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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/28709667/routine-use-of-topical-bacitracin-to-prevent-sternal-wound-infections-after-cardiac-surgery
#1
Joshua L Chan, Andrada C Diaconescu, Keith A Horvath
BACKGROUND: The development of sternal wound infections remains a serious complication after cardiac surgery. A number of studies have assessed the use of topical antibiotics placed on the sternal edges. We evaluated the routine use of bacitracin ointment applied over the sternotomy skin incision as a prophylactic measure against sternal wound infections. METHODS: A retrospective review of all coronary artery bypass graft and valve surgery cases performed at a single institution between 2006 and 2015 was performed (n = 1,495)...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709666/novel-rotational-speed-modulation-system-used-with-venoarterial-extracorporeal-membrane-oxygenation
#2
Noritsugu Naito, Takashi Nishimura, Kei Iizuka, Yutaka Fujii, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Minoru Ono, Eisuke Tatsumi
BACKGROUND: Femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is widely used to maintain blood flow in patients with cardiogenic shock. However, retrograde blood flow increases left ventricular (LV) afterload during femoral VA-ECMO. Additional support by means of an intraaortic balloon pump (IABP) alleviates LV afterload but is associated with significant adverse events. We previously developed a system for rotational speed modulation in synchrony with the native cardiac cycle, for use with implantable continuous-flow LV assist devices...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709665/risk-adjusted-margin-positivity-rate-as-a-surgical-quality-metric-for-non-small-cell-lung-cancer
#3
Chun Chieh Lin, Matthew P Smeltzer, Ahmedin Jemal, Raymond U Osarogiagbon
BACKGROUND: Incomplete lung cancer resection connotes poor prognosis; the incidence varies with patient demographic, clinical, and institutional factors. We sought to develop a valid, survival impactful, facility-based surgical quality metric that adjusts for related patient demographic and clinical characteristics. METHODS: Facilities performing resections for patients diagnosed with stage I to IIIA non-small cell lung cancer in the National Cancer Data Base between 2004 and 2011 were identified...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709664/current-results-of-single-ventricle-palliation-of-patients-with-double-inlet-left-ventricle
#4
Bahaaldin Alsoufi, Courtney McCracken, Kirk Kanter, Subhadra Shashidharan, Brian Kogon
BACKGROUND: Double inlet left ventricle (DILV) is a heterogeneous single ventricle anomaly in which initial presentation, and consequently, timing and palliation mode vary based on morphology and degree of pulmonary or systemic outflow obstruction. Very few reports, mostly old, focused on palliation outcomes of DILV. We report current-era results and examine whether morphologic and subsequently surgical factors influence survival. METHODS: Fifty-eight infants with DILV underwent single ventricle palliation...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709663/pulmonary-resection-for-second-lung-cancer-after-pneumonectomy-a-population-based-study
#5
Adil Ayub, Sadiq S Rehmani, Adnan M Al-Ayoubi, Wissam Raad, Raja M Flores, Faiz Y Bhora
BACKGROUND: Pulmonary resection for a second lung cancer after pneumonectomy is generally considered to be at prohibitive risk. Using a population-based database, we examined treatment patterns and survival in patients who underwent pulmonary resection after pneumonectomy for lung cancer. METHODS: We queried the Surveillance, Epidemiology, and End Results (SEER) database (1988-2012) to identify patients who underwent pneumonectomy and subsequently experienced contralateral non-small cell lung cancer (NSCLC)...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709662/neonatal-aortic-arch-reconstruction-with-direct-splanchnic-perfusion-avoids-deep-hypothermia
#6
Muhammad Aanish Raees, Clinton D Morgan, Venessa L Pinto, Ashly C Westrick, Chevis N Shannon, Karla G Christian, Bret A Mettler, David P Bichell
BACKGROUND: Neonatal aortic arch reconstruction, typically performed with deep hypothermia and selective cerebral perfusion, leaves splanchnic organ protection dependent on hypothermia alone. A simplified method of direct in-field descending aortic perfusion during neonatal arch reconstruction permits the avoidance of deep hypothermia. We hypothesize that direct splanchnic perfusion at mild hypothermia provides improved or equivalent safety compared with deep hypothermia and may contribute to postoperative extracardiac organ recovery...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709661/left-sided-reoperations-after-arterial-switch-operation-a-european-multicenter-study
#7
Vladimiro L Vida, Lorenza Zanotto, Lucia Zanotto, Giovanni Stellin, Massimo Padalino, Georges Sarris, Eleftherios Protopapas, Carol Prospero, Christian Pizarro, Edward Woodford, Thomas Tlaskal, Hakan Berggren, Martin Kostolny, Ikenna Omeje, Boulos Asfour, Alexander Kadner, Thierry Carrel, Paul H Schoof, Matej Nosal, Josè Fragata, Michał Kozłowski, Bohdan Maruszewski, Luca A Vricella, Duke E Cameron, Vladimir Sojak, Mark Hazekamp, Jukka Salminen, Ilkka P Mattila, Julie Cleuziou, Patrick O Myers, Viktor Hraska
BACKGROUND: We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. METHODS: Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28709660/effect-of-gastrointestinal-malformations-on-the-outcomes-of-patients-with-congenital-heart-disease
#8
Carlos M Mery, Luis E De León, J Rubén Rodriguez, R Michael Nieto, Wei Zhang, Iki Adachi, Jeffrey S Heinle, Lauren C Kane, E Dean McKenzie, Charles D Fraser
BACKGROUND: The goal of this study was to assess the effect of associated gastrointestinal malformations (GI) on the outcomes of patients undergoing congenital heart operations. METHODS: Neonates and infants with thoracic (esophageal atresia, tracheoesophageal fistula) and abdominal (duodenal stenosis/atresia, imperforate anus, Hirschsprung disease) GI malformations undergoing congenital heart operations between 1995 and 2015 were included. Two control groups were created, one for each group...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28688632/ecmo-support-in-lung-transplantation-a-contemporary-analysis-of-hospital-charges-in-the-united-states
#9
J W Awori Hayanga, Norihisa Shigemura, Jonathan K Aboagye, Chris Ensor, Mary Amanda Dew, Heather K Hayanga, Stephen A Esper, Kyla Joubert, Matthew R Morrell, Jonathan D'Cunha
BACKGROUND: There is little in the literature pertaining to cost associated with the use of extracorporeal membrane oxygenation (ECMO) in lung transplantation. We sought to evaluate charges associated with the index hospitalization among recipients of a lung transplant who required ECMO to identify factors that increase hospital charges in these patients. METHODS: With the use of the Nationwide Inpatient Sample, we reviewed data pertaining to patients who received a lung transplant between 2000 and 2011 and stratified them into ECMO and non-ECMO groups based on use of ECMO...
July 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28673618/extracorporeal-membrane-oxygenation-and-interfacility-transfer-a-regional-referral-experience
#10
David N Ranney, Desiree Bonadonna, Babatunde A Yerokun, Michael S Mulvihill, Nawar Al-Rawas, Michael Weykamp, Rathnayaka M Gunasingha, Raquel R Bartz, John C Haney, Mani A Daneshmand
BACKGROUND: The number of adults referred to high-volume centers for extracorporeal membrane oxygenation (ECMO) is increasing. Outcomes of patients requiring transport are not well characterized, and referral guidelines are lacking. This study describes the experience and outcomes of a single high-volume center. METHODS: A retrospective study was performed that included adults undergoing ECMO between June 2009 and December 2015. Patient characteristics and outcomes were acquired from the medical record...
June 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669506/risk-factors-for-late-aortic-valve-dysfunction-after-the-david-v-valve-sparing-root-replacement
#11
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. METHODS: A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669505/bioprosthetic-valve-fracture-to-facilitate-transcatheter-valve-in-valve-implantation
#12
Keith B Allen, Adnan K Chhatriwalla, David J Cohen, John T Saxon, Sanjeev Aggarwal, Anthony Hart, Suzanne Baron, J Russell Davis, Alex F Pak, Danny Dvir, A Michael Borkon
BACKGROUND: Valve-in-valve transcatheter aortic valve replacement is less effective in small surgical bioprostheses. We evaluated the feasibility of bioprosthetic valve fracture with a high-pressure balloon to facilitate valve-in-valve transcatheter aortic valve replacement. METHODS: In vitro bench testing on aortic tissue valves was performed on 19-mm and 21-mm Mitroflow (Sorin, Milan, Italy), Magna and Magna Ease (Edwards Lifesciences, Irvine, CA), Trifecta and Biocor Epic (St...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669504/nodal-skip-metastasis-in-esophageal-squamous-cell-carcinoma-underwent-three-field-lymphadenectomy
#13
Feng Wang, Yuzhen Zheng, Zhen Wang, Qingfeng Zheng, Qingyuan Huang, Shuoyan Liu
BACKGROUND: The clinical and prognostic implications of nodal skip metastasis (NSM) remain unclear in patients with esophageal squamous cell carcinoma (ESCC). METHODS: Patients with pathologically confirmed node metastasis who underwent three-field lymphadenectomy from January 1999 to December 2008 were retrospectively enrolled. The node station is determined based on the classification of the Japanese Society for Esophageal Diseases. NSM is defined as the occurrence of metastases in nodes distant from the primary tumor (station 2 or 3) without the involvement of the adjacent nodes (station 1)...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669503/impact-of-adverse-events-and-length-of-stay-on-patient-experience-after-lung-cancer-resection
#14
Emma J M Grigor, Jelena Ivanovic, Caitlin Anstee, Zach Zhang, Sebastian Gilbert, Donna E Maziak, Farid M Shamji, Sudhir Sundaresan, Patrick J Villeneuve, Tim Ramsay, Andrew J E Seely
BACKGROUND: Postoperative adverse events (AEs), prolonged length of stay (PLOS), and patient experience are common quality measures after thoracic surgical procedures. Our objective was to investigate the relationship of postoperative AEs on patient experience and hospital length of stay (LOS) after lung cancer resection. METHODS: AEs (using Thoracic Morbidity and Mortality system based on Clavien-Dindo schema) and LOS were prospectively collected for all patients undergoing lung cancer resection...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669502/the-impact-of-22q11-2-deletion-syndrome-on-surgical-repair-outcomes-of-conotruncal-cardiac-anomalies
#15
Bahaaldin Alsoufi, Courtney McCracken, Subhadra Shashidharan, Shriprasad Deshpande, Kirk Kanter, Brian Kogon
BACKGROUND: We aim to describe the impact of 22q11.2 deletion syndrome (22q11DS) on clinical characteristics, postoperative course, and early and late outcomes of neonates undergoing surgery for conotruncal anomalies. METHODS: A retrospective review was performed (2002 to 2012) of 224 neonates who underwent surgery for interrupted aortic arch (n = 67), truncus arteriosus (n = 85), or ductal-dependent pulmonary atresia and ventricular septal defect (n = 72). Patients were divided into three groups: group 1, n = 119, no genetic syndrome; group 2, n = 64, 22q11DS; and group 3, n = 41, other genetic syndrome...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669501/surgical-ablation-of-atrial-fibrillation-in-the-united-states-trends-and-propensity-matched-outcomes
#16
Vinay Badhwar, J Scott Rankin, Niv Ad, Maria Grau-Sepulveda, Ralph J Damiano, A Marc Gillinov, Patrick M McCarthy, Vinod H Thourani, Rakesh M Suri, Jeffrey P Jacobs, James L Cox
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) effectively restores sinus rhythm. Incompletely defined risk has previously limited concomitant performance of SA during cardiac operations. The study goals were to define performance trends and risk-adjusted outcomes for contemporary SA. METHODS: From July 2011 to June 2014, 86,941 patients with AF, but without endocarditis, underwent primary nonemergent cardiac operations in The Society of Thoracic Surgeons (STS) database...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669500/one-year-experience-with-a-mobile-extracorporeal-life-support-service
#17
Jacob Gutsche, William Vernick, Todd A Miano
BACKGROUND: Severe acute respiratory distress syndrome is associated with a high mortality rate. The International Extracorporeal Membrane Oxygenation Network recommends regionalization of extracorporeal life support (ECLS) to high-volume centers and development of mobile ECLS teams to rescue patients with severe acute respiratory disease. METHODS: A tertiary medical center developed a mobile team and the infrastructure to support a ECLS transport service available 24 hours a day, 7 days a week...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669499/the-impact-of-margins-on-outcomes-after-wedge-resection-for-stage-i-non-small-cell-lung-cancer
#18
Andrea S Wolf, Scott J Swanson, Rowena Yip, Bian Liu, Elizabeth S Tarras, David F Yankelevitz, Claudia I Henschke, Emanuela Taioli, Raja M Flores
BACKGROUND: The relationship between margin distance and recurrence and survival for stage I non-small cell lung carcinoma (NSCLC) less than or equal to 2 cm is not clear. METHODS: Patient clinicopathologic data were reviewed from a pooled data set of stage I NSCLC lesions less than or equal to 2 cm resected by wedge resection at Brigham and Women's Hospital (BWH) between 2000 and 2005 and the International Early Lung and Cardiac Action Program (I-ELCAP) between 1999 and 2015...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28651783/optimal-timing-of-heart-transplant-after-heartmate-ii-left-ventricular-assist-device-implantation
#19
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
June 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648541/coronary-artery-anomalies-in-patients-with-transposition-of-the-great-arteries-and-their-impact-on-postoperative-outcomes
#20
Maciej Moll, Krzysztof W Michalak, Katarzyna Sobczak-Budlewska, Jadwiga A Moll, Marek Kopala, Konrad Szymczyk, Paweł Dryżek, Jacek J Moll
BACKGROUND: Coronary anomalies are frequently present in children with transposition of the great arteries (TGA). Such anomalies significantly increase the complexity of arterial switch operations and may have an effect on postoperative outcomes. In this study, we aimed to assess the frequency of coronary anomalies in children with TGA and describe their effect on postoperative outcomes. METHODS: All patients with TGA who underwent an arterial switch operation between 1991 and 2015 were consecutively enrolled in this study...
June 22, 2017: Annals of Thoracic Surgery
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