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Journal of Cardiothoracic Surgery

Tong Qiu, Yandong Zhao, Jianfang Song, Bo Fu, Yunpeng Xuan, Wenjie Jiao
BACKGROUND: Carina resection and reconstruction is a challenging procedure for thoracic surgeons. We describe a novel technique of thoracoscopic carina reconstruction using the natural bifurcation, following pulmonary resection of the lung neoplasm. To our knowledge, it is the first report of this kind. CASE PRESENTATION: A 71-year-old male diagnosed of squamous cell lung cancer received two-port approached video-assisted thoracoscopic right bilobectomy with carina resection after 2 cycles of neoadjuvant therapy...
October 18, 2016: Journal of Cardiothoracic Surgery
Mustafa Kemal Avsar, Tolga Demir, Cem Celiksular, Cenap Zeybek
BACKGROUND: PDA(Patent ductus arteriosus) is a common and clinically important condition which is presented with a number of hemodynamic and respiratory problems such as intraventricular hemorrhage, pulmonary hemorrhage and necrotizing enterocolitis due to increased pulmonary blood flow and stealing from systemic circulation. The incidence of PDA among the infants that were born before the 28th gestational week is as high as 70 %; and spontaneous closure rates in very-low-birth-weight premature neonates(VLBWPN) is around 34 %...
October 4, 2016: Journal of Cardiothoracic Surgery
Hua Li, Shouguo Yang, Hao Chen, Zhaohua Yang, Tao Hong, Yingyong Hou, Chunsheng Wang
BACKGROUND: Heart transplantation is an uncommon treatment for unresectable and non-metastatic primary cardiac sarcomas, and the role of it is unclear. This study aims to offer a survival analysis of it. METHODS: This study consists of 6 patients from our institution and 40 patients identified in a literature search who underwent heart transplantation for non-metastatic primary cardiac sarcomas. Seven patients with unresectable cardiac angiosarcoma who received palliative therapies at our institution were included for comparison...
October 3, 2016: Journal of Cardiothoracic Surgery
Francesco Nicolini, Antonella Vezzani, Daniela Fortuna, Giovanni Andrea Contini, Davide Pacini, Davide Gabbieri, Claudio Zussa, Rossana De Palma, Tiziano Gherli
BACKGROUND: The main purpose of this study was to evaluate the impact of gender on outcomes after isolated coronary artery bypass grafting, in terms of 5-year rates of overall death, cardiac-related death, myocardial infarction, re-hospitalization, repeat percutaneous or surgical revascularization, stroke, new pacemaker implantation, postoperative renal failure, heart failure and need for long-term care. METHODS: Two propensity-score matched cohorts, each of 1331 patients, undergoing isolated surgical coronary revascularization at the regional public and private centers of Emilia-Romagna region (Italy) from January 1st 2003 to December 31th 2013, were used to compare long-term outcomes of male (5976 patients) versus female gender (1332 patients)...
September 30, 2016: Journal of Cardiothoracic Surgery
Jintae Kwon, Donghyup Lee
BACKGROUND: Post infarction ventricular septal defect (VSD) is an uncommon but life threatening complication of acute myocardial infarction. CASE PRESENTATION: A 62-year-old woman was admitted with acute myocardial infarction (AMI). However, the day after angioplasty and stenting, Transthoracic echocardiography (TTE) showed post infarction VSD. We decided to insert an extracorporeal membrane oxygenation (ECMO) device for stabilization purposes before surgical repair...
September 26, 2016: Journal of Cardiothoracic Surgery
Yushu Wang, Xiuli Shi, Meiqin Wen, Yucheng Chen, Qing Zhang
BACKGROUND: No agreement has been reached for the best surgical treatment for patients with chronic ischemic mitral regurgitation (IMR) undergoing coronary artery bypass grafting (CABG). Our objective was to meta-analyze the clinical outcomes of repair and replacement. METHODS: A computerized search was performed using Pubmed, Embase, Ovid medline and Cochrane Library. The search terms "ischemic or ischaemic" and "mitral valve" and "repair or replacement or annuloplasty" and "coronary artery bypass grafting" were entered as MeSH terms and keywords...
September 1, 2016: Journal of Cardiothoracic Surgery
Clare Burdett, Joel Dunning, Andrew Goodwin, Maureen Theakston, Simon Kendall
There are certain obstacles which left-handed surgeons can face when training but these are not necessary and often perpetuated by a lack of knowledge. Most have been encountered and overcome at some point but unless recorded and disseminated they will have to be resolved repeatedly by each trainee and their trainers. This article highlights difficulties that the left-hander may encounter in cardiac surgery and gives practical operative advice for both trainees and their trainers to help overcome them.
September 1, 2016: Journal of Cardiothoracic Surgery
Yunfei Ling, Sandeep Bhushan, Qiang Fan, Menglin Tang
BACKGROUND: This study was undertaken to determine the midterm outcome in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) undergoing coronary reimplantation and Takeuchi repair. METHODS: A retrospective review of patients who had ALCAPA repair between January 2009 and December 2015. Mortality, echocardiography assessment of left ventricular function including ejection fractionand, shortening fraction, severity of mitral regurgitation, stenosis of the coronary ostium were studied retrospectively...
August 26, 2016: Journal of Cardiothoracic Surgery
Mohamed Ehab Ramadan, Lamia Buohliqah, Juan Crestanello, James Ralston, David Igoe, Hamdy Awad
BACKGROUND: As minimally invasive cardiac and vascular procedures are on the rise, the incidence of iatrogenic acute aortic dissection (IAAD) will increase. Cardiovascular professionals should be aware about the risk factors, means of prevention and best management options for IAAD in the perioperative setting. CASE PRESENTATION: We present the successful clinical management of a complicated case of IAAD after minimally invasive aortic valve replacement. CONCLUSION: High index of suspicion is required for prompt diagnosis of IAAD; collaboration of the whole perioperative team is imperative for management of this catastrophe...
August 24, 2016: Journal of Cardiothoracic Surgery
Hiroshi Munakata, Yu Murakami, Katsuhito Mabuni, Hiroyuki Tsuchiya, Moriaki Shinzato, Takehiro Umemura, Tadao Kugai
BACKGROUND: A traumatic sternal fracture with extensive mediastinal abscess and concomitant native valve endocarditis is an extremely rare but catastrophic situation. CASE PRESENTATION: For 2 weeks, the co-infected patient was treated with aggressive debridement for the mediastinitis, change of vacuum-assisted closure therapy dressings, vegetectomy and valve repair through lower partial sternotomy, and delayed primary wound closure. CONCLUSIONS: To the best of our knowledge, this successful staged strategy has not been previously reported...
August 15, 2016: Journal of Cardiothoracic Surgery
Zengyan Diao, Guoyong Jia, Wei Wu, Cuilan Wang
BACKGROUND: This meta-analysis aimed to evaluate the efficacy of carotid endarterectomy (CE) compared with carotid angioplasty (CA) in preventing stroke. Whether the use of CE is more efficient in preventing stroke than CA is a matter of debate. METHODS: Data were gathered from randomized controlled trials to evaluate the effect of CE compared with CA on the risk of stroke. Electronic searches in PubMed, Embase, and the Cochrane Library were performed to identify studies till November 2014...
2016: Journal of Cardiothoracic Surgery
Taobo Luo, Hongguang Zhao, Xinming Zhou
Thymoma is a disease with malignant potential, which has a recurrence rate after complete resection ranging from 5 to 50 %. Multiple studies on the risk factors, treatment or prognosis have been reported. Many of them are controversial, however. In this review, we summarized some accepted risk factors, means of diagnosis and different treatments of recurrent thymoma. The risk factors of recurrent thymoma haven't been well-studied, and its management remains controversial. We reviewed the literatures and found some key points which should be noticed during the surgery of initial thymoma...
2016: Journal of Cardiothoracic Surgery
Yuichi Matsuzaki, Hideyuki Tomioka, Masaki Saso, Takashi Azuma, Satoshi Saito, Shigeyuki Aomi, Kenji Yamazaki
BACKGROUND: Hereditary spherocytosis is a genetic, frequently familial hemolytic blood disease characterized by varying degrees of hemolytic anemia, splenomegaly, and jaundice. There are few reports on adult open-heart surgery for patients with hereditary spherocytosis. CASE PRESENTATION: We report a rare case of an adult open-heart surgery associated with hereditary spherocytosis. A 63-year-old man was admitted for congestive heart failure due to bicuspid aortic valve, aortic valve regurgitation, and sinus of subaortic aneurysm...
2016: Journal of Cardiothoracic Surgery
Clare Burdett, Maureen Theakston, Joel Dunning, Andrew Goodwin, Simon William Henry Kendall
For ease of use and to aid precision, left-handed instruments are invaluable to the left-handed surgeon. Although they exist, they are not available in many surgical centres. As a result, most operating theatre staff (including many left-handers) have little knowledge of their value or even application. With specific reference to cardiac surgery, this article addresses the ways in which they differ, why they are needed and what is required - with tips on use.
2016: Journal of Cardiothoracic Surgery
Kristina Wachter, Samir Ahad, Christian J Rustenbach, Ulrich F W Franke, Hardy Baumbach
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has proven to be a valid option for patients with severe aortic stenosis who are at high perioperative risk, particularly in patients with previous cardiac surgery. Several patients with previous mitral valve surgery were reported to have been successfully treated with TAVI. CASE PRESENTATION: Two patients, one with mechanical and one with biological mitral valve prosthesis, presented with symptomatic severe aortic stenosis...
2016: Journal of Cardiothoracic Surgery
Thibaut Caruba, Delphine Hourton, Brigitte Sabatier, Dominique Rousseau, Annick Tibi, Cécile Hoffart-Jourdain, Akim Souag, Nelly Freitas, Mounia Yjjou, Carla Almeida, Nathalie Gomes, Pascaline Aucouturier, Juliette Djadi-Prat, Philippe Menasché, Gilles Chatellier, Bernard Cholley
BACKGROUND: Patients with a left ventricular ejection fraction (LVEF) of less than 40 % are at high risk of developing postoperative low cardiac output syndrome (LCOS). Despite actual treatments (inotropic agents and/or mechanical assist devices), the mortality rate of such patients remains very high (13 to 24 %). The LICORN trial aims at assessing the efficacy of a preoperative infusion of levosimendan in reducing postoperative LCOS in patients with poor LVEF undergoing coronary artery bypass grafting (CABG)...
2016: Journal of Cardiothoracic Surgery
Alessandro Gonfiotti, Stefano Bongiolatti, Sara Borgianni, Roberto Borrelli, Massimo O Jaus, Leonardo Politi, Giorgia Tancredi, Domenico Viggiano, Luca Voltolini
BACKGROUND: The development of a video assisted thoracic surgery lobectomy (VATS-L) program provides a dedicated surgical team with a recognized learning curve (LC) of 50 procedures. We analyse the results of our program, comparing the LC with subsequent cases. METHODS: From June 2012 to March 2015, we performed n = 146 VATS major pulmonary resections: n = 50 (Group A: LC); n = 96 (Group B). Pre-operative mediastinal staging followed the National Comprehensive Cancer Network guidelines...
2016: Journal of Cardiothoracic Surgery
Jinshan Ma, Xiaolei Wang, Xaokat Mamatimin, Nuerlan Ahan, Kang Chen, Chuanliang Peng, Yongwei Yang
BACKGROUND: Hydatid disease is a severe and widespread human cestode infection, and in children, the lung is the most commonly infected organ. In current practice, the standard surgical procedure for the removal of pulmonary hydatid cysts is thoracotomy; therefore, we evaluated the efficacy and safety of video-assisted thoracoscopic surgery (VATS) to treat pediatric pulmonary hydatid disease. To our knowledge, this is the first and large sample comparative study of VATS and thoracotomy for pediatric pulmonary hydatid disease...
2016: Journal of Cardiothoracic Surgery
Juan P Gurria, David M De Acosta, Niloufar Hafezi, Eman B Yousif, Ehab AlAmeer, Richard C Anderson
BACKGROUND: Primary malignant tracheal tumors are rare, accounting for approximately 0.2 % of respiratory tract tumors yearly, with squamous cell carcinomas and adenoid cystic carcinomas accounting for two-thirds of these cases. Sarcomatoid carcinomas are a group of poorly differentiated non-small cell lung carcinomas containing a component of sarcoma or sarcoma-like (spindle and/or giant cell) differentiation, categorized into five morphologic subgroups. Spindle cell sarcomatoid carcinoma is a rare variant of sarcomatoid carcinomas, consisting of only spindle-shaped tumor cells...
2016: Journal of Cardiothoracic Surgery
Shokoufeh CheheiliSobbi, Mark van den Boogaard, Arjen J C Slooter, Henry A van Swieten, Linda Ceelen, Gheorghe Pop, Wilson F Abdo, Peter Pickkers
BACKGROUND: Delirium after cardiothoracic surgery is common and associated with impaired outcomes. Although several mechanisms have been proposed (including changes in cerebral perfusion), the pathophysiology of postoperative delirium remains unclear. Blood viscosity is related to cerebral perfusion and thereby might contribute to the development of delirium after cardiothoracic surgery. The aim of this study was to investigate whether whole blood viscosity differs between cardiothoracic surgery patients with and without delirium...
2016: Journal of Cardiothoracic Surgery
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