar, Sohrab Lutchmedial, Craig Brown, Rand Forgie, Jean Francois Légaré, Ansar Hassan
BACKGROUND: Much has been published about the effect of obesity on adverse outcomes after cardiac operations, yet little is known regarding the effect of obesity on intensive care unit (ICU) resource utilization. This study examined the effect of obesity on ICU resource utilization after cardiac operations. METHODS: All patients with a body mass index (BMI) of 18.5 kg/m(2) or higher who underwent a cardiac surgical procedure between 2006 and 2013 were stratified into the following weight categories: normal (BMI 18...
July 24, 2017: Annals of Thoracic Surgery
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