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Annals of Thoracic Surgery

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https://www.readbyqxmd.com/read/27899293/valvular-regurgitation-after-implantation-of-prostheses-secured-with-cor-knot-automated-fasteners
#1
Alexander A Brescia, Steven F Bolling, Himanshu J Patel
Valvular regurgitation is a recognized complication of aortic and mitral valve procedures, with paravalvular leak the primary mechanism and transvalvular less common. The Cor-knot automated fastener (LSI SOLUTIONS, Victor, NY, USA) has been shown to be a safe, viable alternative to knot pushers or manual tying for use in these procedures. Here we present two cases in which Cor-Knot fastener orientation appeared to result in transvalvular regurgitation necessitating redo operation. With adjunctive use of Cor-Knot devices, fastener orientation relative to valve geometry must be assessed for optimal results...
November 26, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27889103/cardiac-autonomic-changes-after-thoracic-sympathectomy-a-prospective-randomized%C3%A2-study
#2
Alfonso Fiorelli, Giovanni Messina, Paolo Chiodini, Saveria Costanzo, Andrea Viggiano, Marcellino Monda, Giovanni Vicidomini, Mario Santini
BACKGROUND: We evaluated whether cardiac autonomic changes could be associated with different extent of sympathetic nerve resection in the management of essential palmar hyperhidrosis. METHODS: Sixty patients with essential palmar hyperhidrosis were randomly allocated to undergo excision of T3 ganglia (sympathicectomy group; n = 30) or to interruption of sympathetic chain at the T2 to T3 level with ganglion sparing (sympathicotomy group; n = 30). Time and frequency domains were measured with a 24-Holter monitor during daytime, nighttime, and 24-hour periods at different interval points (7 days before operation; 24 hours; and 1, 3, and 6 months later), and the differences were statistically compared...
November 23, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27884412/the-society-of-thoracic-surgeons-adult-cardiac-surgery-database-2017-update-on-outcomes-and-quality
#3
Richard S D'Agostino, Jeffrey P Jacobs, Vinay Badhwar, Gaetano Paone, J Scott Rankin, Jane M Han, Donna McDonald, Fred H Edwards, David M Shahian
Established in 1989, The Society of Thoracic Surgeons Adult Cardiac Surgery Database is one of the most comprehensive clinical data registries in health care. It is widely regarded as the gold standard for benchmarking risk-adjusted outcomes in cardiac surgery and is the foundation for all quality measurement and improvement activities of The Society of Thoracic Surgeons. This is the second in a series of annual reports that summarizes current aggregate national outcomes in cardiac surgery and reviews database-related activities in the areas of quality measurement and performance improvement during the past year...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27884411/celsior-versus-microplegia-analysis-of-myocardial-protection-in-elective-aortic-valve-replacement
#4
Jose López-Menéndez, Javier Miguelena, Carlos Morales, Carmen L Díaz, Francisco Callejo, Juan Carlos Llosa, Jacobo Silva
BACKGROUND: Previous studies have analyzed the efficacy of crystalloid cardioplegic solutions, but the use of Celsior (Genzyme Corp, Boston, MA) as a crystalloid cardioplegic solution has not been evaluated. METHODS: In this observational retrospective study, Celsior crystalloid solution was compared with an all-blood continuous myocardial protection (microplegia). The study included all patients who underwent elective aortic valve replacement operations in whom the myocardial protection was Celsior or microplegia...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27884410/complications-after-cardiac-operations-all-are-not-created-equal
#5
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Alejandro Suarez-Pierre, Christopher M Sciortino, Kaushik Mandal, Kenton J Zehr, John V Conte, Robert S Higgins, Duke E Cameron, Glenn J Whitman
BACKGROUND: Postoperative complications are associated with increased morbidity and mortality after cardiac operations. We sought to quantify the effect of multiple complications on noninstitutionalized recovery after cardiac operations. METHODS: We identified 2,477 adult patients from our institutional cardiac surgery database who underwent one of seven index cardiac surgical operations from 2011 to 2014. We calculated failure-to-rescue rates for all individual complications and combinations of complications...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27884409/percutaneous-perventricular-device-closure-of-ventricular-septal-defect-from-incision-to-pinhole
#6
Changping Gan, Ling Peng, Zhonglei Liang, Haibo Song, Jiahuang Yang, Weiqiang Ruan, Shuhua Luo, Ke Lin
BACKGROUND: As an alternative to open surgical repair, perventricular device closure provides minimally invasive treatment for doubly committed subarterial ventricular septal defects. However, unlike percutaneous transcatheter access, mini-thoracotomy is still needed. This report describes the percutaneous perventricular device closure technique and its short-term results for this type of heart defect. METHODS: Sixteen patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous perventricular device closure...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27866651/cardiac-surgery-in-patients-with-previous-hepatic-or-renal-transplantation-a%C3%A2-pair-matched-study
#7
Mina Farag, Marina Nikolic, Rawa Arif, Bastian Schmack, Anton Sabashnikov, Mohamed Zeriouh, Aron-Frederik Popov, Arjang Ruhparwar, Matthias Karck, Alexander Weymann
BACKGROUND: The objective of this study was to compare outcomes of patients with previous solid organ transplant with those of a pair-matched population. METHODS: Data from our prospectively maintained cardiac surgery registry were obtained and identified 70 transplant recipients (21 hepatic, 49 renal) who were operated on at our department of cardiac surgery between 2000 and 2013; they formed the transplant group. Those patients were pair-matched regarding age, sex, and cardinal cardiac risk factors to form the pair-matched group...
November 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27866650/evidence-based-and-personalized-medicine-it-s-and-not-or
#8
REVIEW
Sahar Mokhles, Johanna Jm Takkenberg, Tom Treasure
Good clinical practice is an amalgamation of personalized medicine with evidence-based medicine in the best interests of patient. Hence, our title uses Boolean operators to indicate that it is [AND] not [OR]. This is the syntax of formal searching for systematic reviews, ensuring that all the evidence is found. Comprehensive evidence-based guidance can thus be formulated. Many residents and fellows around the world, and their chiefs, are now exposed to consensus documents, white papers, levels of appropriateness, and guidelines and are in many jurisdictions expected to comply with them...
November 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27865477/tracheostomy-among-infants-with-hypoplastic-left-heart-syndrome-undergoing-cardiac-operations-a-multicenter-analysis
#9
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27865476/endobronchial-and-endoscopic-ultrasound-guided-transvascular-biopsy-of%C3%A2-mediastinal-hilar-and-lung-lesions
#10
Jordan Kazakov, Pravachan Hegde, Mehdi Tahiri, Vicky Thiffault, Pasquale Ferraro, Moishe Liberman
BACKGROUND: Endoscopic techniques, including endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS), are the initial approach for the diagnosis and staging of lung cancer and the diagnosis of mediastinal and hilar lesions. Historically, the transvascular approach has been avoided because of concerns of bleeding. Here we review our experience with EBUS and EUS transvascular biopsy of mediastinal, hilar, and lung lesions. METHODS: A prospective research database was used to retrospectively identify and review the records 33 consecutive patients who underwent EBUS and EUS transvascular biopsy in an outpatient setting over 4 years...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27865475/soluble-receptor-for-advanced-glycation-end-products-quantifies-lung-injury-in-polytraumatized-patients
#11
Lukas L Negrin, Gabriel Halat, Helmut Prosch, Michael Hüpfl, Stefan Hajdu, Thomas Heinz
BACKGROUND: Biomarkers caused by blunt chest trauma might leak into the vascular compartment and therefore reflect the severity of parenchymal lung injury (PLI). Five promising proteins were preselected after a literature scan. The objective of our study was to identify a biomarker that is released abundantly into the serum shortly after trauma and reliably quantifies the loss of functional lung tissue. METHODS: Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27865474/tubeless-uniportal-thoracoscopic-wedge-resection-for-peripheral-lung-nodules
#12
Shun-Mao Yang, Man-Ling Wang, Ming-Hui Hung, Hsao-Hsun Hsu, Ya-Jung Cheng, Jin-Shing Chen
BACKGROUND: Endotracheal intubation and chest tube drainage are considered mandatory for thoracoscopic pulmonary resection. The management of peripheral lung nodules by tubeless uniportal thoracoscopic surgical repair has not been reported previously. METHODS: From October 2015 through January 2016, 30 consecutive patients with peripheral lung nodules underwent uniportal thoracoscopic wedge resection without endotracheal intubation and chest tube drainage (tubeless group)...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27863733/impact-of-left-ventricular-systolic-function-on-outcome-of-correction-of-chronic-severe-aortic-valve-regurgitation-implications-for-timing-of-surgical-intervention
#13
Takashi Murashita, Hartzell V Schaff, Rakesh M Suri, Richard C Daly, Zhuo Li, Joseph A Dearani, Kevin L Greason, Rick A Nishimura
BACKGROUND: The timing of valve repair or replacement in patients with severe aortic valve regurgitation (AR) is controversial. We investigated the effect of left ventricular (LV) function on survival and recovery of LV performance and dimensions after correction of chronic severe AR. METHODS: We reviewed 530 consecutive patients who underwent aortic valve repair or replacement for severe AR between January 1, 2004, and June 30, 2014. RESULTS: The 30-day mortality was 0...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27863732/efficacy-of-aortic-valve-resuspension-in-establishing-valve-competence-in-acute-type-a-dissections
#14
Paul C Tang, Abbasali Badami, Shahab A Akhter, Satoru Osaki, Lucian Lozonschi, Takushi Kohmoto, Nilto De Oliveira
BACKGROUND: This study investigates the efficacy of aortic valve (AV) resuspension with preservation of the native aortic root in maintaining AV competence during type A dissection repair. METHODS: A total of 154 acute type A dissection repairs were performed from January 2000 to July 2015. AV resuspension was performed in 120 patients to address AV insufficiency (AI). Survival data were derived from 120 patients who had AV resuspensions and all 154 acute type A dissection repairs...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27863731/pulmonary-resection-for-synchronous-m1b-cstage-iv-non-small-cell-lung-cancer%C3%A2-patients
#15
Masafumi Yamaguchi, Makoto Edagawa, Yuzo Suzuki, Ryo Toyozawa, Fumihiko Hirai, Kaname Nosaki, Takashi Seto, Mitsuhiro Takenoyama, Yukito Ichinose
BACKGROUND: We wanted to assess the efficacy of curative intent pulmonary resection for non-small cell lung cancer (NSCLC) patients with synchronous M1b-distant metastases in a single organ or lesion. METHODS: Between 1995 and 2015, 23 consecutive synchronous M1b-cStage IV NSCLC patients who underwent any treatment for metastases and curative intent pulmonary resection were retrospectively analyzed. RESULTS: Sixteen patients were men and 7 were women, with a median age of 56 years (range: 41 to 76 years)...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27863730/psoas-muscle-area-and-length-of-stay-in-older-adults-undergoing-cardiac-operations
#16
Jesse Zuckerman, Matthew Ades, Louis Mullie, Amanda Trnkus, Jean-Francois Morin, Yves Langlois, Felix Ma, Mark Levental, José A Morais, Jonathan Afilalo
BACKGROUND: Frailty assessment can help predict which older adults will experience adverse events after cardiac surgical procedures. Low muscle mass is a core component of frailty that is suboptimally captured by self-reported weight loss; refined measures using computed tomographic (CT) images have emerged and are predictive of outcomes in noncardiac surgical procedures. The objective of this study was to evaluate the association between CT muscle area and length of stay (LOS) after cardiac surgical procedures...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27863729/outcomes-of-anterolateral-thoracotomy-with-or-without-partial-sternotomy-for-kommerell-diverticulum
#17
Gaku Uchino, Keiji Yunoki, Shigeru Hattori, Naoya Sakoda, Takuya Kawabata, Munehiro Saiki, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
BACKGROUND: Kommerell diverticulum is a rare aortic arch anomaly. The indications for operative intervention and surgical strategy are still controversial. The standard surgical procedure at our institution is total aortic arch plus descending aortic replacement using anterolateral thoracotomy with partial sternotomy. The aberrant subclavian artery is reconstructed anatomically or extraanatomically. METHODS: From 2002 to 2014, 6 patients (1 woman), aged 55 to 78 years, underwent graft replacement through an anterolateral thoracotomy or anterolateral thoracotomy with a partial sternotomy approach for Kommerell diverticulum...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27863728/fontan-patient-survival-after-pediatric-heart-transplantation-has-improved-in-the-current-era
#18
Kathleen E Simpson, Elizabeth Pruitt, James K Kirklin, David C Naftel, Rakesh K Singh, R Erik Edens, Aliessa P Barnes, Charles E Canter
BACKGROUND: Historically, patients with a prior Fontan procedure for complex congenital heart disease (CHD) have been considered at higher risk for death after heart transplant (HT) compared with other HT transplant candidates. With the overall trend of improved survival of pediatric HT recipients, it is unclear of Fontan patient post-HT survival has also improved in the current era. METHODS: Data from the Pediatric Heart Transplant Study database for Fontan patients who underwent HT was compared between the early era (1993 to 2006, n = 150) and late era (2007 to 2014, n = 252)...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27825692/barriers-to-accessing-optimal-esophageal-cancer-care-for-socioeconomically-disadvantaged-patients
#19
Christina M Lineback, Colin M Mervak, Sha'shonda L Revels, Micheal T Kemp, Rishindra M Reddy
BACKGROUND: The 5-year survival of patients with low socioeconomic status (SES) and esophageal cancer is significantly lower than that in patients with high SES. It is poorly understood what causes these worse outcomes. We hypothesized that a qualitative approach could elucidate the underlying causes of these differences. METHODS: Patients with a diagnosis of esophageal cancer were recruited through flyers in regional cancer centers as well as through Facebook advertisements in cancer support groups and newspapers; they participated in a 1-hour semistructured interview or completed an online survey...
November 5, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27825691/long-term-outcomes-of-open-arch-repair-after-a-prior-aortic-operation-our-experience-in-154-patients
#20
Roberto Di Bartolomeo, Paolo Berretta, Antonio Pantaleo, Giacomo Murana, Mariano Cefarelli, Jacopo Alfonsi, Giuseppe Barberio, Alessandro Leone, Luca Di Marco, Davide Pacini
BACKGROUND: This study assessed the early and long-term results of arch operations performed after a prior aortic operation. METHODS: From 1994 to 2014, 154 consecutive patients (mean age, 59.7 years) underwent an aortic arch repair, after a previous aortic operation, at our institution. Antegrade selective cerebral perfusion was used in all cases. Chronic postdissection aortic aneurysm (87 [56.5%]) and degenerative aneurysm (43 [27.9%]) represented the most common indications for surgical intervention...
November 5, 2016: Annals of Thoracic Surgery
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