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Thoracic and Cardiovascular Surgeon

Antonio Maria Calafiore, Carlo Maria De Filippo, Antonio Totaro, Piero Pelini, Michele Di Mauro
Surgical treatment of severe functional tricuspid regurgitation associated with dilated right ventricle and increased chordal tethering (>8 mm) is challenging. We designed a technique where the anterior and posterior leaflets are detached from 50% of the annulus and a patch as large as the tricuspid orifice is sewn to augment the leaflets' tissue to force the coaptation with the septal leaflet. Annuloplasty is not performed, as it can only increase the chordal tethering, reducing the benefit of tissue augmentation...
March 6, 2018: Thoracic and Cardiovascular Surgeon
Marco Chiappetta, Dania Nachira, Maria Teresa Congedo, Elisa Meacci, Venanzio Porziella, Stefano Margaritora
BACKGROUND:  The aim of this study was to identify prognostic factors in patients affected by non-small cell lung cancer (NSCLC) with chest wall (CW) involvement, analyzing different strategies of treatment and surgical approaches. METHODS:  Records of 59 patients affected by NSCLC with CW involvement underwent surgery were retrospectively reviewed, from January 2000 to March 2013. RESULTS:  Induction therapy was administered to 18 (30...
March 6, 2018: Thoracic and Cardiovascular Surgeon
Barış Akça, Nevzat Erdil, Mehmet Cengiz Colak, Olcay Murat Disli, Bektas Battaloglu, Cemil Colak
BACKGROUND:  We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. METHODS:  This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study...
March 6, 2018: Thoracic and Cardiovascular Surgeon
Kristina Wachter, Ulrich F W Franke, Christian J Rustenbach, Hardy Baumbach
This review aims to provide an overview on recent data to evaluate minimally invasive (MVAD) and conventional (CVAD) left ventricular assist device (LVAD) implantation. A comprehensive literature search of PubMed, Cochrane Library, and was conducted up to April 2017. A total of 183 studies were identified; 13 studies met inclusion criteria. The review revealed a trend toward a lower rate of transfusion, and shorter time for cardiopulmonary bypass, as well as a lower 30-day mortality rate for MVAD...
February 28, 2018: Thoracic and Cardiovascular Surgeon
Jawad Salman, Felix Fleißner, Jamshid Naqizadah, Murat Avsar, Malakh Shrestha, Gregor Warnecke, Issam Ismail, Stefan Rümke, Serghei Cebotari, Axel Haverich, Igor Tudorache
BACKGROUND:  Minimally invasive mitral valve surgery (MIMVS) is superior to "classical" mitral valve surgery via a sternotomy regarding wound healing and postoperative pain. It is however a more challenging procedure. Patients' preference is leading clearly toward minimally invasive approaches, and surgeons are driven by upcoming new technologies in interventional procedures such as the MitraClip. Especially in re-do cases, the access via right mini-thoracotomy, as previously non-operated situs, is a possible advantage over a re-sternotomy...
February 28, 2018: Thoracic and Cardiovascular Surgeon
Kaveh Eghbalzadeh, Elmar W Kuhn, Anton Sabashnikov, Carolyn Weber, Cherif Sahyoun, Tanja Rudolph, Stephan Baldus, Thorsten C W Wahlers, Navid Mader
BACKGROUND:  Advanced visualization software tools have been used in clinics to improve the safety and accuracy of transcatheter procedure. Imaging techniques have greatly evolved during the era of transcatheter aortic valve implantation (TAVI). In a retrospective analysis, we investigated the feasibility of augmented fluoroscopy for iliofemoral access using a novel "Vascular Outlining" roadmapping technology. METHODS:  The Vascular Outlining prototype device (Philips Healthcare) application was used with iliofemoral angiography of 10 patients undergoing transfemoral TAVI...
February 28, 2018: Thoracic and Cardiovascular Surgeon
Ali Cevat Kutluk, Celalettin Ibrahim Kocaturk, Hasan Akin, Sertan Erdogan, Salih Bilen, Kemal Karapinar, Celal Bugra Sezen, Ozkan Saydam
OBJECTIVE:  Video-assisted thoracoscopic surgery (VATS) has become the standard treatment method for primary spontaneous pneumothorax. Concerns about lesser pain and better cosmesis led to the evolution of uniportal access. This study prospectively compared the results of the uniportal, two-port, and three-port thoracoscopic surgery. MATERIAL AND METHODS:  One hundred and thirty-five patients were randomized into three groups according to the port numbers. The groups were compared regarding the operation time, hospital stay, amount of drainage, area of pleurectomy, complications, recurrences, and pain scores...
February 20, 2018: Thoracic and Cardiovascular Surgeon
Gaku Uchino, Takeshi Yoshida, Bunpachi Kakii, Masato Furui
OBJECTIVE:  Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection. METHODS:  This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017. RESULTS:  There were 17 patients included in the analyses, with a mean age at surgery of 71...
February 20, 2018: Thoracic and Cardiovascular Surgeon
Luisa Jungk, Heike Franke, Aida Salameh, Stefan Dhein
BACKGROUND: Atrial fibrillation (AF) is the most common chronic arrhythmia in elderly people and is accompanied by remodeling processes. While much is known about changes in ionic channels and in extracellular matrix, less is known about possible changes of intracellular structures. OBJECTIVE: We wanted to investigate, whether AF may also affect the structure of the Golgi apparatus and the microtubular network. METHODS: One-hundred fifty-three cardiac surgery patients were investigated [ n = 24 in sinus rhythm (SR) and n = 129 with chronic AF of >1 year duration]...
February 20, 2018: Thoracic and Cardiovascular Surgeon
Francisco Estevez-Cid, Jose María Herrera-Norena, Carlos Velasco-García de Sierra
We describe the "auto-sliding graft" technique, a different anastomotic option for reconstructive prosthetic procedures on the ascending aorta especially in patients at risk of circulatory arrest with mild aortic dilatation. This simple technique provides not only an important hemostatic reinforcement for the distal aortic graft anastomosis but also a protective effect on the native ascending aorta beyond the suture line.
February 20, 2018: Thoracic and Cardiovascular Surgeon
Tetyana Leinberger, Claudia Heilmann, Stefan Sorg, Matthias Mueller, Sami Kueri, Claudia Schmoor, Matthias Siepe, Friedhelm Beyersdorf
BACKGROUND:  Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. METHODS:  A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebrüder Martin GmbH & Co. KG-KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and/or sternal instability within 30 ± 5 days, and the secondary end points were mediastinitis and/or sternal instability within 60 ± 5 days; incidence of pneumonia during hospitalization within the first 30 (±5) days and chest pain intensity...
February 2, 2018: Thoracic and Cardiovascular Surgeon
Joung Taek Kim, Young Sam Kim, Yong Han Yoon, Helen Ki Shin, Keun Myoung Park, Wan Ki Baek
BACKGROUND:  The recently developed thoracic endovascular repair (TEVAR) technique seems to offer a good alternative for treating acute traumatic transection of the thoracic aorta (TTA). We reviewed our experience of TEVAR in cases of acute traumatic transection and analyzed the subsequent remodeling changes. METHODS:  The medical records of 17 patients who underwent TEVAR for TTA were reviewed. The trauma mechanisms, anatomical characteristics of the transected aortas, technical details of TEVAR, and postprocedural results were reviewed...
February 2, 2018: Thoracic and Cardiovascular Surgeon
Hao Xu, Linyou Zhang
OBJECTIVE:  Video-assisted thoracic surgery lobectomy is a minimally invasive procedure for major pulmonary resection. The purpose of this study was to present a novel approach with a thoracoscope in the right upper lobe and to compare different lobectomy methods at our institution. METHODS:  We reviewed the medical records of patients who underwent a thoracoscopic right upper lobectomy for lung cancer between September 2015 and September 2016. We performed 128 thoracoscopic right upper lobectomies: group A (n = 50) was treated with the bronchus-first and vessels simultaneously stapled method and group B (n = 78) was treated with the conventional isolation-ligation method...
January 30, 2018: Thoracic and Cardiovascular Surgeon
Geun Dong Lee, Chul Hwan Park, Heae Surng Park, Min Kwang Byun, Ik Jae Lee, Tae Hoon Kim, Sungsoo Lee
BACKGROUND:  We aimed to identify clinicopathologic characteristics and risk of invasiveness of lung adenocarcinoma in surgically resected pure ground-glass opacity lung nodules (GGNs) smaller than 2 cm. METHODS:  Among 755 operations for lung cancer or tumors suspicious for lung cancer performed from 2012 to 2016, we retrospectively analyzed 44 surgically resected pure GGNs smaller than 2 cm in diameter on computed tomography (CT). RESULTS:  The study group was composed of 36 patients including 11 men and 25 women with a median age of 59...
January 22, 2018: Thoracic and Cardiovascular Surgeon
Yoshiyuki Takami, Yasushi Takagi
Transit-time flow measurement (TTFM) has been increasingly applied to detect graft failure during coronary artery bypass grafting (CABG), because TTFM is less invasive, more reproducible, and less time consuming. Many authors have attempted to validate TTFM and to gain the clear cutoff values and algorithm in TTFM to predict graft failure. The TTFM technology has also been shown to be a useful tool to investigate CABG graft flow characteristics and coronary circulation physiology. It is important to recognize the practical roles of TTFM in the cardiac operating room by review and summarize the literatures...
January 19, 2018: Thoracic and Cardiovascular Surgeon
Chul Hwan Park, MinDong Sung, Geun Dong Lee, Young Woo Do, Hee Min Park, Junu Kim, Jin Hur, Kyunghwa Han, Tae Hoon Kim, Jason Jungsik Song, Sungsoo Lee
BACKGROUND: We compared the chest configurations of patients with primary spontaneous pneumothorax (PSP) and age-sex-matched controls to determine the presence of chest wall deformities in patients with PSP. METHODS: We retrospectively enrolled 166 male patients with PSP (age, 18-19 years) and 85 age-sex-matched controls without PSP, who simultaneously underwent chest computed tomography (CT) and radiography at one of two institutes. After correcting for height, the following thoracic parameters were comparatively evaluated between the two groups: maximal internal transverse ( T ) and anteroposterior ( W ) diameters of the chest, maximal internal lung height ( H ), Haller index ( T / W ), and T /Height, T / H , W /Height, W / H , and H /Height ratios...
January 19, 2018: Thoracic and Cardiovascular Surgeon
Keti Vitanova, Cornelius Leopold, Jelena Pabst von Ohain, Cordula Wolf, Elisabeth Beran, Rüdiger Lange, Julie Cleuziou
BACKGROUND:  Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease. Although it is thought to be a simple operation, it is associated with significant morbidity and mortality. METHODS:  Data for all neonates who underwent surgery for a systemic-to-pulmonary artery shunt between 2000 and 2016 were reviewed. The study endpoints were shunt failure and shunt-related mortality. Shunt failure was defined as a shunt dysfunction because of thrombosis or stenosis requiring intervention or reoperation; shunt mortality was defined as death because of a shunt dysfunction...
January 19, 2018: Thoracic and Cardiovascular Surgeon
Karen Magsino, Rohan Sanjanwala, Brett Hiebert, Janet Rothney, Rizwan Manji, Rakesh Arora, Pallav Shah
BACKGROUND:  The increasing prevalence of intravenous drug users (IVDU) has resulted in higher incidence of right-sided infective endocarditis (RSIE). However, treatment guidelines for RSIE in IVDU are not well defined. The aim is to evaluate efficacy of different treatment strategies in reducing mortality and to describe treatment outcomes. METHODS:  We systematically reviewed the literature using PubMed, Cochrane, CENTRAL, OvidEMBASE, Web of Science, and Medline databases to include prospective studies that compare mortality rates among IVDU with RSIE receiving isolated medical treatment versus those receiving medical-surgical treatment...
January 19, 2018: Thoracic and Cardiovascular Surgeon
Markus K Heinemann
No abstract text is available yet for this article.
January 19, 2018: Thoracic and Cardiovascular Surgeon
Samuel Henry Howitt, Camila Caiado, Charles McCollum, Michael Goldstein, Ignacio Malagon, Rajamiyer Venkateswaran, Stuart William Grant
BACKGROUND:  Several cardiac surgery risk prediction models based on postoperative data have been developed. However, unlike preoperative cardiac surgery risk prediction models, postoperative models are rarely externally validated or utilized by clinicians. The objective of this study was to externally validate three postoperative risk prediction models for intensive care unit (ICU) mortality after cardiac surgery. METHODS:  The logistic Cardiac Surgery Scores (logCASUS), Rapid Clinical Evaluation (RACE), and Sequential Organ Failure Assessment (SOFA) scores were calculated over the first 7 postoperative days for consecutive adult cardiac surgery patients between January 2013 and May 2015...
January 9, 2018: Thoracic and Cardiovascular Surgeon
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