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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/28527964/impact-of-high-priority-allocation-on-lung-and-heart-lung-transplantation-for-pulmonary-hypertension
#1
Laurent Savale, Jérôme Le Pavec, Olaf Mercier, Sacha Mussot, Xavier Jaïs, Dominique Fabre, Caroline O'Connell, David Montani, François Stephan, Olivier Sitbon, Gérald Simonneau, Philippe Dartevelle, Marc Humbert, Elie Fadel
BACKGROUND: Since 2006 and 2007, patients in France with severe pulmonary hypertension (PH) who are at imminent risk of death, despite optimal treatment in the intensive care unit, are placed on a high-priority list (HPL) for heart-lung transplantation (HLT) or double-lung transplantation (DLT). We assessed the effect of this approach on the waiting list and outcomes after transplantation. METHODS: We conducted a single-center, retrospective, before-and-after study of consecutive patients with severe group 1, 1', or 4 PH listed for DLT or HLT between 2000 and 2013 (ie, 6 years before and 6 years after HPL implementation)...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527963/clinical-significance-of-spontaneous-pneumomediastinum
#2
Brittany A Potz, Linda H Chao, Thomas T Ng, Ikenna C Okereke
BACKGROUND: Spontaneous pneumomediastinum (SPM) is classified as free air in the mediastinum in the absence of any precipitating cause. It is relatively uncommon, and the clinical significance and risk associated with SPM is not well understood and has not been widely documented in the literature. Our goals were to determine the outcomes of patients who presented with SPM and to determine predictors of severe pathology associated with SPM. METHODS: From 2004 through 2013, a retrospective review was conducted of patients who presented with SPM to our institution...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527969/surgically-managed-clinical-stage-iiia-clinical-n2-lung-cancer-in-the%C3%A2-society-of-thoracic-surgeons-database
#3
Daniel Boffa, Felix G Fernandez, Sunghee Kim, Andrzej Kosinski, Mark W Onaitis, Patricia Cowper, Jeffrey P Jacobs, Cameron D Wright, Joe B Putnam, Anthony P Furnary
BACKGROUND: The role of surgical resection in patients with clinical stage IIIA-N2 positive (cIIIA-N2) lung cancer is controversial, partly because of the variability in short- and long-term outcomes. The objective of this study was to characterize the management of cIIIA-N2 lung cancer in The Society of Thoracic Surgeons General Thoracic Surgery Database (STS-GTSD). METHODS: The STS-GTSD was queried for patients who underwent operations for cIIIA-N2 lung cancer between 2002 and 2012...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527968/rapid-immunohistochemistry-with-thyroid-transcription-factor-1-for-pulmonary-adenocarcinoma
#4
Hayato Konno, Hajime Saito, Hiroshi Nanjo, Yuko Hiroshima, Nobuyasu Kurihara, Satoshi Fujishima, Maiko Atari, Yusuke Sato, Satoru Motoyama, Ryuta Nakamura, Yoichi Akagami, Yoshihiro Minamiya
BACKGROUND: Intraoperative pathologic diagnosis of solitary pulmonary tumors to differentiate between metastatic and primary lung cancer is extremely important to determine the appropriate range of excision. Accurate intraoperative pathologic evaluation may be often difficult, however, and needs additional immunohistochemical (IHC) evaluation to support the diagnosis. Although conventional IHC is a powerful tool for diagnosis, its clinical use is limited intraoperatively because of time constraints...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527967/feasibility-and-safety-of-the-transbronchial-access-tool-for-peripheral-pulmonary-nodule-and-mass
#5
Mark R Bowling, Craig Brown, Carlos J Anciano
BACKGROUND: Navigational bronchoscopy and other imaging modalities have improved the ability to evaluate pulmonary nodules/mass. Many of these lesions are located outside the bronchial airway and are difficult to access even with these devices. The Transbronchial Access Tool (Medtronic, Minneapolis, MN) allows the bronchoscopist to create a pathway from the bronchial airway, across the lung parenchyma, and into the target lesion. We are reporting the feasibility and safety of this new device...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527966/suture-dehiscence-in-the-tricuspid-annulus-an-ex%C3%A2-vivo-analysis-of-tissue-strength-and-composition
#6
Deborah M Paul, Ajay Naran, Eric L Pierce, Charles H Bloodworth, Steven F Bolling, Ajit P Yoganathan
BACKGROUND: Surgical repair of functional tricuspid regurgitation (FTR) is an increasingly common practice, but annuloplasty suture dehiscence remains a significant problem. Quantitative and mechanistic understanding of annular suture holding strength can support more effective techniques for tricuspid valve device anchoring. METHODS: Suture holding strength of ovine tricuspid annuli (n = 15) was quantified ex vivo by pullout testing at 12 positions around their circumference...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527965/perfusion-index-an-indicator-of-success-during-endoscopic-thoracic-sympathectomy-for-hyperhidrosis
#7
Eric I-Hun Jeng, Nikolaus Gravenstein, Charles T Klodell
BACKGROUND: Endoscopic thoracic sympathectomy (ETS) is indicated for refractory hyperhidrosis. The pulse oximetry-derived perfusion index (PI) quantifies pulsatile blood flow at the oximeter. Thoracic sympathectomy increases blood flow; thus we postulate it will reliably increase PI. We evaluated the ipsilateral finger PI as a predictor of successful sympathectomy during ETS. METHODS: After institutional review board approval and informed consent, 100 adult patients undergoing bilateral ETS were studied...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527962/resolution-of-mitral-regurgitation-with-left-ventricular-assist-device-support
#8
Matthew Goodwin, Hassan W Nemeh, Jamil Borgi, Gaetano Paone, Jeffrey A Morgan
BACKGROUND: Cardiac valve disease is common in patients with end-stage heart failure undergoing left ventricular assist device implantation (LVAD). The aim of this study was to determine if preoperative mitral regurgitation (MR) affects outcomes and hemodynamics in patients after LVAD implantation. METHODS: From March 2006 through May 2015, 238 consecutive patients underwent LVAD implantation. Patient cohorts included less than moderate to severe MR (< moderate-severe, n = 195) and greater than or equal to moderate to severe MR (≥ moderate-severe, n = 43)...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527961/major-aortopulmonary-collateral-arteries-with-anatomy-other-than-pulmonary-atresia-ventricular-septal-defect
#9
William L Patrick, Richard D Mainwaring, Olaf Reinhartz, Rajesh Punn, Theresa Tacy, Frank L Hanley
BACKGROUND: Major aortopulmonary collateral arteries (MAPCAs) are frequently found in association with pulmonary atresia with ventricular septal defect (PA/VSD). However, some patients with MAPCAs do not have PA/VSD but have a variety of other "atypical" anatomic diagnoses. METHODS: This was a retrospective review of patients with MAPCAs and atypical anatomy. The 50 patients with MAPCAs could be divided into two subgroups: (1) single ventricle anatomy (n = 33) and (2) two ventricle anatomy (n = 17)...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527960/mortality-and-respiratory-failure-after-thoracoscopic-lung-biopsy-for-interstitial-lung-disease
#10
Michael T Durheim, Sunghee Kim, Brian C Gulack, William R Burfeind, Henning A Gaissert, Andrzej S Kosinski, Matthew G Hartwig
BACKGROUND: Surgical lung biopsy contributes to establishing a specific diagnosis among many patients with interstitial lung disease (ILD). The risks of death and respiratory failure associated with elective thoracoscopic surgical lung biopsy, and patient characteristics associated with these outcomes, are not well understood. METHODS: This is a retrospective cohort study of patients who underwent elective thoracoscopic lung biopsy for ILD between 2008 and 2014, according to The Society of Thoracic Surgeons database...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499737/endovascular-repair-as-a-bridge-to-open-repair-of-a-ruptured-descending-thoracic-aspergilus-aortitis
#11
Philippe Tresson, Arnaud Roussel, Pierre Mordant, Pierre Cerceau, Yves Castier, Quentin Pellenc
Invasive aspergillosis rarely involves the thoracic aorta, and is associated with a poor prognosis. A heart-transplanted 56-year old patient presented with invasive aspergillosis, primary aspergillus aortitis, and ruptured thoracic aorta pseudoaneurysm. Open surgery was not possible due to severe sepsis. A sequential surgical strategy was therefore decided, including emergency thoracic endovascular aneurysm repair, followed by antifungal treatment, and definitive open repair with explantation of the endograft and placement of a cryopreserved arterial allograft under extra-corporeal membrane oxygenator support...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499656/outcome-of-a-step-up-treatment-strategy-for-chyle-leakage-after-esophagectomy
#12
Teun J Weijs, Jelle P Ruurda, Maria E Broekhuizen, Tom C L Bracco Gartner, Richard van Hillegersberg
BACKGROUND: Thoracic chyle leakage is a major complication of esophagectomy. In this study our treatment strategy for chyle leakage was evaluated and its risk factors were identified. METHODS: According to the Esophagectomy Complications Consensus Group recommendations, chyle leakage was classified as follows: I, enteric dietary modifications; II, total parenteral nutrition (TPN); and III, interventional or surgical therapy. It was graded as A, less than 1,000 mL per day; or B, more than 1,000 mL per day...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499655/validating-the-thoracic-revised-cardiac-risk-index-following-lung-resection
#13
Daniel C Thomas, Justin D Blasberg, Brian N Arnold, Joshua E Rosen, Michelle C Salazar, Frank C Detterbeck, Daniel J Boffa, Anthony W Kim
BACKGROUND: The Thoracic Revised Cardiac Index (ThRCRI) is a tool that differentiates patients who may proceed to lung resection (classes A or B) from those who should receive additional cardiac evaluation (classes C or D). This study aims to describe the ability of the ThRCRI to stratify patients based on major cardiac complication rates using a large multi-institutional dataset. METHODS: Patients undergoing lobectomy or pneumonectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program dataset from 2005 to 2012...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499654/hybrid-extracorporeal-membrane-oxygenation-using-avalon-elite-double-lumen-cannula-ensures-adequate-heart-brain-oxygen-supply
#14
Ju Zhao, Dongfang Wang, Cherry Ballard-Croft, Jingkun Wang, Po-Lin Hsu, Matthew Bacchetta, Joseph B Zwischenberger
BACKGROUND: Differential hypoxia exists in peripheral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) patients with compromised lungs, causing hypoxic damage to heart or brain. We proposed an Avalon Elite (Maquet, Rastatt, Germany) double lumen cannula-based hybrid ECMO to add a venovenous (VV) blood flow into the pulmonary circulation onto the existing VA ECMO circuit to increase oxygen saturation in the left ventricle and ascending aorta, mitigating heart/brain hypoxia...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499653/customized-hinged-covered-metallic-stents%C3%A2-for-the-treatment-of-benign-main-bronchial-stenosis
#15
Xinwei Han, Quazi Al-Tariq, Yanle Zhao, Lei Li, Zhe Cheng, Huaqi Wang, Chao Liu, Dechao Jiao, Gang Wu
BACKGROUND: To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications. METHODS: This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance. RESULTS: Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499652/lack-of-furosemide-responsiveness-predicts-acute-kidney-injury-in-infants-after-cardiac-surgery
#16
Aadil Kakajiwala, Ji Young Kim, John Z Hughes, Andrew Costarino, John Ferguson, J William Gaynor, Susan L Furth, Joshua J Blinder
BACKGROUND: This was a retrospective study to determine whether lack of furosemide responsiveness (LFR) predicts acute kidney injury (AKI) after cardiopulmonary bypass surgery in infants. METHODS: Infants (less than 1 year of age) undergoing cardiopulmonary bypass surgery, receiving routine postoperative furosemide (0.8 to 1.2 mg/kg per dose between 8 and 24 hours after surgery) were included. Urine output was measured 2 and 6 hours after furosemide dose. Lack of furosemide responsiveness was defined a priori as urine output less than 1 mL · kg(-1) · h(-1) after furosemide...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499651/bioprosthetic-aortic-valve-durability-a-meta-regression-of-published-studies
#17
REVIEW
Mansen Wang, Anthony P Furnary, Hsin-Fang Li, Gary L Grunkemeier
To compare structural valve deterioration (SVD) among bioprosthetic aortic valve types, a PubMed search found 54 papers containing SVD-free curves extending to at least 10 years. The curves were digitized and fit to Weibull distributions, and the mean times to valve failure (MTTF) were calculated. Twelve valve models were collapsed into four valve types: Medtronic (Medtronic, Minneapolis, MN) and Edwards (Edwards Lifesciences, Irvine, CA) porcine; and Sorin (Sorin Group [now LivaNova], London, United Kingdom) and Edwards pericardial...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499650/the-mesenchymal-state-predicts-poor-disease-free-survival-in-resectable-non-small-cell-lung-cancer
#18
Kunal Mehta, Erika Moravcikova, David McFall, James D Luketich, Arjun Pennathur, Albert D Donnenberg, Vera S Donnenberg
BACKGROUND: The epithelial-mesenchymal transition (EMT) is thought to contribute to the overall invasiveness of malignant cells. Expression of cluster of differentiation (CD) 44 and CD90 mark the mesenchymal state in multiple epithelial malignancies. Their role in lung cancer remains unclear, however. This study evaluated the prognostic significance of CD44 and CD90 coexpression in patients with resectable primary non-small cell lung cancer (NSCLC). METHODS: This was a nonconcurrent cohort study of patients with resectable NSCLC, stratified by the degree of expression of CD44/CD90 double-positive cells in their primary tumor...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28483154/pilot-study-to-integrate-patient-reported-outcomes-after-lung-cancer-operations-into-the-society-of-thoracic-surgeons-database
#19
Onkar V Khullar, Mohammed H Rajaei, Seth D Force, Jose N Binongo, Yi Lasanajak, Scott Robertson, Allan Pickens, Manu S Sancheti, Joseph Lipscomb, Theresa W Gillespie, Felix G Fernandez
BACKGROUND: A critical gap in The Society of Thoracic Surgeons (STS) Database is the absence of patient-reported outcomes (PRO), which are of increasing importance in outcomes and performance measurement. Our aim was to demonstrate the feasibility of integrating PRO into the STS Database for patients undergoing lung cancer operations. METHODS: The National Institutes of Health Patient Reported Outcome Measurement Information System (PROMIS) includes reliable, precise measures of PRO...
May 5, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28483153/vascular-endothelial-growth-factor-prevents-endothelial-to-mesenchymal-transition-in%C3%A2-hypertrophy
#20
Ben M-W Illigens, Alejandra Casar Berazaluce, Dimitrios Poutias, Robert Gasser, Pedro J Del Nido, Ingeborg Friehs
BACKGROUND: In hypertrophy, progressive loss of function caused by impaired diastolic compliance correlates with advancing cardiac fibrosis. Endothelial cells contribute to this process through endothelial-to-mesenchymal transition (EndMT) resulting from inductive signals such as transforming growth factor (TGF-β). Vascular endothelial growth factor (VEGF) has proven effective in preserving systolic function and delaying the onset of failure. In this study, we hypothesize that VEGF inhibits EndMT and prevents cardiac fibrosis, thereby preserving diastolic function...
May 5, 2017: Annals of Thoracic Surgery
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