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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/28619544/changes-in-tracheostomy-and-intubation-related-tracheal-stenosis-implications-for-surgery
#1
Samuel S Kim, Zain Khalpey, Charles Hsu, Alex G Little
BACKGROUND: This study sought to identify the changing characteristic patterns and locations of stenosis after tracheostomy or intubation and to assess the risk factors associated with perioperative complication and restenosis after primary resection and reconstruction. METHODS: A retrospective review was performed (January /2012 to March 2015) on patients treated at the University of Arizona Medical Center (Tucson, Arizona) who had symptomatic tracheal stenosis secondary to prolonged intubation or tracheostomy...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28619543/circumferential-three-dimensional-printed-tracheal-grafts-research-model-feasibility-and-early-results
#2
Faiz Y Bhora, Erik E Lewis, Sadiq S Rehmani, Adil Ayub, Wissam Raad, Adnan M Al-Ayoubi, Robert S Lebovics
BACKGROUND: Methods for tracheal graft research have presented persistent challenges to investigators, and three-dimensional (3D)-printed biosynthetic grafts offer one potential development platform. We aimed to develop an efficient research platform for customizable circumferential 3D-printed tracheal grafts and evaluate feasibility and early structural integrity with a large-animal model. METHODS: Virtual 3D models of porcine subject tracheas were generated using preoperative computed tomography scans...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28619542/development-of-a-multidisciplinary-program-to-expedite-care-of-esophageal-emergencies
#3
DuyKhanh P Ceppa, Carlo Maria Rosati, Lola Chabtini, Samantha M Stokes, Holly C Cook, Karen M Rieger, Thomas J Birdas, John C Lappas, William R Kessler, John M DeWitt, Dean D Maglinte, Kenneth A Kesler
BACKGROUND: Level 1 programs have improved outcomes by expediting the multidisciplinary care of critically ill patients. We established a novel level 1 program for the management of esophageal emergencies. METHODS: After institutional review board approval, we performed a retrospective analysis of patients referred to our level 1 esophageal emergency program from April 2013 through November 2015. A historical comparison group of patients treated for the same diagnosis in the previous 2 years was used...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28619541/can-renal-resistive-index-predict-acute-kidney-injury-after-acute-type-a-aortic-dissection-repair
#4
Hai-Bo Wu, Huai Qin, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Li-Zhong Sun
BACKGROUND: This study sought to determine whether assessment of the renal resistive index (RRI) can predict the short-term reversibility of acute kidney injury (AKI) after repair of acute type A aortic dissection (TAAD). METHODS: This prospective study included 62 patients undergoing repair of acute TAAD. Doppler-based RRIs were obtained preoperatively, immediately after the surgical procedure, and 6, 24, and 48 hours postoperatively. The occurrence of AKI was evaluated daily according to Acute Kidney Injury Network criteria...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28619540/video-assisted-thoracic-surgery-thymectomy-versus-sternotomy-thymectomy-in-patients-with-thymoma
#5
Hiroyuki Agatsuma, Kazuo Yoshida, Ichiro Yoshino, Meinoshin Okumura, Masahiko Higashiyama, Kenji Suzuki, Masanori Tsuchida, Jitsuo Usuda, Hiroshi Niwa
BACKGROUND: This study was designed to evaluate the feasibility of video-assisted thoracoscopic surgery (VATS) and to compare the oncologic outcomes of VATS with those of sternotomy in patients with thymoma. METHODS: The clinical outcomes of 2,835 patients with thymic epithelial tumors treated between 1991 and 2010 in 32 Japanese institutions were collected retrospectively. The study compared postoperative complications, positive surgical margins, location of recurrence, and survival in 140 of 142 VATS-treated patients (VATS group) matched with 140 of 1,294 sternotomy-treated patients (ST group) by using propensity scores...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610886/conversion-from-off-pump-coronary-artery-bypass-grafting-to-on-pump-coronary-artery-bypass-grafting
#6
Brent Keeling, Vinod Thourani, Gorav Aliawadi, Sunghee Kim, Derek Cyr, Vinay Badhwar, Jeff Jacobs, J Matthew Brennan, James Meza, Roland Matsouaka, Michael E Halkos
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) has been shown to be an effective strategy for surgical revascularization. The purpose of this study was to define the incidence of intraoperative conversion from OPCAB to on-pump coronary artery bypass grafting (ONCAB) and report outcomes based on the reason for conversion. METHODS: Starting in July 2007, the Society of Thoracic Surgeons database captured patients that were planned OPCAB but then were converted to ONCAB...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610885/three-dimensional-printed-bioengineered-tracheal-grafts-preclinical-results-and-potential-for-human-use
#7
Sadiq S Rehmani, Adnan M Al-Ayoubi, Adil Ayub, Michael Barsky, Erik Lewis, Raja Flores, Robert Lebovics, Faiz Y Bhora
BACKGROUND: We aimed to develop a process using three-dimensional (3D) printing to create bioengineered tracheal grafts (BETGs) for reconstruction of anterior tracheal defects in a large-animal model (porcine) that would have translational relevance for potential human use. METHODS: Preoperative computed tomographic scans were used to create virtual 3D models of the animal airways. Anatomically scaled tracheal grafts were subsequently developed using 3D-printed polycaprolactone and extracellular matrix...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610884/outcomes-for-low-risk-surgical-aortic-valve-replacement-a-benchmark-for-aortic-valve-technology
#8
Lily E Johnston, Emily A Downs, Robert B Hawkins, Mohammed A Quader, Alan M Speir, Jeffrey B Rich, Ravi K Ghanta, Leora T Yarboro, Gorav Ailawadi
BACKGROUND: Two large, randomized trials are underway evaluating transcatheter aortic valve replacement (AVR) against conventional surgical AVR. We analyzed contemporary, real-world outcomes of surgical AVR in low-risk patients to provide a practical benchmark of outcomes and cost for evaluating current and future transapical AVR technology. METHODS: From 2010 to 2015, 2,505 isolated AVR operations were performed for severe aortic stenosis at 18 statewide cardiac institutions...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610883/the-validation-of-a-no-drain-policy-after-thoracoscopic-major-lung-resection
#9
Junichi Murakami, Kazuhiro Ueda, Toshiki Tanaka, Taiga Kobayashi, Yoshie Kunihiro, Kimikazu Hamano
BACKGROUND: The omission of postoperative chest tube drainage may contribute to early recovery after thoracoscopic major lung resection; however, a validation study is necessary before the dissemination of a selective drain policy. METHODS: A total of 162 patients who underwent thoracoscopic anatomical lung resection for lung tumors were enrolled in this study. Alveolar air leaks were sealed with a combination of bioabsorbable mesh and fibrin glue. The chest tube was removed just after the removal of the tracheal tube in selected patients in whom complete pneumostasis was obtained...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610882/advantage-of-induction-chemoradiotherapy-for-lung-cancer-in-securing-cancer-free-bronchial-margin
#10
Hiroki Sato, Shinichi Toyooka, Junichi Soh, Katsuyuki Hotta, Kuniaki Katsui, Kazuhiko Shien, Hiromasa Yamamoto, Takahiro Oto, Susumu Kanazawa, Katsuyuki Kiura, Shinichiro Miyoshi
BACKGROUND: Bronchoplasty is a useful procedure for preserving pulmonary function. For this procedure, it is critical to secure the negative surgical margin for avoiding local recurrence. In this study, we examined the status of the surgical bronchial margin as well as the clinical outcomes in bronchoplasty with or without induction chemoradiotherapy (CRT) for non-small cell lung cancer (NSCLC). METHODS: The medical records of NSCLC patients who underwent bronchoplasty at our institution between January 1999 and September 2014 were reviewed...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28587739/aortic-valve-pathology-as-a-predictive-factor-for-acute-aortic-dissection
#11
Denis Berdajs, Selim Mosbahi, Enrico Ferrari, Dominique Charbonnier, Ludwig K von Segesser
BACKGROUND: In this study, the effect of aortic valve (AV) pathology on local hemodynamic conditions was evaluated as a potential trigger for the onset of acute type A and B aortic dissection. METHODS: A time- and pressure-related four-dimensional (4-D) computed fluid dynamic model of the aorta was established. In an experimental setup, AV stenosis and AV insufficiency were created. 4-D pressure-related geometry of the aortic root (AR) with valve insufficiency and valve stenosis were determined by high-fidelity (200 Hz) microsonometric crystals...
June 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577852/fascia-temporalis-free-flap-for-cricotracheal-reconstruction-a-novel-approach
#12
Bertrand Baujat, Samuel Struk, Maria Lesnik, Olivier de Crouy Chanel, Jonathan Barbut, Marine Lefevre, Sophie Périé, Jean Lacau St Guily
BACKGROUND: The aim of tracheal reconstruction is to provide an airtight and noncollapsible airway covered with a suitable epithelial lining. To date, no ideal treatment is available for large tracheal defects. METHODS: We report 4 patients who underwent one-stage reconstruction for a cricotracheal stenosis with a free temporoparietal fascia flap and costal cartilage grafts. RESULTS: Closure of tracheostoma was achieved for all patients. The main advantage of this flap compared with the free radial forearm flap is that it supplies a more suitable lining allowing the reepithelialization process with respiratory epithelium...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577851/impact-of-liver-indicators-on-clinical-outcome-in-patients-undergoing-transcatheter-aortic-valve-implantation
#13
Daniel Wendt, Philipp Kahlert, Ali Canbay, Stephan Knipp, Martin Thoenes, Gordina Cremer, Fadi Al-Rashid, Rolf-Alexander Jánosi, Karim El-Chilali, Markus Kamler, Mohamed El Gabry, Philipp Marx, Daniel Sebastian Dohle, Konstantinos Tsagakis, Jaroslav Benedik, Guido Gerken, Tienush Rassaf, Heinz Jakob, Matthias Thielmann
BACKGROUND: Liver dysfunction increases death and morbidity after cardiac operations. There are currently no data evaluating liver function in patients undergoing transcatheter aortic valve replacement (TAVR). We aimed therefore to evaluate our TAVR results in regard to liver function. METHODS: A total of 640 consecutive TAVR patients were evaluated. Of those, 11 patients presented with chronic liver disease before TAVR. The Model for End-Stage Liver Disease score was used to measure liver function in these patients...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577850/chronic-myocardial-ischemia-leads-to-loss-of-maximal-oxygen-consumption-and-complex-i-dysfunction
#14
David A Schipper, Ryan Palsma, Katherine M Marsh, Connor O'Hare, Destiny S Dicken, Scott Lick, Toshinobu Kazui, Kitsie Johnson, Ryszard T Smolenski, Dirk J Duncker, Zain Khalpey
BACKGROUND: Cardiomyocytes rely heavily on mitochondrial energy production through oxidative phosphorylation. Chronic myocardial ischemia may cause mitochondrial dysfunction and affect ATP formation. Metabolic changes due to ischemia alters cardiac bioenergetics and hence myocardial function and overall bioenergetic state. Here, we evaluate differences in functional status of respiratory complexes in mitochondrial isolates extracted from left atrial appendage tissue (LAA) from patients undergoing cardiac surgery, with and without chronic ischemia...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577847/short-term-and-midterm-follow-up-of-transthoracic-device-closure-of-atrial-septal-defect-in-infants
#15
Qiang Chen, Hua Cao, Gui-Can Zhang, Liang-Wan Chen, Fan Xu, Jia-Xin Zhang
BACKGROUND: The purpose of this study was to outline the safety and feasibility of transthoracic device closure of an atrial septal defect (ASD) with a domestic occluder in infants. METHODS: Sixty-eight infants underwent transthoracic device closure of an ASD at Union Hospital, Fujian Medical University, Fuzhou, China from January 2010 to January 2015. All relevant clinical data were recorded and analyzed. All patients were invited to undergo contrast transthoracic echocardiography for 12 to 60 months after ASD closure, and telephone interviews were conducted with the infants' parents to evaluate the patients' clinical status further...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577846/surgical-outcome-and-prognostic-stratification-for-pulmonary-metastasis-from-colorectal-cancer
#16
Takehiro Okumura, Narikazu Boku, Tomoyuki Hishida, Yasuhisa Ohde, Yukinori Sakao, Katsuo Yoshiya, Masahiko Higashiyama, Ichinosuke Hyodo, Keita Mori, Haruhiko Kondo
BACKGROUND: This study investigated recent clinical outcomes and prognostic factors of metastasectomy for pulmonary metastasis (PM) from colorectal cancer. METHODS: Data for 785 patients with PM from colorectal cancer who underwent curative resection, including 376 patients treated with postmetastasectomy adjuvant chemotherapy, between 2004 and 2008, were collected from 46 Japanese hospitals. Disease-free and overall survival was analyzed. Potential prognostic factors were assessed...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577845/ninety-day-mortality-after-video-assisted-thoracoscopic-lobectomy-incidence-and-risk-factors
#17
Alessandro Brunelli, Padma Dinesh, Joshua Woodcock-Shaw, Duncan Littlechild, Cecilia Pompili
BACKGROUND: We evaluated the incidence and risk factors of 90-day mortality rate after video-assisted thoracoscopic (VATS) lobectomy. METHODS: Retrospective analysis on 733 VATS lobectomies or segmentectomies (January 2012 to February 2016), including 66 operations converted to open operation. Several patient-related and surgical variables were tested to verify their association with 90-day mortality using univariable and logistic regression analyses. A score was assigned to each variable in the final model by proportionally weighting the regression odds ratios (ORs) and assigning 1 point to the smallest one...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577844/preoperative-staphylococcus-aureus-screening-and-targeted-decolonization-in-cardiac-surgery
#18
Manoj K Saraswat, Jonathan T Magruder, Todd C Crawford, Julia M Gardner, Damon Duquaine, Marc S Sussman, Lisa L Maragakis, Glenn J Whitman
BACKGROUND: We assessed the impact of preoperative Staphylococcus aureus screening and targeted decolonization on the incidence of postoperative methicillin-resistant S aureus (MRSA) colonization, intensive care unit MRSA transmission, and surgical site infections in cardiac surgery patients. METHODS: We reviewed medical records for all adult patients during two periods: preintervention (January 2007 to April 2010) and intervention (January 2011 to December 2014)...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577843/glutaraldehyde-treatment-of-allografts-and-aortic-outcomes-post-norwood-challenging-surgical-decision
#19
Billie-Jean Martin, Michael Kaestner, Mingkai Peng, David B Ross, Simon Urschel, Lori J West, Ivan M Rebeyka
BACKGROUND: Glutaraldehyde (GA) treatment of allografts used for arch reconstruction prevents the immunologic sensitization that occurs with untreated allografts, but its use may cause tissue changes that predispose to recurrent obstruction. The objective was to determine whether GA treatment of allografts used in Norwood procedures increases the risk of recurrent aortic obstruction. METHODS: All infants who underwent a Norwood procedure between 2000 and 2015 were included...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577841/aortic-atheroma-increases-the-risk-of-long-term-mortality-in-20-000-patients
#20
Carolyn Goldberg Butler, Jamahal Maeng Ho Luxford, Chuan-Chin Huang, Julius I Ejiofor, James D Rawn, Kerry Wilusz, John A Fox, Stanton K Shernan, Jochen Daniel Muehlschlegel
BACKGROUND: The association between long-term survival and aortic atheroma in cardiac surgical patients has not been comprehensively investigated. In this study we determine the relation between grade of atheroma and the risk of long-term mortality in a retrospective cohort of more than 20,000 patients undergoing cardiac operation during a 20-year period. METHODS: We included 22,304 consecutive intraoperative transesophageal and epiaortic ultrasound examinations performed at Brigham and Women's Hospital between 1995 and 2014, with long-term follow-up...
June 1, 2017: Annals of Thoracic Surgery
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