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Journal of Cardiothoracic Surgery

Fausto Biancari, Vesa Anttila, Angelo M Dell'Aquila, Juhani K E Airaksinen, Debora Brascia
BACKGROUND: Perioperative myocardial ischemia (PMI) in patients undergoing coronary artery bypass grafting (CABG) is associated with poor outcome. The aim of this study was to pool the available data on the outcome after control angiography and repeat revascularization in patients with perioperative myocardial ischemia (PMI) after coronary artery bypass grafting (CABG). METHODS: A literature review was performed through PubMed, Scopus, ScienceDirect and Google Scholar to identify studies published since 1990 evaluating the outcome of PMI after CABG...
February 27, 2018: Journal of Cardiothoracic Surgery
Sanaz Amin, Raphael S Werner, Per Lav Madsen, George Krasopoulos, David P Taggart
BACKGROUND: Differing perfusion of the left and right ventricular coronary territory may influence flow-profiles of saphenous vein grafts (SVGs). We compared flow parameters, measured by transit-time flowmetry (TTFM), in left- and right-sided SVGs during coronary artery by-pass grafting (CABG). METHODS: Routine TTFM measurements were obtained in 167 SVGs to the left territory (55%) and 134 SVGs to the right territory (total of 301 SVGs in 207 patients). The four standard TTFM parameters, [mean graft flow (MGF), pulsatility index (PI), percentage diastolic filling (%DF), and percentage backward flow (%BF)] were compared...
February 20, 2018: Journal of Cardiothoracic Surgery
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
Feng Gao, Yongjie Ye, Yongheng Zhang, Bo Yang
OBJECTIVE: We modified the conventional aortic arch replacement procedure to avoid circulation arrest and a prolonged extracorporeal circulation time, especially in cases of acute aortic dissection. We herein present our experience with a modified branch-first approach to acute aortic dissection, with anastomosis of the supra aortic vessels prior to commencing cardiopulmonary bypass. METHODS: Since 2012, 41 patients (aortic dissection, 36; arch aneurysm, 5) have undergone the modified procedure...
February 12, 2018: Journal of Cardiothoracic Surgery
Andrew J Beel, David S Demos, Alfred Chung, Charles Liao, Natalie S Lui
BACKGROUND: Dermatomyositis, an inflammatory myopathy with cutaneous involvement, is associated with malignancy and often manifests paraneoplastically. While co-occurrence with small cell carcinoma is well attested, primary lung adenocarcinoma, which may present as focal ground-glass opacification on computed tomography of the thorax, is less frequently coincident. CASE PRESENTATION: We report the case of a 72-year-old female patient with dermatomyositis - treated with a combination of prednisone, methotrexate, and intravenous immunoglobulin - and an indolent, subsolid, non-hypermetabolic pulmonary lesion, which was determined to be invasive primary lung adenocarcinoma...
February 7, 2018: Journal of Cardiothoracic Surgery
Andreina Pagini, Massimiliano Bassi, Daniele Diso, Michele Anzidei, Sara Mantovani, Camilla Poggi, Federico Venuta, Marco Anile
BACKGROUND: Vena cava anomalies are a rare group of anatomical variations due to an incorrect development of the superior or inferior vena cava during fetal life. They generally show no clinical relevance and the diagnosis is done due to the association with congenital heart diseases in most of cases. However, preoperative identification of these anomalies is mandatory for surgeons to proper surgical planning. If not recognized, lethal complications may occur, as already reported in literature...
February 1, 2018: Journal of Cardiothoracic Surgery
Nicola Oswald, John Hardman, Amy Kerr, Ehab Bishay, Richard Steyn, Pala Rajesh, Maninder Kalkat, Babu Naidu
BACKGROUND: Receiving information about their disease and treatment is very important to patients with cancer. There is an association between feeling appropriately informed and better quality of life. This audit aimed to estimate patient satisfaction with perioperative information in those undergoing surgery for lung cancer and any change in satisfaction over time. METHODS: A questionnaire (EORTC-Info-25) was administered prospectively to patients preoperatively and up to six months postoperatively...
February 1, 2018: Journal of Cardiothoracic Surgery
Takuma Yamasaki, Shuhei Fujita, Yuji Kaku, Junko Katagiri, Takeshi Hiramatsu
BACKGROUND: Ventricular septal perforation (VSP) after acute myocardial infarction (AMI) is accompanied by the worsening of rapid hemodynamics, resulting in a poor prognosis. In our department, infarct lesions are preoperatively detected with electrocardiogram (ECG)-synchronized contrast computed tomography, and the scope of approach and exclusion is determined. Furthermore, to effectively prevent a residual shunt, modified double patch repair and infarct exclusion techniques were used in combination to preserve left ventricular (LV) function...
January 30, 2018: Journal of Cardiothoracic Surgery
Thom G Dahle, Nathaniel J Castro, Brian M Stegman, Jacob R Dutcher, John M Teskey, Wade T Schmidt, Daren S Danielson, Sara J Dezell, Virginia B Daniels, Daniel J Tiede
BACKGROUND: Within the trans-subclavian approach, procedural techniques can vary widely, and reported access generally refers to an infraclavicular axillary approach. We describe and report the use of a novel supraclavicular true subclavian approach for transcatheter aortic valve replacement (TAVR) exclusively for implantation of Sapien 3 valves. CASE PRESENTATION: We report our first five consecutive patients undergoing TAVR with a Sapien 3 valve using a standardized subclavian approach at a single center...
January 30, 2018: Journal of Cardiothoracic Surgery
David Meier, Matthias Kirsch, Salah Dine Qanadli, Olivier Muller, Daniel Fishman, Catalina Trana
BACKGROUND: Purulent pericarditis is an uncommon entity, which is, in very rare cases, associated to infection of the aorta. CASE PRESENTATION: We present the case of a 42-year-old male patient, who was admitted to hospital complaining of tiredness, diarrhea and leg edema. Clinical examination revealed a hypotensive and obviously shocked patient. He was ultimately diagnosed with a rare combination of purulent pericarditis followed by false aneurysm of the ascending aorta...
January 29, 2018: Journal of Cardiothoracic Surgery
Amr A Arafat, Elatafy E Elatafy, Sahar Elshedoudy, Mahmoud Zalat, Neamet Abdallah, Ahmed Elmahrouk
BACKGROUND: Right ventricular (RV) volume overload increases morbidity and mortality after tetralogy of Fallot (TOF) repair. Surgical strategies like pulmonary leaflets sparing and tricuspid valve repair at time of primary repair may decrease RV overload. Our objective is to evaluate early and midterm results of pulmonary leaflets sparing with infundibular preservation and tricuspid valve repair in selected TOF patients with moderate pulmonary annular hypoplasia. METHODS: From 2011 to 2016; 46 patients with TOF and moderate pulmonary annular hypoplasia had surgical repair with sparing of the pulmonary valve leaflets...
January 22, 2018: Journal of Cardiothoracic Surgery
Erkan Kaba, Mehmet Oguzhan Ozyurtkan, Kemal Ayalp, Tugba Cosgun, Mazen Rasmi Alomari, Alper Toker
BACKGROUND: To investigate the feasibility and efficacy of salvage lung resection and describe the possible indications and contraindications in patients with primary lung cancer. METHODS: Thirty patients undergoing anatomical salvage lung resection were classified into three groups: GI, patients with progressive lung tumor despite definitive chemo- and/or radiotherapy; GII, patients who underwent emergency resection; and GIII, patients in whom neoadjuvant or definitive chemo- and/or radiotherapy was contraindicated because of severe comorbidities...
January 22, 2018: Journal of Cardiothoracic Surgery
Saša D Borović, Milica M Labudović Borović, Ivan V Zaletel, Vera N Todorović, Petar A Dabić, Jelena T Rakočević, Jelena M Marinković-Erić, Predrag S Milojević
BACKGROUND: Histopathological changes in the ascending aorta wall in patients with severe tricuspid aortic valve (TAV) stenosis were graded and correlated to echocardiographic parameters. Objective was to associate threshold echocardiographic values with structural defects in the ascending aorta providing a tool to improve decision-making process in cases when simultaneous aortic valve replacement (AVR) and ascending aorta replacement is considered. METHODS: Biopsies from 108 TAV stenosis patients subjected to AVR were graded into three grades according to severity of aortic wall changes...
January 18, 2018: Journal of Cardiothoracic Surgery
Shahrukh N Bakar, Daniel J P Burns, Pantelis Diamantouros, Kumar Sridhar, Bob Kiaii, Michael W A Chu
BACKGROUND: Contemporary transcatheter and minimally invasive approaches allow for improved cosmesis and eliminate sternotomy; however, access to a 'Heart Team' approach to minimally invasive atrial septal defect (ASD) repair remains limited in Canada. METHODS: Retrospective chart review of all minimally invasive atrial septal defect repairs performed between 2009 and 2017 at a quaternary cardiac care centre were included. We compared residual shunt, functional status, periprocedural complications, and hospital lengths-of-stay between patients undergoing transcatheter and minimally invasive endoscopic ASD repair...
January 18, 2018: Journal of Cardiothoracic Surgery
Nicolas Poinot, Jean-Francois Fils, Hélène Demanet, Hugues Dessy, Dominique Biarent, Pierre Wauthy
BACKGROUND: Repair of congenital heart defects involving the right ventricular outflow tract may require the implantation of a right ventricle to pulmonary artery conduit. This conduit is likely to be replaced during childhood. This study compares the operative outcomes of the replacement procedure of Contegra® and homografts in pulmonary position. METHODS: From 1999 to 2016, 82 children underwent 87 right ventricle to pulmonary artery conduit replacements (60 Contegra® and 27 homografts)...
January 17, 2018: Journal of Cardiothoracic Surgery
M Navaratnarajah, R Rea, R Evans, F Gibson, C Antoniades, A Keiralla, M Demosthenous, G Kassimis, G Krasopoulos
INTRODUCTION: No uniform consensus in the UK or Europe exists, for glycaemic management of patients with Diabetes or pre-diabetes undergoing cardiac surgery. OBJECTIVE: [i] Determine the relationship between glycaemic control and cardiac surgical outcomes; [ii] Compare current vs gold standard management of patients with Diabetes or pre-diabetes undergoing cardiac surgery. METHODS: Searches of MEDLINE, NHS Evidence and Web of Science databases were completed...
January 17, 2018: Journal of Cardiothoracic Surgery
Meishuang Li, Yanan Wang, Yulong Chen, Zhenfa Zhang
BACKGROUND: Recent wide spread use of low-dose helical computed tomography for the screening of lung cancer have led to an increase in the detection rate of very faint and smaller lesions known as ground-glass opacity nodules. The purpose of this study was to investigate the clinical factors of lung cancer patients with solitary ground-glass opacity pulmonary nodules on computed tomography. METHODS: A total of 423 resected solitary ground-glass opacity nodules were retrospectively evaluated...
January 17, 2018: Journal of Cardiothoracic Surgery
Ryohei Matsuura, Yasushi Tsutsumi, Osamu Monta, Hisazumi Uenaka, Kenji Tanaka, Takaaki Samura, Hirokazu Ohashi
BACKGROUND: The long-term effects of some surgical treatment procedures of arch replacement for aortic dissection or aortic aneurysm are unknown. CASE PRESENTATION: The present study reports the case of a 68-year-old man admitted to our hospital for aortic arch anastomotic pseudoaneurysm with concomitant aortic root enlargement and coronary artery stenosis. Eleven years ago, at the age of 56 years, he underwent total arch replacement with island reconstruction for chronic aortic dissection...
January 15, 2018: Journal of Cardiothoracic Surgery
Xuhua Shi, Yongfeng Zhang, Yuewu Lu
OBJECTIVES: To investigate the risk factors and treatment strategies for pneumothorax secondary to granulomatosis with polyangiitis (GPA). METHOD: Retrospective analysis of cases with pneumothorax secondary to GPA from our own practice and published on literature. RESULTS: A total of 25 patients, 18 males and 7 females, mean age 44 ± 15.7 years, were analyzed. Diagnosis included pneumothorax (11 cases), hydropneumothorax (n = 5), empyema (n = 8) and hemopneumothorax (n = 1)...
January 15, 2018: Journal of Cardiothoracic Surgery
Takashi Anayama, Kentaro Hirohashi, Ryohei Miyazaki, Hironobu Okada, Nobutaka Kawamoto, Marino Yamamoto, Takayuki Sato, Kazumasa Orihashi
BACKGROUND: Minimally invasive video-assisted thoracoscopic surgery for small-sized pulmonary nodules is challenging, and image-guided preoperative localisation is required. Near-infrared indocyanine green fluorescence is capable of deep tissue penetration and can be distinguished regardless of the background colour of the lung; thus, indocyanine green has great potential for use as a near-infrared fluorescent marker in video-assisted thoracoscopic surgery. METHODS: Thirty-seven patients with small-sized pulmonary nodules, who were scheduled to undergo video-assisted thoracoscopic wedge resection, were enrolled in this study...
January 12, 2018: Journal of Cardiothoracic Surgery
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