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General Thoracic and Cardiovascular Surgery

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https://www.readbyqxmd.com/read/29159658/lung-necrosectomy-in-pediatric-patients-with-necrotizing-pneumonia
#1
Francina V Bolaños-Morales, Emmanuel Peña Gómez-Portugal, María E Aguilar-Mena, Patricio J Santillán-Doherty, Avelina Sotres-Vega, J Alfredo Santibáñez-Salgado
INTRODUCTION: Necrotizing pneumonia is the consolidation of lung parenchyma with destruction and necrosis, forming solitary or multiloculated radiolucent foci. When antibiotic treatment fails and clinical course does not improve, patients might need lung tissue resection: segmentectomy, lobectomy or bilobectomy. We have performed a more conservative surgical approach in pediatric patients with necrotizing pneumonia, lung necrosectomy: resection of unviable necrotic tissue, to preserve more healthy and potentially recoverable lung parenchyma...
November 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29147918/aortic-arch-aneurysm-surgery-what-is-the-gold-standard-temperature-in-the-absence-of-randomized-data
#2
Amer Harky, Mohamad Bashir, Giovanni Mariscalco
In the absence randomized data for assessing the best and optimal temperature for managing open aortic arch surgery patients, cerebral protection method is still performed through hypothermic circulatory arrest with or without the use of adjuncts. A recent consensus has emerged setting to define the temperature levels. In an attempt, this was aimed to establish a solid ground for future trials in aortic arch surgery. This article reviews the current literature and the evidences behind using different temperature methods and their outcomes in patients undergoing open aortic arch surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29147917/recommendations-for-perioperative-management-of-lung-cancer-patients-with-comorbidities
#3
REVIEW
Hiroyoshi Tsubochi, Tomoki Shibano, Shunsuke Endo
OBJECTIVES: To improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery. METHODS: We reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large clinical databases indicate that these comorbidities are significant risk factors for lung cancer surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29143913/chylothorax-post-thoracoscopic-surgery-for-an-anterior-mediastinal-tumor
#4
Hironori Ishibashi, Yuya Ishikawa, Ayaka Asakawa, Sachiko Imai, Masashi Kobayashi, Kenichi Okubo
Chylothorax after anterior mediastinal surgery is rare. We treated a 39-year-old woman who presented with progressive dyspnea over 6 months. Chest computed tomography revealed a 12-cm round mass in the right anterior mediastinum. She underwent video-assisted thoracoscopic surgery for successful excision of the tumor; however, the surgery was complicated by the development of chylothorax. It was treated surgically with no recurrence of the tumor and/or chylothorax for 2 years. Chylothorax should be recognized as a postsurgical complication of anterior mediastinal tumors...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29134538/postoperative-atrial-fibrillation-is-less-frequent-in-pulmonary-segmentectomy-compared-with-lobectomy
#5
Takuya Ueda, Kenji Suzuki, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh
OBJECTIVE: The aim of this study was to elucidate the characteristics and predictors of postoperative atrial fibrillation (POAF) from the standpoint of surgical mode. METHODS: Retrospective analysis was carried out on 607 patients who underwent lobectomy or segmentectomy for clinical stage IA lung cancer. We investigated the clinical factors to determine the predictors of the development of POAF. RESULTS: Of the 607 patients, 443 underwent lobectomy, and 164 underwent segmentectomy...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29134537/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-4-valvular-heart-surgery
#6
Kiyoharu Nakano, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
Data from the Japan cardiovascular surgery database from 2013 to 2014 were analyzed to demonstrate the mortality rate and choice of surgical procedures, especially concerning the selection of valve prosthesis for each valve position and patient age group, and the effects of preoperative complications on mortality and prosthetic valve selection. The proportion of each surgical procedure was compared for each patient age in the aortic, mitral, and tricuspid positions. The proportion of mechanical valve prostheses was 23...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29134536/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-3-coronary-artery-bypass-surgery
#7
Aya Saito, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
OBJECTIVE AND METHODS: Data on isolated coronary artery bypass grafting (CABG) performed in 2013 and 2014, and registered in the Japan Cardiovascular Surgery Database were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery (LAD). RESULTS: Isolated CABG was performed off-pump in 54.7% of cases, and graft material for the LAD was left internal thoracic artery in 74.3% and right internal thoracic artery in 15...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29134535/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a%C3%A2-report-based-on-the-japan-cardiovascular-surgery-database-2-congenital-heart-surgery
#8
Yasutaka Hirata, Norimichi Hirahara, Arata Murakami, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
OBJECTIVES: We analyzed the mortality and morbidity of congenital heart surgery in Japan using the Japan Cardiovascular Surgery Database (JCVSD). METHODS: Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. RESULTS: The mortality rates of atrial septal defect repair and ventricular septal defect repair were less than 1%, and the mortality rates of tetralogy of Fallot repair, complete atrioventricular septal defect repair, bidirectional Glenn, and total cavopulmonary connection were less than 2%...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29134534/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-jcvsd-1-mission-and-history-of-jcvsd
#9
Shinichi Takamoto, Noboru Motomura, Hiroaki Miyata, Hiroyuki Tsukihara
The Japan Cardiovascular Surgery Database (JCVSD) was created in 2000 with the support of the Society of Thoracic Surgeons (STS). The STS database content was translated to Japanese using the same disease criteria and in 2001, data entry for adult cardiac surgeries was initiated online using the University Hospital Medical Information Network (UMIN). In 2008, data entry for congenital heart surgeries was initiated in the congenital section of JCVSD and preoperative expected mortality (JapanSCORE) in adult cardiovascular surgeries was first calculated using the risk model of JCVSD...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29128899/a-no-touch-technique-for-pulmonary-wedge-resection-of-lung-cancer
#10
Noriyoshi Sawabata, Takeru Hyakutaka, Takeshi Kawaguchi, Motoaki Yasukawa, Norikazu Kawai, Takashi Tojo, Shigeki Taniguchi
OBJECTIVE: Many of the surgical patients with lung cancer die by metastasis originated from circulating tumor cells (CTCs) which are seeds of metastases. A ring-shaped catching forceps, which generates the great pressure by compression, may reduce the risk of tumor cell spreading. Here, we investigated the efficacy of such forceps based on CTC occurrence. METHODS: Twenty-three patients with clinical stage IA lung cancer who underwent a pulmonary wedge resection were investigated in a clinical-pathological manner...
November 11, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29124558/development-of-a-simple-device-enabling-percutaneous-flow-regulation-for-a-small-vascular-graft-for-a-blalock-taussig-shunt-capable-of-flow-regulation-complete-translation-of-a-review-article-originally-published-in-pediatric-cardiology-and-cardiac-surgery
#11
Yoshikazu Motohashi, Ryo Shimada, Tomoyasu Sasaki, Takahiro Katsumata, Kazunori Dan, Yasuhiro Tsutsui, Shintaro Nemoto
OBJECTIVES: The Blalock-Taussig shunt (BTS) operation is a cornerstone as initial palliative surgery for congenital heart disease with severely reduced pulmonary blood flow (PBF). The ideal PBF provided by BTS is crucial for an uneventful postoperative course, since excess PBF results in acute distress of the systemic circulation and insufficient PBF requires another BTS surgery. Therefore, the goal of this study was to develop a simple device to control the shunt graft flow percutaneously using a constrictor balloon connected to a subcutaneous port...
November 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29119450/surgical-treatment-for-adult-congenital-heart-disease-consideration-for-indications-and-procedures
#12
REVIEW
Kozo Matsuo, Masashi Kabasawa, Soichi Asano, Shigeru Tateno, Yasutaka Kawasoe, Yoshitomo Okajima, Naoki Hayashida, Hirokazu Murayama
The number of the adult patients with congenital heart diseases (ACHD) continues to grow owing to improvement of surgical results and medical management. Corrective surgery for complex CHD does not always mean complete cure. It is not rare that the patients will visit the cardiology institutes because of secondary lesions due to residua or sequela in adults. Some patients with CHD remain unrepairable with different degree of heart failure and pulmonary arterial hypertension. Association of arrhythmias is common in ACHD patients and sometimes critical...
November 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29119449/successful-coronary-transfer-for-transposition-of-the-great-arteries-with-bilateral-intramural-coronary-arteries-from-a-single-aortic-sinus
#13
Daisuke Machida, Yukihisa Isomatsu, Masami Goda, Shinichi Suzuki, Toshihide Asou, Munetaka Masuda
We experienced an arterial switch operation in a patient with d-transposition of the great arteries associated with bilateral intramural coronary arteries from a single coronary ostium. In performing the coronary transfer, intramural course of bilateral coronary arteries was unroofed and coronary ostium was separated into two coronary buttons. The two coronary buttons were translocated to the neo-aorta using modified trap-door technique. The angiogram performed 6 years after the operation revealed well-developed coronary arteries without stenosis, and the patient is doing well 8 years after the operation...
November 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29119448/total-aortic-arch-replacement-using-frozen-elephant-trunk-technique-with-j-graft-open-stent-graft-for-distal-aortic-arch-aneurysm
#14
Shigeki Koizumi, Atsushi Nagasawa, Tadaaki Koyama
OBJECTIVES: The J Graft Open Stent Graft, the first commercialized stent graft in Japan, has been available since February 2014, and we have used this new device as a frozen elephant trunk technique for distal aortic arch aneurysm. Here, we present our surgical method and result with this new device. METHODS: Between October 2014 and October 2016, 30 patients (26 males, mean age 74.3 ± 9.7 years) underwent total aortic arch replacement using the frozen elephant trunk technique with the J Graft Open Stent Graft for distal aortic arch aneurysm...
November 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29101533/efficacy-of-a-sheet-combined-with-fibrin-glue-in-repair-of-pleural-defect-at-the-early-phase-after-lung-surgery-in-a-canine-model
#15
Takashi Sakai, Noriyuki Matsutani, Eiichi Kanai, Yoshikane Yamauchi, Hirofumi Uehara, Hisae Iinuma, Masafumi Kawamura
OBJECTIVE: Polyglycolic acid and oxidized regenerated cellulose have been widely used as a sealant for repairing pulmonary air leakage during respiratory surgery. However, fundamental research of these materials has not been sufficiently conducted. Therefore, we conducted studies to assess the pressure resistance ability of these materials using a canine visceral pleural defect model at the early phase. METHOD: The 6-mm circular defect and the 12-mm square defect were created on the visceral pleura of anesthetized beagles...
November 3, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29080094/is-there-a-role-for-biomarkers-in-thoracic-aortic-aneurysm-disease
#16
Damian Balmforth, Amer Harky, Benjamin Adams, John Yap, Alex Shipolini, Neil Roberts, Rakesh Uppal, Mohamad Bashir
Thoracic aortic aneurysm (TAA) represents a major cause of mortality and morbidity in Western countries. The natural history of TAA is indolent, with patients usually being asymptomatic until a catastrophic event such as rupture or dissection ensues. As such, early diagnosis is crucial and the search is ongoing for a biomarker that can indicate the presence of TAA with sufficient accuracy to act as a screening tool. To date, no such marker has been developed for the diagnosis of non-familial or 'sporadic' TAA...
October 28, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29080093/effectiveness-and-long-term-outcomes-of-surgical-intervention-for-constrictive-epicardium-in-constrictive-pericarditis
#17
Yangsin Lee, Yoshihiro Naruse, Keita Tanaka
OBJECTIVE: Epicardial resection is considered effective in patients with constrictive pericarditis accompanied by epicardial constriction, but few publications have evaluated its long-term outcomes. The study objective was to evaluate early and late results of epicardial resection. METHODS: A total of 22 patients with pericardiectomy for constrictive pericarditis were treated at our institution between 1989 and 2016. They were stratified by the presence or absence of constrictive epicardium and the surgical intervention performed...
October 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29080092/efficacy-of-modified-less-invasive-quick-replacement-using-mild-hypothermic-arrest-and-partial-retrograde-cerebral-perfusion-for-type-a-acute-aortic-dissection
#18
Mitsumasa Hata, Yukihiko Orime, Shinji Wakui, Tomofumi Umeda, Kenji Akiyama, Masashi Tanaka
OBJECTIVE: We previously reported a unique technique called "less invasive quick replacement (LIQR)" for treating type A acute aortic dissection with moderate hypothermic arrest (28 °C). This study examines the modified LIQR using mild hypothermic arrest (30 °C) with partial retrograde cerebral perfusion (RCP). METHODS: 187 patients were divided into 2 groups: group L consisted of 130 patients underwent LIQR without any cerebral perfusion; group M consisted of 57 patients who were treated with modified LIQR...
October 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29067556/thoracoscopic-resection-of-esophageal-cancer-with-a-tracheal-diverticulum
#19
Hideharu Tanaka, Norihisa Uemura, Tetsuya Abe, Eiji Higaki, Jiro Kawakami, Takahiro Hosoi, Byonggu An, Koji Komori, Seiji Ito, Yasuhiro Shimizu
Tracheal diverticulum, a benign entity characterized by single or multiple invaginations of the tracheal wall, is commonly asymptomatic and detected incidentally. We report the case of a 76-year-old man with a tracheal diverticulum who underwent thoracoscopic esophagectomy with a three-field lymphadenectomy for middle thoracic esophageal cancer. The tracheal diverticulum was located at the right posterolateral region of the trachea, which overlapped the region of dissection of the right recurrent laryngeal nerve lymph nodes...
October 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29067555/posterior-leaflet-reconstruction-using-autologous-pericardium-in-mitral-repair
#20
Mitsuharu Hosono, Shintaro Kuwauchi, Naoki Taniguchi, Kohei Kawazoe
A 75-year-old woman experienced recurrent mitral regurgitation caused mainly by a shrunken and tethered posterior mitral leaflet with a dilated left ventricle. Posterior leaflet motion was severely restricted. We successfully resolved the tethering and restored valve coaptation and competence using posterior leaflet reconstruction, which is a modified method of posterior leaflet augmentation using autologous pericardium. This technique can recover the posterior leaflet function by improving tissue volume and tethering...
October 24, 2017: General Thoracic and Cardiovascular Surgery
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