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Thoracic and Cardiovascular Surgeon

Alfonso Fiorelli, Gaetana Messina, Carlo Santoriello, Mario Santini
We reported the role of endobronchial ultrasound as complement to standard diagnostic exams to better define the benign tracheal stenosis (i.e., thickness and tracheal cartilage integrity) and to plan the treatment with flexible instead of rigid bronchoscope. Under sedation and spontaneous ventilation, the flexible bronchoscope was inserted through the laryngeal mask airway that assured the ventilation. The stenosis was first resected with cold scissors and then dilated with balloon catheter. This strategy was successfully applied in five consecutive patients...
September 19, 2018: Thoracic and Cardiovascular Surgeon
Shekhar Saha, Sam Varghese, Ammar Al Ahmad, Ahmad Fawad Jebran, Narges Waezi, Heidi Niehaus, Hassina Baraki, Ingo Kutschka
OBJECTIVES:  The increasing proportion of elderly patients in cardiac surgery poses additional challenges for the clinical management and leads to a higher operative risk due to multiple comorbidities of these patients. We reviewed the outcome of patients who were 75 years and older and underwent complex multiple valve surgery at our institution. METHODS:  A retrospective review was performed to identify patients who were 75 years and older and underwent multiple valve surgery between January 2011 and May 2016 at our institution...
September 15, 2018: Thoracic and Cardiovascular Surgeon
Jill Jussli-Melchers, Bernd Panholzer, Christine Friedrich, Ole Broch, Katharina Huenges, Joachim Cremer, Assad Haneya
BACKGROUND:  Patients receiving arterial grafts have superior late survival after coronary artery bypass graft (CABG) surgery. The aim of our study was to evaluate the mid- and long-term results of total arterial (TA) revascularization in the elderly. METHODS:  Between January 2005 and December 2012, a retrospective study on age-, gender-, and EuroSCORE-matched patients aged 70 years and older was performed. Altogether, 356 patients who received isolated CABG were assigned to either TA group or control (CON) group...
September 15, 2018: Thoracic and Cardiovascular Surgeon
HongJun Yang, Jianjie Kang, Shufen Zhang, Kairun Peng, Bingmei Deng, Biao Cheng
BACKGROUND:  The present study aimed to evaluate and compare the efficacy of botulinum toxin type A (BTX-A) injection versus thoracic sympathectomy for idiopathic palmar hyperhidrosis. METHODS:  Fifty-one patients with idiopathic palmar hyperhidrosis were treated with either BTX-A injection or thoracic sympathectomy between March 2013 and April 2016. The severity of palmar hyperhidrosis was qualitatively measured via the Hyperhidrosis Disease Severity Scale (HDSS)...
September 14, 2018: Thoracic and Cardiovascular Surgeon
Duk Hwan Moon, Min Kyun Kang, Hye Sun Lee, Sungsoo Lee
BACKGROUND:  Pectus carinatum (PC) is one of the most common types of congenital chest wall deformity. Recently, noninvasive compressive brace therapy has been more frequently used than invasive surgical correction to treat PC. Hence, the purpose of this study was to determine the long-term outcome of compressive brace therapy. METHODS:  We retrospectively reviewed patients with PC who underwent compressive brace therapy between January 2014 and December 2016...
September 14, 2018: Thoracic and Cardiovascular Surgeon
P P Grimminger, E Tagkalos, E Hadzijusufovic, F Corvinus, B Babic, H Lang
BACKGROUND:  The incidence of esophageal carcinoma is increasing in the western world, and esophageal resection is the essential therapy. Several studies report advantages of minimally invasive esophagectomies (MIEs) versus conventional open procedures (OPs). The benefits of the use of fully MIE or robot-assisted MIE (RAMIE) compared with the hybrid approaches (laparoscopic gastric preparation and open transthoracic esophagectomy) remain unclear. METHODS:  Between July 2015 and August 2017, the data of 75 patients with esophageal carcinoma were prospectively registered...
September 14, 2018: Thoracic and Cardiovascular Surgeon
Mahmoud Diab, Gloria Färber, Christoph Sponholz, Raphael Tasar, Thomas Lehmann, Sophie Tkebuchava, Marcus Franz, Torsten Doenst
OBJECTIVE:  Coronary artery bypass grafting (CABG) using bilateral internal thoracic artery (BITA) is associated with the best long-term survival. However, using BITA increases the risk of sternal wound infections with conventional sternotomy. We describe here our initial results of minimally invasive CABG (MICS-CABG) using BITA. METHODS:  Patients were operated through an incision similar to that of standard minimally invasive direct CABG. All operations were performed off-pump...
September 7, 2018: Thoracic and Cardiovascular Surgeon
Cenk Oezpeker, Fabian Barbieri, Daniel Hoefer, Bastian Schneider, Nikolaos Bonaros, Michael Grimm, Ludwig Mueller
BACKGROUND:  Minithoracotomy (MT) has gained broad acceptance for mitral valve surgery (MVS) in the last decade. In the presence of defined limitations of MT, however, full sternotomy (FS) is still widely preferred. We assume that the less investigated partial upper sternotomy (PS) will permit the gap between MT and FS in MVS to be closed. The purpose of this study is to investigate a valid less invasive alternative to MT for isolated MVS or multivalve surgery. METHODS:  This retrospective analysis includes data on 1,639 patients, who underwent either isolated or combined primary MVS at our department from May 2011 to August 2017...
September 4, 2018: Thoracic and Cardiovascular Surgeon
Shaodong Wang, Yun Li, Jun Wang
OBJECTIVE:  The aim of this report is to summarize the experience of completely video-assisted thoracoscopic surgery (VATS) for pulmonary sequestration in a single center and to evaluate the long-term outcome in a larger series of patients. METHODS:  The data of 35 pulmonary sequestrations who received completely VATS consecutively in Peking University People's Hospital between January 2008 and November 2017 were retrospectively reviewed. Twenty-three females and twelve males with an average of 38 years old were included...
August 30, 2018: Thoracic and Cardiovascular Surgeon
Kazuhiro Ueda, Junichi Murakami, Toshiki Tanaka, Kimikazu Hamano
BACKGROUND:  Although infectious complications occur occasionally after lung lobectomy, some of them are overlooked if the pathogen or origin is unidentifiable. METHODS:  We retrospectively reviewed 425 patients who underwent lobectomy for lung cancer. Infectious complications developed in 61 patients who consequently underwent empiric therapy: 44 had an identifiable focus and 17 did not irrespective of systemic surveillance. RESULTS:  The 17 patients without an identifiable focus were predominantly patients with squamous cell carcinoma, a smoking history, large tumor size, and undergoing lower lobectomy...
August 28, 2018: Thoracic and Cardiovascular Surgeon
Alicja Zientara, Sergio Mariotti, Sonja Matter-Ensner, Burkhardt Seifert, Kirk Graves, Omer Dzemali, Michele Genoni
BACKGROUND:  Dexmedetomidine (DEX) is a highly selective α-2 agonist with many desirable effects including analgesia, improvement of hemodynamic stability, and potential myocardial and renal protection. The aim of this study was to investigate the effect of DEX on patients undergoing off-pump coronary artery bypass (OPCAB) grafting with regard to less pain medication, earlier extubation, faster transfer to normal ward, and cardiac protection. PATIENTS AND METHODS:  From January 2012 to March 2015, 464 patients receiving OPCAB were included for retrospective analysis...
August 28, 2018: Thoracic and Cardiovascular Surgeon
Peter Roth, Jenna Stella, Bernd Niemann, Philippe Grieshaber, Rainer Roehrig, Andreas Böning
BACKGROUND:  To examine if fibrin-coated collagen fleece (Tachosil) interferes with bone and wound healing when it is used on the cut surface of the sternum after median sternotomy. METHODS:  A total of 25 patients with osteoporotic sternal disorders were treated with fibrin-coated collagen fleece at the cut surface of the sternum after median sternotomy (therapy group). We compared the occurrence of impaired wound healing and sternal instability, reoperation rate, and 30-day mortality with a control group of 25 case-matched patients...
August 28, 2018: Thoracic and Cardiovascular Surgeon
Thomas Ratschiller, Eva Sames-Dolzer, Wolfgang Schimetta, Michaela Kreuzer, Hannes Müller, Andreas Zierer, Rudolf Mair
BACKGROUND:  Neo-aortic root dilatation accounts for the majority of reoperations needed after the Ross procedure with implantation of the pulmonary autograft as complete root replacement. This study evaluates early results of external prosthetic reinforcement of the autograft. METHODS:  From July 2015 to October 2017, 16 adolescent and adult patients received a Ross procedure at our department by this technique. A congenital-dysplastic valve was present in 13 patients, including 9 patients with a bicuspid aortic valve...
August 28, 2018: Thoracic and Cardiovascular Surgeon
Kathleen Fenton, Marcelo Cardarelli, Frank Molloy, William Novick
Congenital heart disease is the most common birth defect worldwide, and accounts for a high proportion of the world's infant mortality. About 9 of every 10 babies born each year are born in areas without adequate access to heart surgery; overcoming this problem will necessitate addressing the worldwide shortage of an estimated 3,700 pediatric cardiac surgeons. Establishing sustainable heart surgery programs requires more than an investment of money: political, social, and cultural issues unique to each environment need to be addressed...
August 24, 2018: Thoracic and Cardiovascular Surgeon
Rebekka Finkbeiner, Sebastian Krinner, Andreas Langenbach, Manuel Besendörfer, Stefan Schulz-Drost
BACKGROUND:  As the population ages, low-energy thoracic injuries are becoming increasingly relevant in individual injuries, particularly pulmonary contusions (PCs) and their common concomitant injuries. The objective of this study was to determine the prevalence and age distribution of thoracic trauma, especially PC, to make conclusions about common secondary diagnoses and developments in management. METHODS:  A retrospective analysis of 209,820 cases, based on German routine data from the years 2009 to 2015, with a main diagnosis (MD) or secondary diagnosis (SD) of thoracic trauma (S27 according to ICD-10) was performed...
August 24, 2018: Thoracic and Cardiovascular Surgeon
Fan Zhang, Jing Chen, Zhi-Gang Yang, Han Liu
BACKGROUND:  To retrospectively evaluate characteristics of coronary artery disease (CAD) in patients undergoing lung resection for cancer by using dual-source computed tomography (DSCT), thus increasing our understanding of perioperative evaluation. METHODS:  DSCT coronary angiography was performed for perioperative evaluation in 145 patients with non-small cell lung cancer (NSCLC) due to suspected CAD. The imaging characteristics of CAD including extent, distribution and types of plaques, and luminal stenosis and congenial anomalous including origin of coronary arteries and myocardial bridge (MB) were evaluated and compared by sex, smoking behavior, and pathological types...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Hisato Takagi, Shohei Mitta, Tomo Ando
OBJECTIVE:  The objective of this study was to determine whether valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) is associated with better survival than redo surgical aortic valve replacement (SAVR) in patients with degenerated aortic valve bioprostheses, and we performed a meta-analysis of comparative studies. METHODS:  To identify all comparative studies of VIV-TAVI versus redo SAVR; MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched through October 2017...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Alberto Repossini, Lorenzo Di Bacco, Laszlo Gazdag, Herko Grubitzsch, Theodor Fischlein, Alessandra Stara, Claudio Muneretto, Giuseppe Santarpino
BACKGROUND:  The Freedom SOLO (FS) stentless bovine-pericardial prosthesis with a supra-annular implantation technique can be a viable option for patients with endocarditic annular destruction. We assessed early- and long-term outcomes following the use of this prosthesis in extensive aortic valve endocarditis. METHODS:  From 2006 to 2016, 59 patients with extensive aortic endocarditis underwent aortic valve replacement (AVR) with FS (cumulative follow-up 263 patients-years) in three European centers; all patients presented annular tissue infection, while 54...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Cenk Oezpeker, Fabian Barbieri, Vitalijs Zujs, Michael Grimm, Antonio Lio, Mattia Glauber, Nikolaos Bonaros
OBJECTIVES:  Increasing experience with minimally invasive cardiac (MIC) aortic valve (AV) replacement makes AV reoperations (rAVR) an appealing alternative to conventional redo surgery. The aim of the study was to compare the perioperative outcome after isolated MIC versus full-sternotomy (FS) rAVR. METHODS:  We retrospectively analyzed data of 116 patients from three centers who underwent rAVR by using a FS ( n  = 70, 60.3%) or a partial upper sternotomy approach ( n  = 46, 39...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Thilo Noack, Kathleen Wittgen, Philipp Kiefer, Fabian Emrich, Matthias Raschpichler, Sarah Eibel, David Holzhey, Martin Misfeld, Friedrich-Wilhelm Mohr, Michael Borger, Joerg Ender, Joerg Seeburger
BACKGROUND:  The aim of this study was to quantify acute mitral valve (MV) geometry dynamic changes throughout the cardiac cycle using three-dimensional transesophageal echocardiography (3D TEE) in patients undergoing surgical MV repair (MVR) with ring annuloplasty and optional neochord implantation. METHODS:  Twenty-nine patients (63 ± 10 years) with severe primary mitral regurgitation underwent surgical MVR using ring annuloplasty with or without neochord implantation...
August 16, 2018: Thoracic and Cardiovascular Surgeon
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