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Annals of Thoracic Surgery

Jules Gregory, Souhail Bennani, Gaël Freche, Audrey Mansuet-Lupo, Marie-Pierre Revel, Guillaume Chassagnon
No abstract text is available yet for this article.
March 15, 2018: Annals of Thoracic Surgery
Bastien Provost, Gilles Missenard, Ciprian Pricopi, Olaf Mercier, Sacha Mussot, Dominique Fabre, Nathaniel Langer, Olivier Mir, Cécile Le Pechoux, Philippe Dartevelle, Elie Fadel
BACKGROUND: Radiotherapy has long been the treatment of choice for local control of Ewing sarcoma of the chest wall (ESCW). However, there is debate regarding the use of surgery versus RT. Our objective was to identify risk factors that may affect long-term outcomes of non-metastatic ESCW all treated with preoperative chemotherapy followed by en-bloc resection and adjuvant Chemotherapy or Chemoradiation. METHODS: Between 1996 and 2014, 30 patients with a median age of 25 years (SD +/-8...
March 15, 2018: Annals of Thoracic Surgery
Anita Nguyen, Hartzell V Schaff
No abstract text is available yet for this article.
March 14, 2018: Annals of Thoracic Surgery
Matthew J Bott, Jonathan Cools-Lartigue, Kay See Tan, Joseph Dycoco, Manjit S Bains, Robert J Downey, James Huang, James M Isbell, Daniela Molena, Bernard J Park, Valerie W Rusch, Smita Sihag, David R Jones, Prasad S Adusumilli
BACKGROUND: Surgeons are increasingly asked to operate on patients with residual disease after immunotherapy. The safety and utility of lung resection in this setting are unknown. METHODS: We performed a retrospective review of patients who underwent lung resection within 6 months of treatment with checkpoint blockade agents for metastatic or unresectable cancer. Survival was estimated from first resection using the Kaplan-Meier approach. RESULTS: Database query identified 19 patients who underwent 22 resections for suspected residual disease with therapeutic intent following immunotherapy between 2012 and 2016...
March 14, 2018: Annals of Thoracic Surgery
Adishesh K Narahari, J Hunter Mehaffey, Robert B Hawkins, Pranav K Baderdinni, Anirudha S Chandrabhatla, Curtis G Tribble, Irving L Kron, Mark E Roeser, Dustin M Walters, Gorav Ailawadi
BACKGROUND: Obtaining National Institutes of Health (NIH) R01 funding remains extremely difficult. The utility of career development grants (K awards) for achieving the goal of R01 funding remains debated, particularly for surgeon-scientists. We examined the success rate for cardiothoracic and vascular (CTV) surgeons compared to other specialties in converting K-level grants into R01 equivalents. METHODS: All K (K08 and K23) grants awarded to surgeons by the NIH between 1992-2017 were identified through NIH RePORTER, an online database combining funding, publications, and patents...
March 14, 2018: Annals of Thoracic Surgery
Tara R Semenkovich, Margaret A Olsen, Varun Puri, Bryan F Meyers, Benjamin D Kozower
BACKGROUND: Empyema affects up to 65,000 patients annually in the United States. Recent consensus guidelines demonstrate ambiguity about optimal treatment. We examined current treatment practices and outcomes for inpatient treatment of empyema using a comprehensive, longitudinal dataset that encompasses an entire state cohort of hospitalized patients. METHODS: We queried the Healthcare Cost and Utilization Project (HCUP) New York State Inpatient Database (2009-2014) for patients with primary empyema and subsequent readmissions...
March 14, 2018: Annals of Thoracic Surgery
Yawei Gu, Yunlang She, Chenyang Dai, Yijiu Ren, Ziwen Fan, Huiyuan Zhu, Xiwen Sun, Huikang Xie, Gening Jiang, Dong Xie, Chang Chen
BACKGROUND: Some clinical N0 lung adenocarcinoma have been pathologically diagnosed as N1 or N2. To improve the preoperative diagnostic accuracy of lymph node (LN) disease, we developed a prediction model for LN metastasis in cT1N0M0 lung adenocarcinoma based on computed tomography (CT) texture analysis and clinical characteristics to estimate the probability of LN metastasis. METHODS: The records of 501 consecutive patients with cT1N0M0 lung adenocarcinoma who underwent CT scan and pulmonary resection with systematic lymph nodes dissection or lymph nodes sampling were reviewed...
March 14, 2018: Annals of Thoracic Surgery
Joseph P DeSimone, David J Malenka, Paul W Weldner, Alexander Iribarne, Bruce J Leavitt, Jock N McCullough, Reed D Quinn, Joseph D Schmoker, Robert S Kramer, Yvon Baribeau, John D Klemperer, Gerald L Sardella, Elaine M Olmstead, Cathy S Ross, Anthony W DiScipio
BACKGROUND: Coronary artery bypass graft surgery (CABG) arterial conduits are preferred to venous conduits because of longer patency. A single internal mammary artery (SIMA) is used routinely. Bilateral internal mammary arteries (BIMA) are used less frequently. We sought to determine if BIMA were superior to SIMA. METHODS: From our regional registry of consecutive open heart surgery, we identified 47,984 patients who underwent isolated CABG from 1992-2014. Of the 1,482 BIMA patients, 1,297 were propensity matched to a cohort of SIMA patients...
March 14, 2018: Annals of Thoracic Surgery
John M Trahanas, Benjamin S Van Boxtel, Steven E Miller, Christopher Irobunda, Susheel K Kodali, Isaac George
There are few case reports in the literature of transcatheter aortic valve replacement used as emergent therapy for aortic insufficiency. We present a case in which transcatheter aortic valve replacement was implemented successfully as a salvage therapy in a hemodynamically unstable patient experiencing aortic insufficiency as a result of a torn bio-prosthetic leaflet during an unrelated abdominal operation. The successful use of this technique in a non-cardiac operating room allowed the patient to be placed on extracorporeal support and ultimately to be discharged home...
March 13, 2018: Annals of Thoracic Surgery
Jeffrey Rich, Clifford E Fonner, Jayna Eller, Ivan Berkel, Deborah Nadzam
No abstract text is available yet for this article.
March 13, 2018: Annals of Thoracic Surgery
Francesca Uccheddu, Marco Ghionzoli, Yary Volpe, Michaela Servi, Rocco Furferi, Lapo Governi, Flavio Facchini, Roberto Lo Piccolo, Kathleen S McGreevy, Alessandra Martin, Monica Carfagni, Antonio Messineo
BACKGROUND: Current approaches to quantifying the severity of pectus excavatum (PE) require internal measurements based on cross-sectional imaging. The aim of this study is to exploit a novel index evaluated on the external surface of the chest with a 3D optical scanner. METHODS: 51 children (41 males, 10 females), between 2 and 17 years old, were evaluated with a 3D optical scanner. PE severity was calculated by using an ad hoc instant 3D scanner and defining an automatic procedure to generate an optical 3D index (CI-3D)...
March 13, 2018: Annals of Thoracic Surgery
Prateek Bhatnagar, Shubhi Bhatnagar
Mesocardia is an extremely rare congenital cardiac anomaly of counter clockwise rotation of the heart. We report here a case of coronary artery bypass grafting in mesocardia, which has not been described in medical literature earlier. A 52 years male suffered an anterior wall myocardial infarction. Chest X Ray, 2 D Echocardiography and computed tomography of chest confirmed the presence of mesocardia. Off pump total arterial revascularization was done. Exposure of aorta and right atrium through the standard median sternotomy is very difficult in mesocardia due to cardiac rotation and should be kept in mind in this surgery...
March 13, 2018: Annals of Thoracic Surgery
David B Nelson, Myrna Cb Godoy, Marcelo F Benveniste, Jitesh B Shewale, Jonathan D Spicer, Kyle G Mitchell, Wayne L Hofstetter, Reza J Mehran, David C Rice, Boris Sepesi, Garrett L Walsh, Ara A Vaporciyan, Stephen G Swisher, Jack A Roth, Mara B Antonoff
BACKGROUND: Ground glass opacities pose diagnostic challenges, and even after malignancy is confirmed, prognosis is often unclear. We sought to identify clinicoradiographic features that could predict aggressive tumor biology in lung adenocarcinoma with associated ground glass components. METHODS: A retrospective review of patients with resected lung adenocarcinoma from 2008-2013 was performed. Detailed radiographic features were reviewed by two radiologists. Logistic regression was used to identify risks of poor differentiation or a composite outcome of nodal metastases/lymphovascular invasion...
March 10, 2018: Annals of Thoracic Surgery
Meredith A Ray, Nicholas R Faris, Matthew P Smeltzer, Carrie Fehnel, Cheryl Houston-Harris, Paul Levy, Lynn Wiggins, Vishal Sachdev, Todd Robbins, David Spencer, Raymond U Osarogiagbon
BACKGROUND: Accurate pathologic nodal staging improves early-stage non-small-cell lung cancer survival. In an ongoing implementation study, we measured the impact of a surgical lymph node specimen collection kit and a more thorough pathologic gross dissection method, on attainment of guideline-recommended pathologic nodal staging quality. METHODS: We prospectively collected data on curative-intent non-small cell lung cancer resections from 2009-2016 from 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions...
March 10, 2018: Annals of Thoracic Surgery
Duk Hwan Moon, Jae Hyun Jeon, Hee Chul Yang, Young-Il Kim, Jong Yeul Lee, Moon Soo Kim, Jong Mog Lee, Geon-Kook Lee
BACKGROUND: The purpose of this study was to assess the clinicopathological implications of intramural metastasis (IM) in patients with esophageal squamous cell carcinoma (ESCC). METHODS: We retrospectively analyzed 743 patients who underwent esophagectomy. Among these patients, IM was detected in 41 patients (5.5%). The clinicopathological features of IM and its influence on postoperative recurrence were investigated. RESULTS: In total, 710 male patients and 33 female patients with a mean age of 64...
March 10, 2018: Annals of Thoracic Surgery
Konstantin V Borisov
BACKGROUND: In patients with hypertrophic obstructive cardiomyopathy myocardial fibrosis is an independent predictor of adverse outcome. A new technique of HOCM surgical correction in patients with severe hypertrophy and septal myocardial fibrosis has been proposed. METHODS: The excision of the asymmetrical hypertrophied area of the interventricular septum causing obstruction was performed from the conal part of the right ventricle corresponding to the zone of obstruction of the left ventricle (LV)...
March 10, 2018: Annals of Thoracic Surgery
Sara A Hayes, James Huang, Jennifer Golia Pernicka, Jane Cunningham, Junting Zheng, Chaya S Moskowitz, Michelle S Ginsberg
BACKGROUND: The aim of this study was to assess pre-operative computed tomography (CT) characteristics of thymic carcinomas and to investigate which features could predict an incomplete surgical resection. A secondary aim was to correlate pre-operative imaging features with Masaoka stage. METHODS: In this study, approved by our Institutional Review Board, two readers retrospectively reviewed pre-operative CTs at our tertiary referral oncology center between 1994 and 2014...
March 10, 2018: Annals of Thoracic Surgery
Wan Kee Kim, Joon Bum Kim
A 58-year-old man visited the emergency department with vague anterior chest discomfort. Based on computed tomographic findings, our initial suspicion was intramural hematoma (IMH) in the ascending aorta. After a comprehensive discussion with relevant departments, emergent operation was planned. Intra-pericardial space, however, was severely adhered suggesting chronic inflammation. Biopsies were performed, and additional surgical procedures were discontinued. The patient was finally diagnosed as having Granulomatosis with Polyangiitis...
March 9, 2018: Annals of Thoracic Surgery
Joshua L Chan, Justin G Miller, Mandy Murphy, Ann Greenberg, Peggy Iraola, Keith A Horvath
BACKGROUND: Prolonged intubation following cardiac surgery is associated with significant morbidity. A fast-track extubation protocol primarily driven by bedside providers was instituted for all postoperative cardiac surgery patients to facilitate safe and expeditious extubation. METHODS: A retrospective review of 1581 cardiac surgery patients over an 8-year period was performed. Prior to 2011, non-protocolized standard perioperative management was utilized (n=807)...
March 9, 2018: Annals of Thoracic Surgery
Robert B Hawkins, J Hunter Mehaffey, Eric J Charles, John A Kern, D Scott Lim, Nicholas R Teman, Gorav Ailawadi
BACKGROUND: Frailty is an important predictor of outcomes after cardiac surgery, but utility is limited by difficult assessment and quantification. We hypothesize that sarcopenia defined as psoas muscle cross-sectional area is a useful predictor of surgical aortic valve replacement (SAVR) outcomes in moderate to high-risk patients. METHODS: Moderate to high-risk (predicted risk of mortality [PROM] >3%) patients who underwent SAVR with or without coronary bypass were extracted from an institutional database (2009-2016)...
March 9, 2018: Annals of Thoracic Surgery
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