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Thoracic and Cardiovascular Surgeon

Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
Henning Gaissert, Susan R Wilcox
The perioperative management of diaphragmatic weakness and phrenic nerve dysfunction is complex, due to varied etiologies and clinical presentations. The factors leading to diaphragmatic weakness may culminate after the operation with transient or persistent respiratory failure. This review discusses diaphragmatic disorders and postoperative respiratory failure caused by unilateral or bilateral diaphragmatic impairment. The origins of neuromuscular weakness involving the diaphragm are diverse, and often lie within the domains of different medical specialties, with only a portion of the condition related to surgical intervention...
November 26, 2016: Thoracic and Cardiovascular Surgeon
Bruno Reichart
No abstract text is available yet for this article.
November 26, 2016: Thoracic and Cardiovascular Surgeon
Stefan Sponholz, Natalie Baldes, Moritz Schirren, Selma Oguzhan, Henrik Menke, Joachim Schirren
Background Sternal infiltration of breast cancer (BC) is a rare but known phenomenon. Sternal resection for this cancer is not completely investigated. For this reason, the aim of this study was to examine long-term survival and prognosticators for prolonged survival of our patients after sternal resection. Also, morbidity and mortality were investigated. Materials and Methods We retrospectively analyzed our prospective database of 20 patients who underwent a sternum resection (partial/complete) for BC in our institution between 2003 and 2014...
November 17, 2016: Thoracic and Cardiovascular Surgeon
Rafael Garza-Castillon, Jonathan Berger, Rafael Andrade, Eitan Podgaetz
Background Long-term nasogastric tubes are uncomfortable and associated with complications such as impairment with speech and swallowing, septum trauma, epistaxis, alar necrosis, and intubation of the trachea among others. Pharyngostomy tubes (PTs) are an alternative for prolonged enteral feeding, transluminal drainage of collections, and gastric decompression in patients with an intestinal obstruction and an inoperable abdomen. Patients and Methods This is a retrospective analysis of patients who had a PT placed at our institution from May 2005 to March 2015...
November 17, 2016: Thoracic and Cardiovascular Surgeon
Brigitte Gansera, Alem Delalic, Edgar Eszlari, Walter Eichinger
Objectives Despite encouraging late outcomes, the use of bilateral internal thoracic artery (BITA) grafting for myocardial revascularization in diabetic patients remains controversial because of an increased risk of sternal wound complications. In the present study, early- and long-term outcomes of the use of left-sided BITA versus single internal thoracic artery (SITA) grafting in young (< 65 years of age) diabetic patients were reviewed retrospectively. Methods A total of 250 propensity score pair-matched diabetic patients, operated on between February 2000 and December 2011, receiving either BITA (n = 125) or SITA (n = 125) grafting were analyzed retrospectively...
November 17, 2016: Thoracic and Cardiovascular Surgeon
Erik Beckmann, Issam Ismail, Serghei Cebotari, Alexander Busse, Andreas Martens, Malakh Shrestha, Christian Kühn, Axel Haverich, Christine Fegbeutel
Background Right ventricular failure is a life-threatening postoperative complication after pericardiectomy. We conducted a retrospective study with a special emphasis on right ventricular failure. Methods Between June 1997 and September 2011, 69 patients underwent surgical pericardiectomy at our center. Mean age was 59 ( ±  15.5) years, and 49 (71%) patients were male. Causes of constrictive pericarditis included idiopathic (52%, n = 36), tuberculosis (9%, n = 6), postcardiotomy (12%, n = 8), radiation (4%, n = 3), renal insufficiency (12%, n = 8), and autoimmune disease (12%, n = 8)...
November 17, 2016: Thoracic and Cardiovascular Surgeon
Qi Wang, Zixiang Wu, Gang Chen, Sai Zhang, Gang Shen, Ming Wu
Background Minimally invasive esophagectomy (MIE) Ivor Lewis has been increasingly performed over the last two decades. To guide the implementation of this technically demanding procedure, a comprehensive assessment of MIE-Ivor Lewis learning curves should include both the general competence to accomplish the procedure and the ability to generate oncological benefits. These objectives are believed to be associated with different phases of the learning curve. Methods A retrospective review of the first 109 patients who underwent MIE-Ivor Lewis by a single qualified surgeon was conducted...
October 5, 2016: Thoracic and Cardiovascular Surgeon
Dominik Müller-Arnecke
Background We investigated the technical handling of a y-shaped double-branched thoracic catheter with the aim of combining the effect of two separate catheters and the ease of use of a single one. Methods A total of 20 catheters were placed consecutively in 20 patients. Results In all patients, it was technically simple to position the catheter, whether in open or video-assisted surgery. The handling during removal corresponded to that of a single drain. Conclusion This type of drain appears to hold a lot of potential compared with the use of a single drain...
September 29, 2016: Thoracic and Cardiovascular Surgeon
Charles Kik, Richard van Valen, Mostafa M Mokhles, Jos A Bekkers, Ad J J C Bogers
Minimally invasive video-assisted epicardial beating heart ablation for lone atrial fibrillation claims to be safe and effective. We, however, report on three patients with an atrioesophageal fistula after this procedure. The exact pathogenesis of this complication is unknown. All patients presented around 6 weeks after surgery with either fever or neurological deficits. Diagnosis can be made by computed tomography scan. We advocate an aggressive surgical approach with closure of the atrial defect on cardiopulmonary bypass and closure and reinforcement of the esophagus with an intercostal muscle flap in a single-stage surgery...
September 29, 2016: Thoracic and Cardiovascular Surgeon
Anaïs Lemaire, Sylvie DiFilippo, Jean-Jacques Parienti, Olivier Metton, Julia Mitchell, Roland Hénaine, Jean Ninet
Background Total anomalous pulmonary venous connection is a rare cardiac malformation associated with significant morbidity and mortality rates. We report a large surgical series study to evaluate mid-term and long-term results of conventional surgical techniques. Methods and Results We performed a retrospective analytic study of all patients operated on for simple total anomalous pulmonary venous connection in the University Hospital of Lyon, France, between January 1973 and June 2014. A total of 180 patients were included (43% supracardiac, 27% intracardiac, 19% infracardiac, and 11% mixed types)...
September 16, 2016: Thoracic and Cardiovascular Surgeon
Mehmet Zeki Gunluoglu, Celalettin Ibrahim Kocaturk, Adalet Demir, Halide Nur Urer, Seyyit Ibrahim Dincer, Mehmet Ali Bedirhan
Purpose The purpose of this study was to evaluate the following parameters after complete resection in established lung cancer patients: the frequency of bronchial stump recurrence (BSR), the effect of the distance between the tumor and bronchial resection margin (DBTM) on BSR, the survival of patients with BSR, and the effect of the DBTM on survival. Patients and Methods We retrospectively evaluated 553 consecutive lung cancer patients who underwent complete lung resection. The patients were classified as DBTM: ≤ 10 mm (group 1), 11 to 20 mm (group 2), and > 20 mm (group 3)...
September 13, 2016: Thoracic and Cardiovascular Surgeon
Zahra Mosala Nezhad, Alain Poncelet, Caroline Fervaille, Laurent de Kerchove, Pierre Gianello
No abstract text is available yet for this article.
September 13, 2016: Thoracic and Cardiovascular Surgeon
Valerie Lacroix, Zahra Mosala Nezhad, David Kahn, Arnaud Steyaert, Alain Poncelet, Thierry Pieters, Philippe Noirhomme
No abstract text is available yet for this article.
September 13, 2016: Thoracic and Cardiovascular Surgeon
Alfonso Fiorelli, Antonio Mazzella, Marina Accardo, Mario Santini
To manage primary spontaneous pneumothorax, we use an alternative technique for bleb resection and we induce pleurodesis with an ultrasonic-driven scalpel. This technique was successfully performed in nine consecutive patients with primary spontaneous pneumothorax with small (<20 mm) and limited number of blebs (<2) and without significant underlying lung disease. After identification of air leakage, the jaws of the instrument were clamped onto the bleb and included a margin of normal lung. Power level 3 energy was applied to resect the bleb and to seal the parenchyma...
September 12, 2016: Thoracic and Cardiovascular Surgeon
Markus K Heinemann
No abstract text is available yet for this article.
October 2016: Thoracic and Cardiovascular Surgeon
Sandra Brunner, Claudius Diez, Bernhard Flörchinger, Philipp Kolat, Christof Schmid, Daniele Camboni
Objective The percentage of patients undergoing cardiac surgery under some sort of psychiatric medication (PM) is not negligible. Thus, this study aimed to evaluate a possible impact of preoperative PM on the outcome after cardiac surgery. Methods A matched case-control study was conducted by including all patients who underwent myocardial revascularization and/or surgical valve operation in our institution from December 2008 till February 2011 by chart review and institutional quality assurance database (QS) analysis...
October 2016: Thoracic and Cardiovascular Surgeon
Claus Behrend Christiansen, Ronan M G Berg, Ronni Plovsing, Andreas Ronit, Niels-Henrik Holstein-Rathlou, Stig Yndgaard, Kirsten Møller
Background Cerebral hemodynamic disturbances in the peri- or postoperative period may contribute to postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). We therefore examined dynamic cerebral autoregulation (dCA) post-CPB and changes in neurocognitive function in patients that had undergone CABG. Materials and Methods We assessed dCA by transfer function analysis of spontaneous oscillations between arterial blood pressure and middle cerebral artery blood flow velocity measured by transcranial Doppler ultrasound in eight patients 6 hours after the cessation of CPB; 10 healthy volunteers served as controls...
October 2016: Thoracic and Cardiovascular Surgeon
Namhee Kim, Si Yuan Dai, Victoria Pang, C David Mazer
Background Acute kidney injury (AKI) is a common and serious complication of surgeries that include cardiopulmonary bypass (CPB). Currently, increases in serum creatinine levels are used to diagnose AKI, but this change may be slow to detect. Animal studies pertaining to renal hypoxia suggest a correlation between vasopressinase activity and AKI. The objective of this study is to determine if vasopressinase activity can be used as an early biomarker for renal hypoxia and CPB-associated AKI. This could potentially help improve the diagnosis and subsequent treatment of the condition...
October 2016: Thoracic and Cardiovascular Surgeon
Don Hayes, Benjamin T Kopp, Shahid I Sheikh, Richard D Shell, Grace R Paul, Patrick I McConnell, Joseph D Tobias, Dmitry Tumin
Background Pre-lung transplant (LTx) panel reactive antibody (PRA) levels are associated with adverse outcomes in adult LTx recipients, but their impact in pediatric LTx recipients is unknown. Methods The United Network for Organ Sharing registry was queried from 2004 to 2013 to compare survival between pediatric LTx recipients with PRA class I and II levels = 0 versus > 0. Results Overall, 333 pediatric LTx recipients had data on class I or II PRA and were included in the analysis. Univariate analysis demonstrated that PRA > 0 was not associated with survival benefit for class I (hazard ratio [HR] = 0...
September 5, 2016: Thoracic and Cardiovascular Surgeon
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